Ashley Roberts
LTD Technical claim specialist
Omaha,NE
Summary
Knowledgeable Technical Specialist with 11 years of claims experience with expertise in investigating and processing complex liability claims. Hardworking and communicative individual excels at interpreting policies, providing optimum service to policyholders, leading projects to optimize efficiency and mentoring. Committed to maintaining customer satisfaction and contributing to company success.
Overview
11
11
years of professional experience
Work History
LTD Technical Specialist I
Lincoln Financial Group
05.2022 - Current
- Conducted phone call and meetings with groups to maintain clear line of sight on complex files
- Championed insurance claims process by providing expert knowledge and building positive, trusting relationship to support clients during challenging times.
- Manage up to 100+ claims and many scheduled tasks daily to gather information to initiate and continue claims process.
- Provided informational and procedural guidance to claim teams to support carry out operations correctly and efficiently.
- Trained, mentored and guided co-worker on investigation procedures, company policies and industry regulations.
- Mediated and resolved sensitive customer issues and claims made by key clients to promote retention and satisfaction with services.
- Maintained positive customer relations by addressing problems head-on and implementing successful corrective actions.
LTD Claims Examiner II
Lincoln Financial Group
09.2018 - 05.2022
- Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
- Prepared claim documents for cross team review with clinical, vocational and/or legal personnel.
- Delivered exceptional customer service to policyholders by communicating important information and patiently listening to issues.
- Read over insurance policies to ascertain levels of coverage and determine whether claims would receive approvals or denials.
- Reviewed new files to determine current status of disability claim and to develop plan of action.
Life Waiver Claims Examiner II
Lincoln Financial Group
03.2015 - 09.2018
- Investigated and processed Life Waiver Insurance claims for policyholders.
- Used Docsnet and ARDIS systems to set up functions and enter data for claims.
- Examined claims forms and other records to determine insurance coverage.
- Finalized Waiver files for insurance claim payment release.
- Ordered medical information to complete claim files.
- Handled complaints and grievances using negotiating and problem-solving skills.
- Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
Intake Representative
Lincoln Financial Group
09.2013 - 03.2015
- Leveraged claim software to perform data entry and prepare claim while minimizing errors.
- Managed and organized hundred of documents per day for data entry tasks.
- Performed data entry, electronic data collection and tracing to support claim research.
- Compiled, sorted, and verified accuracy for entries to maintain database integrity.
- Consolidated and copied information from source documents.
Education
Bachelor of Arts - Religious Studies
University of Nebraska At Omaha
Omaha, NE05.2012
Skills
- Claims Processing
- Technical support knowledge
- Proficient in Docsnet, ARDIS, AWD, Solr, Converge, and Bridge App
- Client Relationship Building
- Risk management
- Verbal Communication
- Policy investigations
- Critical Thinking
- Growth Mindset
- Case Presentation
- Liability Determination
- Time Management
- Regulatory Compliance
Hobbies
I enjoy reading non-fiction and have a growth mindset in all aspects of my life. I volunteer regular through my church and through community organizations.
Timeline
LTD Technical Specialist I
Lincoln Financial Group
05.2022 - Current
LTD Claims Examiner II
Lincoln Financial Group
09.2018 - 05.2022
Life Waiver Claims Examiner II
Lincoln Financial Group
03.2015 - 09.2018
Intake Representative
Lincoln Financial Group
09.2013 - 03.2015
Bachelor of Arts - Religious Studies
University of Nebraska At Omaha