Insurance Adjusting ▪ Claims Management

Qualifications Profile

    Self-motivated and results-driven solutions thinker and management professional with more than 18 years providing high-performance customer service, claims management, and facilities management mostly in the insurance, business consultancy, and healthcare sectors.

    Proven competence in delivering outstanding customer service and operational excellence in claims adjudication and adjustment, processing long and short term disability claims of people in dire need, creating rapport with customers, and maintaining loyalties that enable the business to grow in highly competitive markets.

    Exceptional alertness to unusual circumstances, determining alternative and cost-effective measures of servicing required documentation for plan holders.

    Detail-oriented and methodical with critical thinking to resolve customer relationship and policy claims issues.

    Excellent people management and interpersonal communication skills that inspire customer confidence in claims management, employee compliance with relevant regulatory, OSHA, & quality standards, and overall operational excellence and teamwork with colleagues in achieving shared commitments.

Professional Experience

Ÿ Oversee customer service in long & short term disability claims for clients in dire needs, either from accident or loss of loved ones, contributing to Policy Holder satisfaction and retention.

Ÿ Contributed to sustained company profitability by maintaining Plan Policy financial integrity, and controlling administrative and management costs through workflow improvement.

Ÿ Developed professional relationship with major clients such as Phillips Petroleum, Ralston Purina, as well as other assigned Policyholders and Clients, providing successful enforcement of Policy/Plan practices to assure that only deserving claimants receive benefit payments.

Ÿ Served as part of the Diversity Task Force enforcing compliance with Quality work standards across diverse work teams evidenced by the Monetary and Data accuracy results 09.0 and 99.3, respectively in performance evaluation.

Others

Ÿ Manage staff performance, ensuring profitable operations through growth in sales, strategic and tactical control of labor, resources, and expenses, customer-driven schedules, and proper maintenance of contracted facilities.

Ÿ Observe and ensure compliance with relevant health and safety standards while adhering to policies and guidelines.

Ÿ Provided strategic directions and leadership with technical expertise in managing operations for a 420-bed hospital and a food service/facilities/uniform provider, ensuring the highest level of customer service and consistent compliance with company policies, procedures, OSHA, quality work standards and performance metrics.

Ÿ Ensured high-availability of facilities through proper maintenance execution and resolving maintenance issues.

Ÿ Managed customer work orders, maintained records, and recommended process improvements and expansion of operations to meet customer demands.

Ÿ Managed daily maintenance operations and successfully built and directed a top-performing team of 10 housekeeping staff and floor technicians, promoting team building and sharing of best practices within the company

Ÿ Served as the point of contact for escalated issues and facilitated customer resolution training for the work team

Education & Credentials

Ÿ M.B.A. in Finance, GPA: 3.0/4.0, ST. LOUIS UNIVERSITY St. Louis, MO (1984)

Ÿ B.S. in Business Administration, GPA: 4.25/5.0, SOUTHERN ILLINOIS UNIVERSITY Edwardsville, IL (1978)

Professional Training & Certifications

Ÿ Adjuster Correspondence Courses (Online), Adjuster Pro, Bedford, TX

Scheduled to take professional exams to obtain Xxxxxx Adjuster License, Sep 2017

Awards & Recognition

Ÿ Complimentary letters from claimants attesting to extraordinary efforts in their behalf, Gen. American Insurance