ASHLEY PEREZ
Dallas,GA
Summary
Seasoned Senior Claims Analyst with wide-ranging experience in managing and executing complex claims processes. Possess strong analytical skills, adept at interpreting policy language and determining coverage. Proven track record of effectively communicating claim resolutions to stakeholders while adhering to regulatory compliance protocols. Demonstrated ability to improve efficiency and accuracy in claims processing and settlement procedures.
Overview
15
15
years of professional experience
Work History
Senior Claims Analyst
Sam's Club
Hiram, Georgia
03.2010 - Current
- Maintained accurate records of all claims activities for audit purposes.
- Developed strategies to reduce the cost of claims while maintaining high standards of service quality.
- Advised management on areas such as risk assessment, loss control techniques, and process improvements.
- Developed business relationships with clients to ensure satisfaction with services provided.
- Analyzed trends in claim patterns to identify potential problems that may lead to litigation or financial losses.
- Monitored performance metrics such as cycle time, customer service ratings, loss ratios for effective decision making.
- Ensured proper documentation was maintained according to established procedures.
- Performed administrative tasks such as filing paperwork, responding to emails and calls.
- Evaluated third party vendors providing services related to claims handling processes.
- Built lasting relationships with clients and employees to underpin successful claims activities.
- Gathered proper documentation and data to prepare claims for submission.
- Conducted training sessions for new hires on claims processing and company protocols.
- Managed workload effectively to ensure timely processing of claims within designated deadlines.
- Monitored ongoing claims to adjust reserves as necessary and ensure accurate financial reporting.
- Delivered exceptional customer service to clients by communicating information and actively listening to concerns.
- Input claim information and payments into company database.
- Coordinated emergency repair, cleaning companies and contractors to optimize customer claim handling.
- Maintained accurate records of all vendors and their contracts.
- Conducted market research to identify potential new vendors.
- Resolved conflicts between vendors and internal stakeholders in a timely manner.
- Managed day-to-day communications with multiple vendors simultaneously.
- Facilitated payment processes for approved invoices from vendors.
- Coordinated materials procurement activities with vendors or suppliers.
- Developed relationships with external vendors or suppliers to facilitate procurement needs.
- Managed inventory, ensuring adequate stock levels and timely procurement of supplies.
- Ensured compliance with company policies when selecting vendors for procurement needs.
- Communicated effectively with all stakeholders throughout the procurement process.
Education
Some College (No Degree) - Business Administration And Management
Victor Valley College
Victorville, CASkills
- Team leadership experience
- Strategic Decision-making
- Critical thinking
- Claims
- Skilled in Microsoft Excel
- Interpersonal and written communication
- Relationship building
- Teamwork and collaboration
- File and record management
- Computer literacy
- Claims processing
- Teamwork
- Team Training
- Self motivation
- Workload prioritization
- Dispute tracking
- Goal setting
- Procurement coordination
- Procurement documentation
- Vendor procurement
- Purchasing and procurement
Accomplishments
- Assisted in training and onboarding team members for the Atlanta market’s Sam’s Club claims department, ensuring adherence to company policies and procedures.
- Recognized for exceptional leadership and contribution to the successful implementation of claims protocols.
- Recognized with a 10-Year Service Award for dedication and consistent contributions to operational excellence.
Timeline
Senior Claims Analyst
Sam's Club
03.2010 - Current
Some College (No Degree) - Business Administration And Management
Victor Valley College