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Skills

  • Insurance policy interpretation
  • Customer service
  • Budgets
  • Business operations
  • Project organization
  • Customer Relationship Management (CRM)
  • Insurance Metrics and KPIs Analysis
  • Client expectations management
  • Call Center or Customer Service Software
  • Account management

Work Experiences

  • Consistently received above 80% score in customer satisfaction surveys by providing timely and empathetic communication.
  • Had an excellent attendance record and was always on time for work.
  • Achieved results within a several months timeframe.
  • Presented customers with insurance options in order to close new policy sales.
  • Collaborated with legal teams to resolve disputed claims.
  • Authored training manuals in injury claims management.
  • Consistently met or exceeded monthly targets for claim settlements while maintaining a 55% customer satisfaction rating.
  • Achieved accurate resolutions for 14 claims per month.
  • Achieved savings of $14 for the company.
  • Analyzed medical reports.

Summaries

  • Proven leadership, operational excellence, and organizational development skills, as well as a thorough understanding of the standard business.
  • Achieved a 51% boost to team performance.
  • Accomplished Personal Injury Protection Adjuster with 13 years of experience.
  • Experienced system Insurance Specialist with a track record of managing large caseloads in high-pressure situations.
  • Achieved a $7 reduction in claim loss payouts.
  • Achieved a $12 reduction in fraudulent payouts.
  • Achieved a 66% decrease in outstanding claim inventory.
  • Hardworking Personal Injury Protection Adjuster with 10 years of telecommuting experience meeting customer needs.
  • Bringing 10 years of insurance experience to the table.
  • Achieved results within a 18 months timeframe.

Accomplishments

  • Achieved a 31% reduction in turnaround time for claim appeals by implementing a system for prioritizing complex cases.
  • Resolved product issue through consumer testing.
  • Achieved PMP to enhance knowledge of state-specific PIP regulations, improving the accuracy of claims processing across multiple regions.
  • Reduced claims resolution time from 8 days to 13 days by redesigning workflow processes and introducing new software solutions.
  • Mentored 13 newly hired adjusters, improving their claims-resolution efficiency by 62%.
  • Tracked and analyzed PIP-related customer service metrics, identifying areas for improvement that reduced call handling times by 25%.
  • Successfully met department KPIs, closing an average of 14 claims per month, contributing to a team-wide target achievement of 18%.
  • Delivered 17 hours of training that led to increased subject matter expertise in PIP processes and regulations amongst newer team members.
  • Managed PIP claims worth $77,000 with compliance-driven accuracy, minimizing legal risks and achieving a 29% audit success rate across 2024.
  • Reviewed and accurately processed claims averaging 10 per month with minimal errors, achieving 82% accuracy.

Affiliations

  • National Insurance Crime Bureau (NICB)
  • National Association of Social Workers
  • International Council of Nurses
  • American Bar Association (ABA) — Practice Management Division
  • Certified Risk Manager (CRM)
  • Jaycees
  • Project Management Institute (PMI) — Claims Management Focus Group
  • Principles of Insurance Regulation (PIR) Advisory Board
  • National Association of Professional Process Servers (NAPPS)
  • Project Management Institute

Certifications

  • Associate in Claims (AIC) Certification
  • Microsoft Certified Systems Engineer (MCSE)
  • Chartered Property Casualty Underwriter (CPCU)
  • National General Adjuster (NGA) Certification
  • Certified Professional Insurance Adjuster (CPIA)
  • Medicare Set-Aside Certified Consultant (MSCC)
  • Workers' Compensation Claims Professional (WCCP)
  • Project Management Professional (PMP)
  • Salesforce
  • CompTIA A+ Technician

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