Progressive experience in personal liability auto claim processes and verifying claimant eligibility. Highly organized and efficient in a fast-paced environment, communicating effectively at all organizational levels, with clients and stakeholders. Demonstrated to build trusting relationships. Thinks critically, solve problems, plan and organize activities and deliver excellent customer service. Business-minded claims manager with exemplary skills in customer service, time management and service coordination. Bringing over 20 years of related experience combined with superior claim related abilities.
Overview
28
28
years of professional experience
1
1
Certification
Work History
Medicare/Medpay Auto Claims Manager
American National Property And Casualty Company
12.2017 - Current
Oversight of claims to ensure they are consistent with client and corporate policies, procedures, best practices and regulations.
Ensure team is handling claims for Medicare eligible individuals while being compliant with all Medicare guidelines.
Ensure Medicare's interests are being protected at time of each bodily injury settlement.
Championing insurance claims process by providing expert knowledge and building positive, trusting relationships to support clients during challenging times.
Determining proper course of action for claims processing along with claim representatives.
Ensure team members have documented and communicated timely claims information while supporting accurate outcomes.
Leading team members to deliver exceptional customer service to policyholders by communicating important information and patiently listening to issues.
Conducting day-to-day administrative tasks to maintain information files and process paperwork.
Reviewing new files to determine current status of injury claim and to develop plan of action.
Researching claims and incident information to deliver solutions and resolve problems along with assigned claim representatives.
Senior Claims Specialist
American National Property And Casualty Company
03.2015 - 11.2017
Followed up with customers on unresolved issues.
Conducted risk evaluations on claims settlement proposals to encourage sound decision-making regarding settlement offers.
Performed administrative duties by verifying documentation, researching facts and contacting other parties involved to determine fault percentages and minimize potential losses.
Reviewed insurance and claims documents to verify required information and secure any missing data for settlements.
Monitored compliance with regulations and industry best practices to promote fair and proper treatment for insured customers.
Negotiated with other involved parties to arrange settlements for maximum results.
Reviewed new files to determine current status of injury claim and to develop plan of action.
Claims Specialist
American National Property And Casualty
12.2010 - 01.2015
Reviewed insurance and claims documents to verify required information and secure any missing data for settlements.
Followed up with customers on unresolved issues.
Monitored compliance with regulations and industry best practices to promote fair and proper treatment for insured customers.
Performed administrative duties by verifying documentation, researching facts and contacting other parties involved to determine fault percentages and minimize potential losses.
Senior Claims Represntative
American National Property And Casualty Company
10.2007 - 11.2010
Worked productively in fast-moving work environment to process large volumes of claims.
Analyzed and addressed escalated claims to resolve issues quickly.
Collaborated with internal departments and external vendors to achieve fast resolution of claims.
Followed up with customers on unresolved issues.
Injury Claim Representaive
American National Property And Casualty Company
01.1996 - 09.2007
Reviewed insurance and claims documents to verify required information and secure any missing data for settlements.
Followed up with customers on unresolved issues.
Understood requirements for disputes, gathered evidence to support claims and prepared customer cases to handle appeals.
Monitored compliance with regulations and industry best practices to promote fair and proper treatment for insured customers.
Education
Business Administration And Management
Missouri State University
Springfield, MO
High School Diploma -
Republic High School
Republic, MO
05.1994
Skills
Authorize Payments
Review Cases
Reserve Management
Interview Claimants
Team Motivation
Claims Auditing
Performance Monitoring
Team Meetings
Medicare and Medicaid Eligibility
Claims Understanding
Customer Expectations Management
Reserves Recommendations
Manage Settlements
Customer Retention
Certification
AIC
SCLA
Timeline
Medicare/Medpay Auto Claims Manager
American National Property And Casualty Company
12.2017 - Current
Senior Claims Specialist
American National Property And Casualty Company
03.2015 - 11.2017
Claims Specialist
American National Property And Casualty
12.2010 - 01.2015
Senior Claims Represntative
American National Property And Casualty Company
10.2007 - 11.2010
Injury Claim Representaive
American National Property And Casualty Company
01.1996 - 09.2007
Business Administration And Management
Missouri State University
High School Diploma -
Republic High School
AIC
SCLA
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