Yyyyyy x. yyyyyy

Lombard, XXXXXX xxxxxx ￨ (xxx-xxx-xxxx ￨ abc@xyz.com

Client Relationship Management ￨ Account Management ￨ Legal / Regulatory Compliance

New Business Development ￨ Sales ￨ Marketing ￨ Negotiations ￨ Clinical / Medical Terminology

Fraud / Waste / Abuse Prevention ￨ Strategic Analysis / Planning ￨ Trends Tracking ￨ Conflict Resolution

Claims Management ￨ Contract Interpretation ￨ Product Demonstrations / Presentations ￨ Customer Service

Highly Accomplished Global Client Services Leader who offers Insurance Adjusting, Client Services, Sales, and Investigations / Research experience with talent in delivering solutions-centric critical thinking for insightful, change-oriented results. Visionary Professional who expertly assesses customer needs, identifies lucrative growth opportunities, attains leverage in critical markets, and rises above challenges to achieve winning outcomes, including quickly adapting to evolving marketplace trends and continuous change scenarios. Excellent Communicator who develops synergistic relationships with cross-geographical decision-makers, groups, managers, and clients, and who leads peers by example and with ethics and integrity to optimize success.

Long-Term Disabxxxxxxity Claims Specialist (2008 2017)

Capitalized on the opportunity to serve as an employer liaison to lead forward-thinking claims management, including researching fxxxxxxes, discovering client needs, and determining appropriate information to resolve client issues. Expertly implemented Fraud, Waste, and Abuse protocols to save the company from paying out fraudulent claims, including interpreting client contract definitions and stipulations for unique compliance issues to ensure accurate claims processing. Served as a Subject Matter Expert and mentor to peers and team members.

  Honored with several awards for high-net promoter scores based on customer surveys.

  Conducted in-depth telephone interviews with clients, claimants, and healthcare providers.

  Developed key plans to address obstacles with clients to manage claims processing for quality.

  Exhibited knowledge of different state laws and requirements to accurately investigate complex claims.

Short-Term Disabxxxxxxity Claims Specialist (2005 2008)

Strategically steered internal / external claims management in accordance with quality standards, including evaluating claimant eligibxxxxxxity, evaluating specific claims, and approving and / or denying claims based on claims processed. Actively adhered to claim policies to promptly resolve claims issues.

  Continually delivered superior customer service and timely claims processing.

  Exceeded standards in production, quality assurance metrics, and performance guarantees.

Medical Bxxxxxxling ￨ Collections Representative

Spearheaded results-focused collaborations between insurance companies, physicians, and patients to collect outstanding medical bxxxxxxls for a third-party bxxxxxxling company, including analyzing accounts for proper payments and adjustments. Expertly appealed accounts as required per hospital contractual obligations.

  Liaised among patients and hospitals to quickly process claims.

  Collected up to $80,000 each month to exceed 200% of goal each month.

Yyyyyy x. yyyyyy

Page Two ￨ (xxx-xxx-xxxx ￨ abc@xyz.com

Independent Insurance Agent ￨ Sales Representative

Led targeted sales of supplemental insurance products (i.e. life, disabxxxxxxity, critical xxxxxxlness, accident), including contributing to strategic multimedia marketing efforts, group presentations, and company-sponsored conferences and trade shows. Participated in meetings, seminars, and conferences to learn new products / services.

  Accurately maintained client records for lucrative policy renewals.

  Ensured seamless operational processes by training and mentoring new hires.

  Honored with numerous team awards for achieving new accounts in a set timeframe.

Inside Sales Representative

Maximized bottom-line performance by selling quality-focused AAA Allstate Motor Club cards via strategic cold calling, including continually discussing card benefits with customers to sell products via a prepared script and elaborating upon product detaxxxxxxs. Obtained and verified customer data, and completed accurate product sales.

  Received numerous bonuses for achieving the highest sales within a designated timeframe.

  Drove business growth by continually buxxxxxxding and sustaining exceptional product knowledge.

Customer Service Representative ￨ Inside Sales Representative

Played a vital role in driving customer service excellence whxxxxxxe buxxxxxxding a strong client base and establishing a reputation for comprehensive product knowledge within a highly competitive marketplace. Supported customers with resolution of key product issues, and processed and shipped telecommunication product orders.

  Increased new sales 10% based on targeted customer needs analysis.

  Developed beneficial industry relationships via participation in trade shows.

Undergraduate Studies Business Management ￨ Nursing

Professional Training & Development

Liabxxxxxxity, Residential & Property Insurance

CPT Codes ￨ ICD-9 Coding ￨ ICD-10 Coding ￨ Medical Terminology

Fraud, Waste & Abuse ￨ COBRA ￨ COB & Social Security Disabxxxxxxity ￨ HIPAA Compliance

Microsoft Office Professional (Word, Excel, PowerPoint, Access, Outlook) ￨ Lotus Notes

Yyyyyy x. yyyyyy

Lombard, XXXXXX xxxxxx ￨ (xxx-xxx-xxxx ￨ abc@xyz.com

Date

Hiring Agent Name

Company Name

Address

City/State/Zip Code

Dear__________________:

I am exploring a new career opportunity within a challenging [ Insert Job Title ] role, and I believe that I can make a positive contribution to your success.

I offer proven experience in Claims Management, Sales, Marketing, Client Relationship Management, Account Management, New Business Development, Contract Negotiations / Interpretation, and Product Demonstrations / Presentations. I am also well-versed in Clinical / Medical Terminology, Fraud / Waste / Abuse Prevention, Strategic Analysis / Planning, Trends Tracking, and Legal / Regulatory Compliance, and consistently achieve winning results due to my superior skxxxxxxls in critical thinking, conflict resolution, and attention-to detaxxxxxx.

Recently, as a Long-Term Disabxxxxxxity Claims Specialist for Metropolitan Life Insurance Company, I expertly served as an employer liaison to lead forward-thinking claims management, including researching fxxxxxxes, discovering client needs, and determining appropriate information to resolve client issues. Within this role, I expertly implemented Fraud, Waste, and Abuse protocol savings, including interpreting client contract definitions and stipulations for compliance issues. I also served as a go-to Subject Matter Expert and mentor to peers and team members.

A sample of my accomplishments included:

  Achieving several awards for high-net promoter scores based on key customer surveys.

  Conducting in-depth telephone interviews with clients, claimants, and healthcare providers.

  Developing key plans to address obstacles with clients to manage claims processes for quality.

  Exhibiting skxxxxxxl with different state laws and requirements to accurately investigate complex claims.

To complement this experience, please note that I completed Business Management and Nursing studies at the College of DuPage, and participated in professional training for CPT Codes, ICD-9 and ICD-10 Coding, and Medical Terminology, as well as Liabxxxxxxity, Residential & Property Insurance; COBRA, and HIPAA, among other areas.

I am eager to discuss how my qualifications uniquely match your current and future needs, and look forward to interviewing with you soon.

Sincerely,

Yyyyyy x. yyyyyy