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Skills

  • Client Dispute Resolution
  • Operational improvement
  • Business operations
  • Knowledge of insurance policies and clauses
  • Standard equipment
  • Financial analysis to prevent overpayment
  • Process improvement
  • Data analysis
  • Fraudulent Activity Detection
  • Change Management

Work Experiences

  • Avoided fines or claim reductions.
  • Addressed inquiries.
  • Analyzed previous inaccurate claims decisions and recommended corrective measures, lowering company error rates by 77%.
  • Achieved Top Performer in 2015.
  • Collaborated with clients and third-party vendors.
  • Oversaw the quality assurance program, which included on-site assessments, internal audits, and customer surveys.
  • Transported Salesforce to several months customer locations.
  • Had an excellent attendance record and was always on time for work.
  • Analyzed property damage claims.
  • Looked for industry trends on social media and through online sources.

Summaries

  • Accomplished Property Field Claims Examiner.
  • Achieved a 16% increase in customer satisfaction.
  • Achieved a 81% reduction in claim cycle times.
  • Avoided unnecessary legal expenses.
  • Proven leadership, operational excellence, and organizational development skills, as well as a thorough understanding of the system business.
  • To deliver information to policyholders, makes use of well-developed communication skills.
  • Consistently recognized for customer service excellence, maintaining a 18% closure rate on escalated claims cases while delivering impactful, customer-centered solutions.
  • Contributed to company-wide cost savings of $7 per year.
  • Procedure professional with 14 years of experience evaluating coverage and supervising claims review.
  • Excellent track record of resolving issues, increasing customer satisfaction, and driving overall operational improvements.

Accomplishments

  • Conducted bi-annual auditor reviews of claims, ensuring compliance and increasing audit scores by 51% above industry benchmarks.
  • Led cross-functional collaboration with legal, construction, and underwriting teams to resolve complex disputed claims, achieving 40% success in pre-litigation resolutions.
  • Collaborated with engineering teams to assess damage for major commercial claims, resulting in claim savings of $17 due to accurate damage valuation.
  • Performed comprehensive property damage investigations, identifying and preventing potential overpayments across claims representing over $5.
  • Partnered with local contractors to establish a rapid-response repair network, lowering average repair timeframes by 54% during catastrophe events.
  • Led internal compliance teams through 3 successful audits, surpassing location-specific industry compliance standards by 81%.
  • Analyzed trends in claim submissions and settlements, providing actionable insights that aided underwriting teams in refining policy terms and reducing risk exposure.
  • Spearheaded the implementation of a digital claims management system, reducing the operational processing time by 25% within one year and improving accuracy.
  • Received commendation for maintaining a PMP within the industry, leading to a 37% overall increase in departmental compliance rates.
  • Advised legal teams on potential fraudulent claims, providing detailed analysis that resulted in denials of 3 high-risk claims, saving the company $13.

Affiliations

  • Toastmasters
  • Society of Women Engineers
  • Association of Information Technology Professionals
  • National Alliance for Insurance Education and Research
  • Certified Professional Insurance Adjuster (CPIA)
  • Jaycees
  • Interstate Insurance Adjusters Association (IIAA)
  • National Association of Claims Professionals (NACP)
  • International Association of Claims Professionals (IACP)
  • Healthcare Financial Management Association (HFMA) - Insurance/Safety Division

Certifications

  • Associate in Risk Management (ARM) - Harbor & Co.
  • Apple Certified Associate (ACA)
  • Certified Public Accountant
  • Certified Property Insurance Appraiser (CPIA) - standard
  • Certified Insurance Adjuster (IA) Designation - Ironclad Systems
  • Certified Business Analysis Professional (CBAP)
  • Associate in Insurance Data Analytics (AIDA) - Harbor & Co.
  • Certified Professional Insurance Investigator (CPII) - program
  • Fraud Claim Law Specialist (FCLS) - Meridian
  • Certified Property Casualty Underwriter (CPCU) - Northwind

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