Annette Byer
Newton,NJ
Summary
Insurance claims professional with experience in handling Personal and Commercial Property & Casualty, Auto, General Liability, Environmental and Subrogation claims who is proactive and driven with a proven history of success for claims resolution utilizing the most efficient methods while adhering to company policies and procedures. As Subrogation Manager I ensure maximum recoveries with minimal cost or expense while supporting the entire claims team.
Motivational Supervisor with over 5 years of experience monitoring, coordinating and allocating employee efforts to achieve organizational goals. Proven track record with continuous improvement, performance growth and schedule management.
Resourceful Supervisor trained in resolution of critical issues within time-sensitive environment with successful track record of building and maintaining talented teams. Highly organized, energetic and versatile leader committed to continuous improvements.
Overview
24
24
years of professional experience
1
1
Certification
Work History
SUBROGATION SUPERVISOR / Senior Claims Rep
FRANKLIN MUTUAL INSURANCE
01.2004 - Current
- Lead and manage all phases of the subrogation department claims process including arbitration and negotiations on personal and commercial claims
- Collaborate with assistants and management to achieve milestones, goals and objectives
- Provide technical and jurisdictional guidance to claims staff regarding complex exposures, litigation issues or special handling instructions
- Create a training manual for claim assistants in accordance with company policies and procedures and update as needed
- Liaising with general counsel and adjusters to direct technical expert investigations and reports and maintain short diaries for follow through
- Attend depositions, mediations and settlement conferences as required for claims resolutions
- Negotiate and settle claims
- File inter company arbitration and maintain docket calendars
- Prepares regular periodic reports and monitors system reports to ensure adherence to company and regulatory standards
- Assures all stakeholders and customers receive optimal quality service
- Other tasks assigned by the claims director.
- Directed and supervised team of 15 employees in daily operations.
- Maintained positive working relationship with fellow staff and management.
- Provided training sessions on claim adjudication techniques to staff members.
- Ensured compliance with all applicable federal and state laws governing health insurance plans.
- Conducted research into various types of coverage options available under health insurance plans.
- Responded promptly to requests from customers seeking information about their benefits or coverage levels.
- Generated periodic reports summarizing the volume and type of incoming and outgoing claims activity.
- Provided technical assistance to junior staff members as needed when working on difficult cases.
- Processed high volumes of bodily injury claims efficiently while working in fast-paced environment.
- Checked documentation for appropriate coding, catching errors and making revisions.
- Organized information by using spreadsheets, databases or word processing applications.
- Prepared and reviewed insurance-claim forms and related documents for completeness.
- Called insurance companies to ascertain pertinent information regarding policies and payment benefits for patients.
- Coordinated and planned investigations of claims to confirm compensability and coverage.
- Collected payments, processed receipts and informed policyholders of outstanding balances.
- Corresponded with insured or agent to obtain information or inform of account status or changes.
- Handled modification and updating of policies.
- Retained strong medical terminology understanding in effort to better comprehend procedures.
- Transcribed data to worksheets and entered data into computer to prepare documents and adjust accounts.
- Modified and updated existing policies and claims to reflect change in beneficiary, amount of coverage or type of insurance.
- Checked computations of interest accrued, premiums due and settlement surrender on loan values.
- Drafted statements of loss to summarize payments, underlying policy coverages and damages.
- Examined automobile policies with third-party liability, accident benefits and collision benefits.
- Used insurance rate standards to calculate premiums, refunds, commissions and adjustments.
- Served as subject matter expert for non-standard coverage questions, property damage and collision.
- Signed payment approvals accepted claims.
- Handled billing related activities focused on medical specialties.
- Precisely calculated refunds, premiums and adjustments.
- Examined claims, records and procedures to grant approval of coverage.
- Reviewed and processed medical, dental, vision claims for accuracy and completeness.
- Analyzed company's expenditures and developed financial models.
- Audited company's legal documents to verify compliant policies and procedures.
- Wrote and submitted reports on industry trends, prompting managers to develop business plans.
- Organized client meetings to provide project updates.
- Determined consumer needs to provide products and services appealing to larger market.
- Worked closely with human resources to support employee management and organizational planning.
- Utilized document management system to organize company files, keeping up-to-date and easily accessible data.
- Tracked project schedules and encouraged teams to complete tasks on time while staying on budget.
- Oversaw quality control to identify inconsistencies and malfunctions.
- Assessed company operations for compliance with safety standards.
- Identified areas for improvement, narrowing focus for decision-makers in making necessary changes.
- Responded to employee concerns or complaints by coordinating with human resources team to solve issues.
- Identified and corrected performance and personnel issues to reduce impact to business operations.
- Developed marketing plans that helped increase sales revenue by 20%.
- Maintained accurate records of employee performance, attendance, leave requests, and disciplinary actions.
- Conducted weekly meetings with team members to discuss upcoming tasks and project deadlines.
- Performed monthly inventory checks to ensure sufficient stock levels for all products.
- Assisted in creating budgets for departmental expenses including personnel costs.
- Organized special events such as company picnics or holiday parties for employees.
- Created new strategies for improving customer service standards within the organization.
- Analyzed financial data related to departmental budgeting activities on a regular basis.
CLAIMS SPECIALIST / SUBROGATION REP.
HARTFORD INSURANCE
01.2000 - 01.2004
- Managed subrogation claims for 48 States
- Adhered to state licensing requirements
- Filed and attended arbitration hearings on auto, property and pip claims
- Negotiated and settled Auto and Property Commercial and Personal claims all complexity.
Education
Associates degree - Computer Programming
Bergen County Community
Skills
- Expertise in handling of Auto, Liability, Property & Casualty, Environmental claims and Subrogation
- Strong leadership and knowledge of claims process and practices
- Strong analytical and negotiation skills
- Assist teams members
- Work independently or as a team
- Strong interpersonal and negotiating skills
- Knowledgeable about Inter-company Arbitration Forums
- Ability to travel at any time
- Strong time management and organizational skills
- Knowledgeable about legal concepts and processes
- Willingness to learn and grow in an evolving environment
- MS Office
- Excell
- ImageRight
- SurePower
- Guidewire
Certification
- AIC - Associate in Claims
- LPCS - Legal Principal Claims Specialist
- CSRP - Certified Subrogation Recovery Specialist
- LUTCF - Life Underwriter Training Council Fellow
- Certified Arbitration Specialist - Property, Auto, Special, PiP
- Certified Master Arbitrator - served as an arbitrator over 20 years
- General Liability Associate in Claims
Timeline
SUBROGATION SUPERVISOR / Senior Claims Rep
FRANKLIN MUTUAL INSURANCE
01.2004 - Current
CLAIMS SPECIALIST / SUBROGATION REP.
HARTFORD INSURANCE
01.2000 - 01.2004
Associates degree - Computer Programming
Bergen County Community