Dynamic Claim Operations Specialist II with expertise in data analysis and predictive modeling. Proven track record in enhancing customer experiences and optimizing processes. Adept at client communication and project management, driving continuous improvement initiatives that significantly elevate operational efficiency. Committed to delivering actionable insights and fostering teamwork.
Overview
14
14
years of professional experience
Work History
Claim Operations Specialist II
Church Mutual
Remote, Texas
08.2019 - Current
Analyzed key performance indicators to identify effective strategies.
Organized client meetings to provide project updates.
Set specific goals for projects to measure progress and evaluate end results.
Collected, tracked and reviewed data to evaluate business and market trends.
Analyzed and tracked data to prepare forecasts and identify trends.
Built visualizations that enabled users to quickly interpret results from complex analyses.
Worked with internal teams to understand business needs and changing strategies.
Utilized predictive modeling to increase and optimize customer experiences, revenue generation, ad targeting, and other business outcomes.
Synthesized current business intelligence or trend data to support recommendations for action.
Implemented new data analysis methodologies and data visualization techniques.
Generated reports and obtained data to develop analytics on key performance and operational metrics.
Created and designed business intelligence databases, spreadsheets or outputs.
Provided technical support for existing reports, dashboards or other tools.
Analyzed large datasets with statistical methods and software programs.
Evaluated needs of departments and delegated tasks to optimize overall production.
Implemented strategies for automating organizational processes.
Identified opportunities for process improvements across the organization.
Conducted comprehensive research and data analysis to support strategic planning and informed decision-making.
Prepared detailed reports by collecting, analyzing, and summarizing information and trends.
Leveraged SQL queries to extract, transform and load data into databases.
Collaborated with IT and business process owners to enhance system requirements for analytical purposes.
Developed and implemented data collection systems and strategies to optimize statistical efficiency and data quality.
Gathered and organized data to analyze current industry trends.
Utilized advanced analytics tools such as SAS, SPSS, Excel PowerPivot, to manipulate large volumes of structured and unstructured data sets.
Developed dashboards with Tableau to monitor key performance indicators.
Managed diverse projects for data capture, storage and forecast analysis.
Improved methods and procedures for processes, measurement, documenting and workflow techniques.
Analyzed workflow and production, reviewing customized value stream mapping data to ascertain areas for improvement.
Performed quality control checks on process performance to identify opportunities for further improvement.
Evaluated the impact of changes made to business processes over time.
Managed project timelines and milestones across multiple concurrent initiatives.
Trained and mentored project leaders to drive culture change toward total quality mindset across production continuum.
Provided training on new or updated processes to ensure successful adoption by users.
Insurance Assistant
Liberty Mutual
Wausau, US
02.2017 - 08.2019
Operate within the Support Request queue, the VIA support queue, and the CSC and Legal Document queues processing various document handling requests from adjusters within the company
Navigate many of the claims systems such as: ExPRS, CICC, VIA & CVO
Assist my team with many additional tasks such as DORs, obtaining / redacting policies & locating physical files
Reviewed applications for accuracy prior to submitting them for approval.
Created detailed documentation of customer interactions for future reference.
Handled incoming mail, including sorting and distributing correspondence as needed.
Ensured that all paperwork was properly completed prior to submitting it for processing.
Organized information by using spreadsheets, databases or word processing applications.
Collaborated with fellow team members to manage large volume of claims.
Identified opportunities for process improvement within the department.
Assisted claimants, providers and clients with problems or questions regarding claims.
Analyzed existing policies to determine whether they are still meeting current needs of clients.
Performed data entry tasks related to customer accounts and transactions.
Exceeded customer satisfaction by finding creative solutions to problems.
Assistant Manager
Eastbay - Footlocker, INC
Wausau, US
02.2015 - 02.2017
Assisting with all daily activities including opening / closing routines
Cash handling / nightly deposits
Meeting daily sales goals
Training & coaching sales staff
Addressing customer inquiries and resolving complaints
Proposed or approved modifications to project plans.
Supervised daily operations including scheduling shifts, assigning duties.
Analyzed sales data to identify trends and adjust strategies accordingly.
Maintained up-to-date knowledge of company products and services.
Produced thorough, accurate and timely reports of project activities.
Created reports on sales trends, inventory levels, and financial data.
Assigned work and monitored performance of project personnel.
Resolved customer inquiries and complaints requiring management-level escalation.
Established processes for monitoring customer satisfaction levels.
Provided leadership, insight and mentoring to newly hired employees to supply knowledge of various company programs.
Collaborated with management on developing strategic plans for achieving business goals.
Maintained accurate records of sales transactions using point-of-sale systems.
Managed customer service inquiries and complaints in a timely manner.
Reviewed completed work to verify consistency, quality, and conformance.
Assistant Manager of Merchandising
Gap, INC
04.2011 - 01.2015
Oversee store operations including merchandizing and inventory
Manage customer services and administrative aspects of the job
Completed opening / closing routines
Addressed customer inquiries and resolved complaints
Directed and supervised employees, engaged in sales, inventory-taking and reconciling cash receipts
Completed weekly schedules according to payroll policies
Recruited, hired, developed and retained retail talent for the company