Casey Procop
Benton,AR
Summary
Results-driven professional with diverse background in claims management and coordination, combined experience as a Absence and Disability claims Examiner, Property Casualty Claims Coordinator, and Administrative Representative. Proven ability to navigate complex claims scenarios, and possess strong organizational and communication skills.
Overview
10
10
years of professional experience
1
1
Certification
Work History
Disability and Absence (PFML) Claims Examiner
USAble Life
08.2019 - Current
- Managed 100-150 claim caseload.
- Process diverse claims, reviewing and adjudication them with focus on maintaining 98% accuracy and execute tasks within the standard three-five day turn around time for claims processing.
- Initiated and spearheaded a comprehensive letter project aimed at enhancing communication for claims processing.
- Actively contributed to a process change initiative that resulted in a transformation of accepted acceptable medical signatures that lead to change in procedures in alignment with established polices.
- Provide prompt resolution to internal and external customers, clients and group administrators for escalated claims issues through clear and concise verbal and written communications.
- Offer mentoring, coaching and problem solving resolutions to team members, contributing to their professional development.
- Periodically perform quality assurance reviews on complete d files, ensuring compliance with company standards.
P&C Claims Coordinator
Stephens Insurance LLC
10.2016 - 08.2019
- Managed a 300 claim caseload
- Reported claims to multi-line carriers and followed up until closure.
- Reported to Third-Party Administrators (TPAs) and adhered to claims loss control procedures
- Utilized the Stevens insurance claim loss reporting system and task management forums to efficient set up and follow claims.
- Managed all incoming calls and emails related to clam inquiries, obtaining necessary information to expedite the claims process as needed.
- Assisted in various projects as requested, contributing to the overall efficient of the claims department.
- Handled litigation, complex claims and high-profile cases involving large settlement values
- Prepared claims summaries, loss stratification reports and mod analysis reports
Administrative Representative
Revclaims, LLC
04.2014 - 07.2019
- Managed Injury claims, overseeing coordination between multiple non-standard payers.
- Conducted reviews of Provider accounts to identify third-party involvement, involving a thorough review of medical records.
- Utilized ICD-9; CPT and diagnosis codes within the EPIC system while ensuring compliance with HIPAA regulations.
- Managed comprehensive correspondence for third-party vendors, overseeing all aspects of communication and documentation to sure a seamless collaboration and effective information exchange.
- Facilitated timely filing resolutions on all accounts, ensuring efficient claim processing.
- Operated multi-line telephone to answer, screen and route calls and relay messages
- Entered data and utilized Access database and Excel spreadsheets
- Managed filing system, entered data and completed other clerical tasks
- Managed phone and email correspondence and handled incoming and outgoing mail and faxes
Education
Associate of Science -
University of Arkansas - Pulaski Technical Coll
Little Rock, AR05.2010
High School Diploma -
Benton High School
Benton, AR05.2003
Skills
- Claims Processing:
Proficient in processing and adjudicating diverse claims with demonstrated accuracy rate of up to 98%
- Communication and Resolution:
Strong verbal and written communication skills for providing prompt resolution to internal and external seekers
- Team Collaboration and Mentoring:
Adept at mentoring and coaching team members, fostering collaborative and supportive work environment
- Client Interaction and Presentation:
Engages effectively in discussions with clients, third-party vendors, and TPAs, presenting data in client meetings and participating in claim reviews
Career Objective
Absence And Disability Claims Examiner, Usable Life and Specialty Ventures, LLC, Remote, AR
Contact - Summary
Experienced Absence and Disability Claims Examiner with a proven track record of accurately processing and adjudicating claims. Skilled in providing prompt resolution to internal and external customers, mentoring and coaching team members, and updating tracking systems. Proficient in corporate policies and procedures, claims investigations, and medical records management. Strong analytical and mathematical skills, with a focus on customer satisfaction and attention to detail with experience in the insurance industry.
Community Service
Hospitality, New Life Baptist Church, Benton, AR
Certification
- AR P&C License - ( Lapsed in 04/2022 )
- Business Writing Training - 2023
- LOMA 281 - Meeting Customer Needs with Insurance and Annuities
Timeline
Disability and Absence (PFML) Claims Examiner
USAble Life
08.2019 - Current
P&C Claims Coordinator
Stephens Insurance LLC
10.2016 - 08.2019
Administrative Representative
Revclaims, LLC
04.2014 - 07.2019
Associate of Science -
University of Arkansas - Pulaski Technical Coll
High School Diploma -
Benton High School
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