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Skills

  • Business operations
  • Data entry
  • Software training
  • Patient contact
  • Budgets
  • Case review time reduction
  • Organization
  • Claims Management
  • Proficient in Microsoft Excel
  • Supervision

Work Experiences

  • Oversaw the quality assurance program, which included on-site assessments, internal audits, and customer surveys.
  • Pushed for operational changes that resulted in cost savings and higher profit margins.
  • Collaborated with the IT department to automate manual data entry tasks, saving the team approximately 13 hours per month.
  • Created and maintained reports on policy outcomes.
  • Created and maintained reports on processing times and policy outcomes that were used by senior management to drive strategic decisions.
  • Consistently exceeded monthly key deliverable targets, processing 69% more policies than department averages.
  • Contributed to regulatory audit preparations.
  • Achieved savings of $6 in overtime expenses.
  • Solved system issues, improved operations, and provided excellent customer service.
  • Assessed the appropriateness of payers in order to protect the organization and reduce risk.

Summaries

  • Policy Processor with 9 years of successful cross-functional collaboration and vendor management experience.
  • Advanced proficiency in compliance audits.
  • Closed compliance gaps.
  • Achieved results within 2018.
  • Advanced proficiency in compliance audits and document processing, providing invaluable support in preparing for regulatory evaluations.
  • Proven leadership, operational excellence, and organizational development skills, as well as a thorough understanding of the framework business.
  • Policy Processor with 3 years of experience, dedicated to providing personalized, courteous service.
  • Collaborative Insurance Verification Specialist with a track record of establishing rapport with patients and maintaining data integrity.
  • Collaborated with brokers, clients, and internal stakeholders to reduce claims processing errors by 79%, ensuring stronger customer relations.
  • Adept at reducing policy errors by 36%.

Accomplishments

  • Utilized Microsoft Excel to process policy applications faster, reducing response time to customer inquiries by 82% days.
  • Processed claims and policy amendments within set deadlines, ensuring service-level agreements (SLAs) were consistently met.
  • Advised management on improving claim-handling processes, which led to a 20% faster resolution rate for disputed claims.
  • Developed a knowledge base for common policy queries, improving first-call resolution rate by 60% for customer service teams.
  • Regularly communicated with policyholders to correct coverage inaccuracies, reducing customer complaints by 67%.
  • Processed over 13% of all company-issued policies using QuickBooks, contributing to streamlined workflow and enhanced performance.
  • Facilitated weekly team meetings to suggest improvements in claim-cycle timelines, reducing average case completion by 57% days.
  • Assisted in resolving escalated claims, identifying fraud indicators, and reducing overall claims rejections by 30%.
  • Created automated reports for claims data trends, improving decision-making and minimizing processing delays by 44%.
  • Coordinated cross-departmental efforts to resolve policyholder issues, improving interdepartmental workflow efficiency by 57%.

Affiliations

  • Toastmasters
  • National Alliance for Insurance Education & Research
  • Insurance Information Institute (III)
  • International Risk Management Institute (IRMI)
  • International Association of Administrative Professionals
  • Institute for Operations Research and the Management Sciences (INFORMS)
  • Association of Information Technology Professionals
  • National Association of Professional Insurance Agents (PIA)
  • Certified Regulatory Compliance Manager (CRCM)
  • American Society of Safety Professionals

Certifications

  • Life and Health Insurance License Oregon
  • Financial Risk Manager (FRM)
  • SHRM Senior Certified Professional (SHRM-SCP)
  • Compliance and Regulatory Professional (CCRP)
  • Associate in General Insurance (AINS)
  • Certified Public Accountant (CPA)
  • ServSafe
  • Claims Adjuster Licensing Georgia
  • Apple Certified Associate (ACA)
  • Cisco Certified Network Associate (CCNA)

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