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Skills

  • Supervision
  • Collaborative relationships
  • Attention to detail in policy documentation
  • Data integrity
  • Insurance coverage verification
  • Client portfolio management
  • Endorsements and renewals tracking
  • Investigation of complex policy issues
  • Client needs assessment and support
  • Client communication and information gathering

Work Experiences

  • Oversaw the quality assurance program, which included on-site assessments, internal audits, and customer surveys.
  • Acted as the liaison between clients and insurance carriers, facilitating claim disputes and achieving a 77% resolution rate.
  • Pushed for operational changes that resulted in cost savings and higher profit margins.
  • Collaborated with underwriters and claims adjusters to resolve complex policy issues, reducing claim processing time by 84%.
  • Boosted retention rates by 79% annually.
  • Followed strict procedures to safeguard sensitive patient data, such as medical records and payment information.
  • Addressed discrepancies.
  • Collaborated with policyholders to explain coverage options and regulations, leading to a 83% increase in satisfaction scores for 2016.
  • Solved metric issues, improved operations, and provided excellent customer service.
  • Accelerated recovery of over $8 in outstanding payments.

Summaries

  • Achieved recovery targets ahead of schedule by 47%.
  • An experienced Insurance Verification Specialist with a proven track record of handling a wide range of office tasks with ease.
  • Hardworking Insurance Processor with 11 years of telecommuting experience meeting customer needs.
  • Adept collaborator.
  • Achieved results within 18 months.
  • Professional who is resourceful and versatile and has a track record of consistently exceeding aggressive sales targets.
  • Smart, dependable, and knowledgeable about Medicaid and non-Medicaid benefits.
  • Clear understanding of client relations and cross-functional collaboration as well as client relations training.
  • Achieved a 78% resolution rate.
  • Exceptional organizational skills and meticulous attention to detail.

Accomplishments

  • Collaborated with IT department to integrate a new claims management system, achieving a reduction in manual tasks by 25%.
  • Implemented a cross-training program for insurance processors, improving team flexibility and overall productivity by 59%.
  • Collaborated with team of 2 in the development of program.
  • Streamlined policyholder verification process, minimizing claim rejection rates by 29% through detailed information audits.
  • Processed 9 claims per week, ensuring compliance with state and federal insurance regulations, and achieving 45% accuracy.
  • Successfully handled cancellations and endorsements for policies, completing 3 change requests in 2022 with zero errors.
  • Performed daily reconciliations of outstanding claim status reports, ensuring 37% compliance with insurance company protocols.
  • Enhanced accuracy of insurance data entry on Workday, ensuring 100% adherence to underwriting documentation guidelines in 2016.
  • Trained 4 new team members on claims processing procedures, which contributed to a 34% improvement in processing efficiency.
  • Leveraged Workday to manage and organize 16 insurance policies, maintaining a 25% error-free record system.

Affiliations

  • National Alliance for Insurance Education & Research
  • Jaycees
  • International Association of Administrative Professionals
  • Society of Women Engineers
  • National African-American Insurance Association (NAAIA)
  • Property Casualty Insurers Association of America (PCI)
  • Rotary International
  • International Association of Insurance Professionals (IAIP)
  • Society of Insurance Research (SIR)
  • Project Management Institute

Certifications

  • Insurance Data and Analytics Certificate Meridian
  • Certified Benefits Consultant (CBC)
  • Anti-Money Laundering Certification (AML) - Cedar Works
  • Project Management Professional (PMP)
  • Health Insurance Associate (HIA)
  • Long-Term Care Insurance Certification
  • Medical Billing and Coding Certification – Beacon Labs
  • Claims Handling Certificate - Summit Group
  • Certified Risk Manager (CRM)
  • Certified Business Analysis Professional (CBAP)

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