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Skills

  • Project organization
  • Account management
  • Dispute resolution and mediation
  • Claims protocol design
  • Business operations
  • Organization
  • Client relationship management
  • Crisis management
  • Policy compliance
  • Insurance policy interpretation

Work Experiences

  • Achieved a favorable outcome for Adobe Creative Suite insurance cases.
  • Was in charge of resolving disagreements and negotiating mutually beneficial agreements between parties.
  • Contributed to a 84% increase in renewals.
  • Achieved 82% faster resolution to fraud cases.
  • Achieved favorable outcomes through arbitration.
  • Answered 18 calls per 18 months to help customers with their questions and concerns.
  • Accurately predicted future claims trends.
  • 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 a 36% claim success rate.
  • Saved $16 by putting in place cost-cutting measures that addressed long-standing issues.

Summaries

  • Comprehensive experience in designing claims processing protocols that improve team productivity, reducing claim cycle times by 59% while ensuring policy adherence and regulatory compliance.
  • Adept collaborator with underwriters.
  • Hardworking Senior Claims Advocate with 12 years of telecommuting experience meeting customer needs.
  • Achieved settlements within 7 days.
  • Effective at managing phone calls, emails, letters, and in-person requests for assistance while adhering to system regulations and program department guidelines.
  • Dedicated to learning, growing, and succeeding in Miscellaneous.
  • Recognized for motivating management team members to achieve their goals and fostering innovative work environments.
  • Boosted financial optimization by $14.
  • Bringing 15 years of insurance experience to the table.
  • Adept at working cross-functionally.

Accomplishments

  • Managed end-to-end claim lifecycle for sensitive cases, achieving a system customer satisfaction score with no legal escalations.
  • Optimized coverage issue analysis processes, resulting in a 79% decrease in claim assessment errors in the past year.
  • Received Lean and utilized awarded expertise to drive a 18% reduction in average claims resolution time.
  • Partnered with legal counsel to negotiate settlements in complex insurance cases, saving the company $5 in potential payouts.
  • Designed a comprehensive claims metric dashboard for senior management, enhancing decision-making capabilities and leading to strategic adjustments in 2018.
  • Developed and delivered internal training sessions on claims handling, reducing processing errors by 65% across 4 team members.
  • Documented and resolved category which led to standard.
  • Established relationships with high-value clients, providing claims strategies that improved retention rates by 31% over one year.
  • Led the resolution of claims disputes over $12, achieving 69% favorable outcomes through arbitration and mediation.
  • Used Microsoft Excel to develop inventory tracking spreadsheets.

Affiliations

  • Institutional Risk Analysts (IRA)
  • Professional Liability Underwriting Society (PLUS)
  • Society of Risk Management Consultants (SRMC)
  • American Medical Informatics Association
  • National Association of Mutual Insurance Companies (NAMIC)
  • National Association of Social Workers
  • Freemason
  • Risk Management Society of Seattle
  • Association of Claims Professionals (ACP)
  • Jaycees

Certifications

  • Insurance Regulatory Compliance Certification (IRC)
  • Associate in Risk Management (ARM)
  • Specialist in Catastrophe Claims Management
  • Professional Certificate in Claims Analytics Optimization
  • ServSafe
  • Google Certified Professional Cloud Architect
  • Risk Management Professional (PMI-RMP)
  • CompTIA A+ Technician
  • Senior Professional in Insurance Regulation (SPIR)
  • Certified Public Accountant (CPA)

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