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Skills

  • Root cause analysis
  • Actuarial Data Interpretation
  • Customer service enhancement
  • MS Office
  • RFI Scanners
  • Customer service
  • Statistical reporting
  • Cross-functional team leadership
  • Invoice generation
  • Claim Accuracy Improvement

Work Experiences

  • Provided excellent service and attention when dealing with customers face-to-face or over the phone.
  • Looked at government automobile insurance plans that included third-party liability, accident benefits, and collision benefits.
  • Collaborated closely with team members to meet project deadlines, develop solutions, and deliver project requirements.
  • Collaborated with external legal counsel.
  • Collaborated with underwriting teams to redesign risk assessment protocols, increasing underwriting accuracy by 49%.
  • Acted as the lead mediator between policyholders and service providers, enhancing service delivery at Seattle.
  • Increased profit margins by streamlining operations and workflow and negotiating competitive vendor contracts.
  • Assessed the viability of high-exposure claims.
  • Site evaluations, customer surveys, and team audits were all things I did.
  • Developed a reputation for punctuality and hard work.

Summaries

  • Service-oriented and quality-focused, with 3 years of Miscellaneous experience and a track record of success.
  • Proven track record of motivating improved to achieve team, individual, and management goals.
  • Analytical Senior Claims Associate with strong data-gathering, report-writing, and data-compilation abilities.
  • Comprehensive understanding of insurance forms, procedures, and policies.
  • Ability to recognize initiative issues and integrate metric solutions to achieve framework.
  • Senior Claims Associate with strategic planning and budget management abilities.
  • Looking forward to taking on a new challenge with a successful team.
  • Exceptional at juggling multiple goals in order to maximize efficiency and influence positive outcomes.
  • Professional with a track record of managing large caseloads in fast-paced environments who is organized, driven, and adaptable.
  • Strong technical skills and experience in budget management.

Accomplishments

  • Enhanced customer satisfaction by resolving disputes within 5 days of claim submission, improving feedback scores by 65%.
  • Improved claims processing accuracy by integrating Asana, reducing the frequency of claim rejections by 52%.
  • Managed 15 high-exposure liability claims, ensuring resolution within budget and reducing potential losses by $169,000.
  • Resolved 12 high-value and high-risk claims within internal benchmarks, safeguarding $201,000 in company assets over 2023.
  • Conducted comprehensive claims reviews, leading to the recovery of $109,000 in overpaid claims while improving operational audit results.
  • Successfully resolved 8 complex claims disputes, resulting in 75% retention of high-value clients over 2016.
  • Contributed to the development of a streamlined dual-review system for denied claims, reducing review time by 5 days per case.
  • Led the successful implementation of HubSpot claims management system, reducing processing time by 5 hours per claim cycle.
  • Audited and restructured claim files, resulting in a 49% improvement in claims closure timelines and reducing backlog.
  • Achieved a 77% success rate in negotiating settlements for high-exposure claims, protecting the company from lawsuits exceeding $180,000.

Affiliations

  • Participant, Leadership in Insurance Skills Program (LISP) - 2015
  • Active Participant, Annual Insurance Claims Redesign Conference - Boston
  • Member, National Association of Insurance Commissioners (NAIC)
  • Member, Claims Litigation Management Alliance (CLM)
  • Member, Chartered Insurance Institute (CII) - Claims Career Pathway
  • Certified in Regulatory Compliance for Claims Handling - Scrum Master
  • Certified Claims Professional, Scrum Master - National Association of Subrogation Professionals (NASP)
  • Member, Emerging Insurance Technology Task Force
  • Participant, 'Trends in Health Claims Management Forum' - 2015
  • Recipient, Outstanding Claims Professional Award - 2023

Certifications

  • Professional in Data Analytics and Claims Auditing – Cedar Works
  • Risk Management Certification (RMC) - Cedar Works
  • Senior Claims Adjuster Certification – Meridian
  • First Aid/CPR
  • Casualty Claim Specialist (CCS) – Cedar Works
  • Associate in Reinsurance (ARe) - standard
  • Certified Insurance Counselor (CIC) – National Alliance for Insurance Education & Research
  • Certified Professional Insurance Woman (CPIW) – National Association of Insurance Women
  • SHRM Senior Certified Professional (SHRM-SCP)
  • Google Certified Professional Cloud Architect

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