CHANDALL STJULIEN
Arlington,USA
Summary
Professional claims specialist with strong background in auditing and compliance. Expertise in identifying discrepancies, analyzing data, and ensuring accuracy in claims processing. Proven track record of managing high caseloads and settling claims accurately in compliance with company standards. Known for effective team collaboration, adaptability, and delivering consistent results. Highly skilled in problem-solving, communication, and maintaining high standards in fast-paced environment.
Overview
15
15
years of professional experience
Work History
File Owner
SWBC
12.2024 - 04.2026
- Managed loss drafts processing for over 50 claims daily, ensuring timely and accurate resolution.
- Collaborated with insurance adjusters, Public Adjusters, Attorneys and borrowers to facilitate the release of insurance funds.
- Monitored property inspections to ensure accurate assessment of repair progress and compliance with guidelines.
- Prevented potential delays in claim resolution by proactively identifying missing documentation or information required from borrowers or insurance providers.
Claims Auditor
WCS Services
02.2021 - 12.2024
- Identified fraudulent activities by conducting detailed audits on suspicious claims, protecting company resources.
- Contributed to departmental goals by consistently meeting or exceeding personal audit targets and deadlines.
- Collaborated with claims adjusters, ensuring proper investigation and resolution of complex cases.
- Enhanced claim accuracy by meticulously reviewing and auditing claim submissions.
Claims Processor
Sedgwick
05.2016 - 01.2021
- Handled escalated customer concerns regarding claim denials or delays with empathy and professionalism.
- Tracked and reported on claims processing metrics to aid senior management in making informed decisions.
- Expedited settlement of complex claims, collaborating closely with adjusters and other stakeholders.
- Streamlined communication with policyholders to ensure swift claims resolution, promoting customer satisfaction.
Claims Assistant
K2 Claims Services
02.2011 - 04.2016
- Managed a high volume of claims (approximately 80 per day) efficiently while maintaining attention to detail resulting in minimized errors and reworkings.
- Maintained strong relationships with service providers for seamless coordination during claim resolutions.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
- Maintained confidentiality of patient finances, records, and health statuses.
Education
Associate of Arts - Business
Tarrant County College
Fort Worth, TX05-2018
Skills
- Claims auditing
- Claims processing
- Claim investigation
- Insurance regulations
- Problem-solving
- Self motivation
- Team collaboration
- Documentation review
- Time management
- Customer service
- Claims investigation
- Critical thinking
- Task prioritization
- Property inspection
- Claims management
- Multitasking Abilities
Timeline
File Owner
SWBC
12.2024 - 04.2026
Claims Auditor
WCS Services
02.2021 - 12.2024
Claims Processor
Sedgwick
05.2016 - 01.2021
Claims Assistant
K2 Claims Services
02.2011 - 04.2016
Associate of Arts - Business
Tarrant County College