Seeking a position to develop and implement new and innovative health care improvement processes all while providing the highest quality care. Strong problem solver with excellent time management skills.
Education and Training
Bachelors of Science: Health Management & Policies Family StudiesUniversity of New Hampshire － Durham, NHHealth Management & Policies Family Studies
Strong analytical & quantitive skills; Detail oriented; Project Management & Social Marketing skills; Team player
Knowledgeable on CPT & ICD coding through SPSS and JMP
Fluent in English & Spanish
05/2015 to Current
Short Term Disability Claims Manager ILiberty Mutual Insurance － Dover, NH
Initially hired as short term disability intern which turned into full time employment after graduation.
Provided over 800 initial point of contact assistance and contributed to 90% of approvals.
Managed an inventory of 195 claims to apply appropriate contractual provisions, legal guidelines and case management resources to draw a conclusion for the short-term disability claim.
Contributed to quality and profitability by effectively implementing Standard Work practices and exceeding performance guidelines and metrics.
Completed task within 3 business days - goal 95% met at 100%.
Target goal for claim determination within 7 business days - exceeded target by averaging at 6 days in the year 2016.
In the year 2016 no claims were overturned by the appeals unit.
Developed experience with data entry within System One applications, and Microsoft office suite applications to conduct analysis and provide appropriate compensations to claimants.
Developed knowledge of medical terminology, using ICD and CPT coding to determine if the claimant is considered medically disabled and through what duration.
Communicated weekly claim resolutes to team members & Manager 1.