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Skills

  • Account management
  • Initiative equipment
  • Claims triage system development
  • Industry trend analysis
  • Liability investigation
  • Workflow Optimization
  • Customer service excellence
  • Communications
  • Claims fraud analytics
  • Reporting skills

Work Experiences

  • Collaborated with the legal team to process complex liability cases, reducing fraudulent claims by 36%.
  • Conducted root cause analysis on claim denials, resulting in the adjustment of 5+ claims to policyholder satisfaction.
  • Assisted in the development of new training programs to reduce adjustment errors, cutting return claim reviews by 35%.
  • Looked for industry trends on social media and through online sources.
  • Assisted in the development of new training programs.
  • Assessed QuickBooks claims for accuracy.
  • Collaborated with initiative customers to determine their needs and deliver method service.
  • Placed a high value on punctuality and worked hard to maintain an excellent attendance record, consistently arriving at work ready to work right away.
  • Achieved 23% higher recovery rates for the company.
  • Conducted root cause analysis on claim denials.

Summaries

  • Listening to customers, meeting productivity goals, and staying current on company offerings are all skills she possesses.
  • Balanced regulatory compliance with fast-paced settings.
  • Achieved a 58% reduction in repeat service inquiries.
  • Excellent track record of resolving issues, increasing customer satisfaction, and driving overall operational improvements.
  • Offering 13 years of experience as well as the willingness to take on any challenge.
  • Professional who is resourceful and versatile and has a track record of consistently exceeding aggressive sales targets.
  • Dedicated to learning, growing, and succeeding in Miscellaneous.
  • Achieved high accuracy in claim processing.
  • Overall morale and productivity are boosted by experience in policy development and staff management procedures.
  • Aligned company objectives with customer needs.

Accomplishments

  • Established vendor contracts to expedite claims resolution, reducing processing costs by $4.
  • Processed high-volume property, casualty, and liability claims while meeting or exceeding quality metrics by 38%.
  • Enhanced cross-department communication, leading to faster claim assessments and improving customer satisfaction scores by 51%.
  • Increased claims processing speed by 74% through process documentation and implementation of best practices.
  • Facilitated successful resolution of escalated claims by collaborating with external legal counsel and adjusters, reducing litigation costs by 58%.
  • Monitored a high volume of claims for quality and compliance, achieving a President's Club for team efficiency.
  • Collaborated with team of 6 in the development of method.
  • Worked with external adjusters to ensure prompt and accurate property damage assessments for over 11 claims.
  • Successfully mediated 10 disputed claims between claimants and insurance carriers, resulting in 40% satisfaction improvement.
  • Created training materials for new hires on claims system usage, resulting in a 79% decrease in onboarding times.

Affiliations

  • Jaycees
  • Toastmasters
  • American Medical Informatics Association
  • Active contributor to the Consortium of Insurance Claims Fraud Researchers (CICFR)
  • Active participant in continuing education forums by the National Association of Public Insurance Adjusters (NAPIA)
  • Association for Supply Chain Management (APICS)
  • Continuing education via workshops offered by the American Institute For Chartered Property Casualty Underwriters (AICPCU)
  • Membership in the Council on Litigation Management (CLM), training on best claims practices
  • Volunteer mentor for the Insurance Industry Charitable Foundation (IICF)
  • Certification in Enterprise Risk Management from the Institute of Risk Management (IRM)

Certifications

  • Fundamentals of Insurance Regulation (FIR) Certification from The Institutes
  • Certified Healthcare Claims Professional (CHCP)
  • Insurance Billing and Coding Certification from procedure, 2021
  • SHRM Senior Certified Professional (SHRM-SCP)
  • CompTIA A+ Technician
  • Certified Claims Professional (CCP)
  • Property and Casualty (P&C) Licensing Exam from Texas
  • Customer Experience Professional (CXP) from the Customer Experience Professionals Association (CXPA)
  • Ethics for Insurance Professionals (EIP) from The Institutes
  • Licensed Claims Adjuster from the National Insurance Adjusters Association

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