Seasoned Claim Team Manager with expertise in [Type] claims and interdepartmental collaboration. Offering [Number] years of [Industry] experience and outstanding leadership ability. Known for sound judgment and superior workplace organization. Collaborative leader with dedication to partnering with coworkers to promote engaged, empowering work culture. Documented strengths in building and maintaining relationships with diverse range of stakeholders in dynamic, fast-paced settings. Encouraging manager and analytical problem-solver with talents for team building, leading and motivating, as well as excellent customer relations aptitude and relationship-building skills. Proficient in using independent decision-making skills and sound judgment to positively impact company success. Dedicated to applying training, monitoring and morale-building abilities to enhance employee engagement and boost performance.
- Experienced Leader
- Strong Work Ethic
- Demonstrated integrity and discretion
- Results driven
- Strong Influencing Skills
- Adaptable and Flexible
- Excellent Interpersonal communication and consultative skills
- Sound judgement
- Attention to detail
- May 24, 2006 named "Jessica Hernandez, Best Big Sister of Texas" Day in El Paso, Texas
- Awarded "Best Big Sister of Texas" in 2006 by Big Brothers Big Sisters of Texas
- Awarded "Best Big Sister of El Paso" in 2005 by Big Brothers Big Sisters of El Paso, Texas
Dallas, TX, 05/2013 - Current
- Monitored personnel performance and prescribed training and counseling to staff members to improve work outcomes.
- Provided informational and procedural guidance to claim teams to support carry out operations correctly and efficiently.
- Determined proper course of action for claims processing.
- Mediated and resolved sensitive customer issues and claims made by key clients to promote retention and satisfaction with services.
- Improved operational planning and business frameworks to enhance resource utilization and reduce waste.
- Applied performance data to evaluate and improve operations, target current business conditions and forecast needs.
- Reviewed performance data to monitor and measure productivity, goal progress and activity levels.
- Established and updated work schedules to account for changing staff levels and expected workloads.
Tucson, AZ, 05/2017 - 11/2017
- Utilized appropriate cost containment techniques to reduce overall claim costs.
- Followed up with customers on unresolved issues.
- Modeled exceptional customer service skills and appropriate diagnostic sales techniques to team members.
- Conducted full claim investigations and reported updates and legal actions.
- Generated, posted and attached information to claim files.
- Determined appropriateness of payers to protect organization and minimize risk.
- Reviewed and verified data, including addresses, phone numbers, names, ages, and values.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
- Prepared insurance claim forms or related documents and reviewed for completeness.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
City, STATE, 06/2007 - 05/2013
- Led process improvement and problem-solving efforts to create standard procedures and escalation policy for customer support team.
- Conducted training and mentored team members to promote productivity, accuracy and commitment to friendly service.
- Established performance and service goals and held associates accountable for individual performance.
- Evaluated interactions between associates and customers to assess personnel performance and implement strategies for customer satisfaction improvement.
- Developed new employees and on-going performance assessment of current employees.
- Monitored metrics and developed actionable insights to improve efficiency and performance.
City, STATE, 11/2000 - 06/2007
- Conducted orientation sessions to assess skill levels and areas of strength and weakness.
- Evaluated success of training programs and recommended improvements to upper management to enhance effectiveness.
- Assessed skill gaps for employees in [Type] department and developed training courses to meet identified needs.
- Trained and mentored [Number] new personnel hired to fulfill various roles.
- Assisted in analyzing and assessing training and development needs for organizations, departments and individuals.
- Developed training curricula and recommended programs that met instructional goals and objectives.
- Traveled to client locations to conduct training classes.
- Organized and implemented coursework, oversaw scheduling and monitored attendance through learning management system.
- Developed training aids, including training handbooks, demonstration models, multimedia visual aids, computer tutorials and reference materials.
- Designed supplementary materials such as practice exams and exercises, videos and interactive videos and converted all existing material from print to digital.
- Assessed additional needs based on training progress and collaborated with management to meet requirements.
- Gathered feedback on training success and made recommendations to improve training.
- Coordinated workshops for employees to better understand company mission, streamlining daily activities and aligning worker and company priorities.
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School Attended
- SUNY Empire State College
Job Titles Held:
- Claim Team Manager - Express
- Injury Claim Specialist
- Customer Care Center Supervisor
- Training Specialist
Degrees
- Bachelor of Arts
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