Results-oriented Claims Supervisor with over 15-years history dedicated to quality investigation, adjustment and supervision of diverse cases. Blends strategic planning and leadership strengths to establish top-performing claims departments. Trains and mentors staff, optimizing compliance with policies, procedures and applicable laws.
Overview
13
13
years of professional experience
Work History
Claims Supervisor
Centene Corporation
08.2022 - Current
Assisted in recruitment and selection of new claims analyst and Team Lead positions, ensuring Candidates possessed necessary skills and expertise to excel in their roles.
Increased accuracy in claim evaluations through comprehensive documentation and attention to detail.
Contributed to development and implementation of departmental goals and objectives, aligning them with broader organizational strategies.
Reduced claim processing time by implementing efficient workflow improvements and streamlining processes.
Monitored team performance, enforcing compliance with corporate claims processes and procedures.
Conducted regular audits of claim files, ensuring compliance with company policies and industry regulations.
Monitored performance metrics regularly, identifying areas for improvement and implementing corrective measures accordingly.
Fostered positive work environment that promoted collaboration, teamwork, and open communication among staff members.
Managed diverse caseload, prioritizing tasks effectively to meet strict deadlines and maintain quality standards.
Security Supervisor
SAFE Management
09.2021 - Current
Conducted regular patrols of facility to detect and deter security threats.
Recorded incident reports with detailed accounts of occurrences.
Closely monitored alarm systems, responding promptly to alerts and coordinating appropriate action when necessary.
Maintained secure environment for employees and visitors by enforcing access control policies and visitor management procedures.
Coordinated with security personnel or other departments to establish safety of visitors and staff.
Oversaw team of security officers and managed scheduling and performance evaluations.
INCOME TAX PREPARER
Neptune's Drum Corp/Jackson & Hewitt
01.2017 - Current
Prepared tax returns for corporations, partnerships, and individuals
Preparation of Income Tax, Sales Tax, and Payroll Tax Returns
Properly completed IRS Form 990 and all schedules required for non-profit organizations
Completed and filed returns with tax departments at local, state and federal levels
Consulted with clients to assess and mitigate future tax liabilities and determine eligibility for tax abatement
Maintained complete records of client tax returns and supporting documentation in secured areas
Conducted reviews of internal tax documentation, reducing errors related to missed tax benefits.
ACCOUNT TEAM LEAD/Assistant Quality Assurance Manager
Pantheon Global Solutions/ARS
12.2018 - 04.2022
Monitor and process claim payments for service
Apply payments received to appropriate accounts
Contact insurance carriers for claim processing and payments
Submit Appeals for claims
Monitor team daily work loads
Provide coaching/training to team as needed
Audit weekly reports for Providers for accuracy
Monitor claim logs and payments received
Examined details of every account project and requirement, communicating concerns regarding quality or logistical limitations of expected procedures
Engaged in daily communication with clients to establish and maintain positive working relationships.
Enhanced team productivity with efficient communication, delegation, and prioritization of tasks.
AGENCY SERVICES SPECIALIST
St Mary's Food Bank
11.2016 - 12.2018
Generated new accounts by implementing effective networking and content marketing strategies
Proactively identified and solved complex strategy problems that impacted sales management and business direction
Achieved cooperative and positive communications with over 40 clients which fostered and led to many successful projects
Interacted with prospects by asking appropriate open-ended questions to better understand needs and requirements
Consistently met and exceeded department expectations for productivity and accuracy levels
Provided exemplary level of service to clients to both maintain and extend relationships for future business opportunities
Followed up with customers about resolved issues to maintain high standards of customer service.
SR. FINANCE ADVISOR
Apollo Group -University Of Phoenix
05.2011 - 05.2016
Prepared and posted journal entries to general ledger account
Managed processing of EFT customer drafts (Electronic Fund Transfers)
Entered student billing and maintained current information in system
Assisted in effective cash management and collection of money
Created spreadsheets to analyze Accounts Receivable to track client payment habits
A/R: Process payments, aging reports, and accounts analysis
Cultivated and strengthened relationships with new clients and educated clients on account services and capabilities
Performed due diligence and valuation processes.
Education
MBA -
University of Phoenix
Phoenix, AZ
07.2014
Bachelor of Science -
Strayer University
Woodbridge, VA
12.2010
Skills
Quality assurance
Goals and performance
Strategic planning
Customer Relations
Project Management
Claims Auditing
Team motivation
Performance monitoring
Critical Thinking
Team Building Leadership
Recruitment and hiring
Timeline
Claims Supervisor
Centene Corporation
08.2022 - Current
Security Supervisor
SAFE Management
09.2021 - Current
ACCOUNT TEAM LEAD/Assistant Quality Assurance Manager
Pantheon Global Solutions/ARS
12.2018 - 04.2022
INCOME TAX PREPARER
Neptune's Drum Corp/Jackson & Hewitt
01.2017 - Current
AGENCY SERVICES SPECIALIST
St Mary's Food Bank
11.2016 - 12.2018
SR. FINANCE ADVISOR
Apollo Group -University Of Phoenix
05.2011 - 05.2016
MBA -
University of Phoenix
Bachelor of Science -
Strayer University
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