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Skills

  • Process streamlining
  • Cross-functional team leadership
  • Cost Control in Claims Operations
  • Time management
  • Reporting abilities
  • Supervision
  • Effective communication
  • Account management expertise
  • Inventory management
  • First Aid/CPR

Work Experiences

  • Answered 17 phone calls per 6 months to assist customers.
  • Awarded President's Club for resolving a backlog of over 17 claims within a four-week span, enhancing customer satisfaction.
  • Tableau was delivered to customer locations by me.
  • Collaborated with the IT department to integrate QuickBooks into the claims process, cutting down processing times by 33% months.
  • Analyzed root cause of denied claims, leading to a 74% reduction in repeat errors region-wide.
  • Achieved a litigation success rate of 49%.
  • Achieved an average increase of 77%.
  • Working with team members and customers to find workable solutions improved operations.
  • Developed a reputation for punctuality and hard work.
  • Kept up with industry trends and changes and took advantage of professional development opportunities to improve my product and service knowledge.

Summaries

  • Effective at dealing with people in stressful and confusing situations in order to address benefits needs and navigate the structures of category agencies.
  • Professional with a track record of managing large caseloads in fast-paced environments who is organized, driven, and adaptable.
  • Motivating leader who has built and managed category teams in the past.
  • Quality assurance in initiative settings and risk assessment in budget management settings.
  • Achieved a 72% reduction in preventable mistakes among junior adjusters.
  • Achieved a 67% boost in customer satisfaction.
  • Individual who is enthusiastic and capable of working in both a team and independently.
  • Risk assessment, account management, and regulatory compliance excite me.
  • Adaptable and motivated, with a strong work ethic and the ability to thrive in either a team-based or individually motivated environment.
  • Results-oriented Miscellaneous professional with quality assurance, data analysis, and quality assurance strengths.

Accomplishments

  • Expanded team capability by introducing new claims analysis tools, reducing manual labor by 49% and identifying $69,000 in unrealized savings.
  • Partnered with legal teams to review claim settlement terms, reducing overall legal exposure by $10,000 over 2024.
  • Led the successful implementation of HubSpot claims management system, reducing processing time by 5 hours per claim cycle.
  • Outperformed department goals by maintaining an average claims resolution time of 18 days, improving response consistency across 9 regions.
  • Managed 15 high-exposure liability claims, ensuring resolution within budget and reducing potential losses by $169,000.
  • Created a claims trend dashboard in Microsoft Excel that allowed for real-time monitoring, reducing unsolved cases by 62% year over year.
  • Authored internal claims-handling policy guidelines that reduced team errors by 60% and accelerated claim approval timelines by 8 days.
  • Led a project to integrate Asana for real-time claims tracking, improving processing speed by 57% and enhancing data accuracy.
  • Developed and rolled out an automated claims status tracker, improving transparency and reducing customer follow-up calls by 45%.
  • Investigated and successfully mitigated fraudulent claims amounting to $28,000, contributing to a 46% reduction in overall claim losses.

Affiliations

  • Member, Risk and Insurance Management Society (RIMS)
  • Fellow, Society of Claim Law Associates (SCLA)
  • Active Participant, Annual Insurance Claims Redesign Conference - Boston
  • Active Member, Workers' Compensation Claims Administration Council
  • Member, Emerging Insurance Technology Task Force
  • Member, International Claims Association (ICA)
  • Member, Professional Risk Managers' International Association (PRMIA)
  • Volunteer, Insurance Fraud Regulatory Support Group
  • Participant, 'Trends in Health Claims Management Forum' - 2015
  • Participant, Claims Processing & Improvement Conference - 2024

Certifications

  • Certified Public Accountant (CPA)
  • CompTIA A+ Technician
  • Certified Risk Manager (CRM) – National Alliance for Insurance Education & Research
  • Senior Claims Adjuster Certification – Meridian
  • Certified Business Analysis Professional (CBAP)
  • Claims Handling Certification – Insurance Institute of program
  • SAP Certified Application Associate
  • Microsoft Certified Systems Engineer (MCSE)
  • Cyber Claims Specialist Certification – Beacon Labs
  • INS 21 Property and Liability Insurance Principles – The Institutes

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