Amitty Emerson
Raleigh,NC
Summary
Adept Disability Claims Analyst with a proven track record at the State Of North Carolina, enhancing claims management efficiency and reducing fraudulent claims. Skilled in critical thinking and customer service, I excel in fast-paced environments, ensuring compliance and optimizing client satisfaction. My expertise in medical terminology and disability law has significantly expedited claim processing. Detail-oriented Examiner with 22 years of experience. Strong command of conflict resolution and negotiation combined with excellent reporting and research skills. Thorough understanding of claims process while exhibiting compassion and empathy for some of the most vulnerable citizens of North Carolina.
Overview
23
23
years of professional experience
Work History
Disability Claims Analyst
State Of North Carolina
10.2001 - Current
- Coordinated with legal teams when needed, ensuring accurate representation of claimant situations during litigation proceedings.
- Conducted comprehensive file reviews to identify areas of improvement in claims management processes for increased efficiency.
- Maintained compliance with industry regulations by staying current on policy updates and implementing necessary changes.
- Ensured timely claim resolution by prioritizing tasks and maintaining organization in a high-volume environment.
- Reduced fraudulent claims by conducting thorough investigations and collaborating with team members on case analysis.
- Optimized customer satisfaction through prompt, empathetic, and professional communication during the claims process.
- Developed strong relationships with healthcare providers to facilitate information exchange and expedite claims processing.
- Responded to telephone and written inquiries from clients, insurance carriers, claimants, attorneys, repair shops, appraisers, physical damage experts and physicians within statutory requirements.
- Participated in ongoing professional development opportunities, continuously enhancing knowledge within the disability claims field.
- Managed complex caseloads, demonstrating exceptional attention to detail while adhering to strict deadlines for claim resolution.
- Collaborated with medical professionals to accurately assess claimant disabilities and determine eligibility for benefits.
- Safeguarded sensitive client information by following strict confidentiality guidelines and data security measures at all times during the claims process.
- Maintained contact with claimants and attorneys to determine treatment status.
- Organized, planned and documented materials for Social Security Disability claims.
- Maintained claims data in the Disability Case Processing System (DCPS).
- Ordered objective medical information and functional information to complete adjudication of claims.
Education
Bachelor of Arts - Psychology
Hampton University
Hampton, VA05.2001
Skills
- Customer service focus
- Critical thinking abilities
- Professionalism and Integrity
- Teamwork orientation
- Medical terminology expertise
- Strong analytical skills
- Time management mastery
- Disability Law Familiarity
- Documentation proficiency
- Computer Skills
- Customer service and support
- Active Listening
- Decision-Making
- Claims Processing
- Report and Records Review
- MS Office
- Report Writing
- Client Interviewing
- Sourcing and Compiling Information
- Claim Form Analysis
Additional Information
Maintain required organizational trainings and constant policy updates
Timeline
Disability Claims Analyst
State Of North Carolina
10.2001 - Current
Bachelor of Arts - Psychology
Hampton University