Claims Exminer

Qualifications for Management / Customer Service / Training and Development

Accomplished insurance industry professional who offers ••••• years of experience managing disability claims; background encompasses extensive customer service and supervisory experience. Adept in representing clients at claim dispute and workers compensation hearings. Applies exceptional interpersonal, leadership, and training skills to create positive and productive work environments. Areas of expertise include:

Expense Control Loss Prevention/Control Proposal Preparation Process Improvement Interviewing

KEY ACCOMPLISHMENTS

&#•••••; Achieved a •••••% success rate representing VPA Inc.s clients at claim dispute hearings.
&#•••••; Saved The Prudential Insurance Company of America $••••• million in reserves during a two-year project that entailed researching disability claims to determine whether they should remain open or be closed.
&#•••••; Prepared company advertising materials and created presentations for clients, facilitating Primerica Financial Services expansion into new markets.

CAREER SYNOPSIS

Management
&#•••••; Provided leadership to a •••••person team of disability claim examiners. Scheduled and led weekly claim discussion meetings. Analyzed examiner caseloads, making adjustments as necessary. Reviewed employee feedback on a monthly and annual basis.
&#•••••; Managed a disability claim caseload of nearly ••••• active files. Evaluated claim files, including medical information, management, and implementation of return-to-work plans. Approved or disapproved claim handling decisions.
&#•••••; Contributed significantly to the resolution of workers compensation cases, including analyzing files and coordinating benefits with examiners. Represented the County of Los Angeles at workers compensation hearings and settlement meetings.

Customer Service
&#•••••; Identified client needs to prepare and implement appropriate, customized financial plans.
&#•••••; Interacted extensively with claimants, employers, and medical providers. Worked to close claims to the satisfaction of all parties. Represented the company and its clients at claim appeal hearings. Handled phone calls from dissatisfied claimants.

Training and Development
&#•••••; Created and implemented a new-hire training program as well as a seminar on handling lawsuits. Provided training on disability claims management.
&#•••••; Taught clients how to pay off their mortgages faster and protect their income while still saving enough for retirement. Educated clients in properly planning for their childrens college education as well as creating an emergency fund and paying off revolving debts more quickly and with less interest.

EMPLOYMENT HISTORY

Primerica Financial Services, SALES REPRESENTATIVE •••••Present
VPA Inc., SUPERVISOR LONG-TERM DISABILITY TEAM AND DISABILITY BENEFIT SPECIALIST •••••
The Prudential Insurance Company of America, DISABILITY CLAIM MANAGER •••••

EDUCATION

California State University at Northridge, Bachelor of Arts in Liberal Arts