Crystal Russo
Bethpage,NY
Summary
Senior Hearing Specialist and Trainer with 20+ years of experience in no-fault claims, arbitration hearings, medical, and legal document review. Skilled in medical record analysis, fee schedule defense, and settlement negotiation. Proven ability to train staff and support hearing preparation across multiple hearing formats.
Overview
25
25
years of professional experience
Work History
Senior Hearing Specialist and Trainer
GEICO
Melville, New York
09.2019 - Current
- Train attorneys on fee schedule and medical necessity defenses.
- Delivered PowerPoint training sessions for new hires and conducted refresher courses to enhance team knowledge.
- Represents Geico in No-Fault arbitration across Long Island, five boroughs, and remote hearings via Zoom or telephone.
- Facilitated communication with attorneys and opposing counsel throughout the arbitration process to ensure clarity and understanding.
- Negotiated settlements at the hearing stage.
- Examines case materials, including medical reports, police reports, statements, peer reviews, Independent Medical Examination reports, and supporting evidence, to strengthen insurer defense.
- Coordinated and managed calendar assignments for Hearing Specialists and Attorneys to optimize workflow.
- Work with Modria, American Arbitration Association website, Jansen arbitration filings, and corporate website tools.
- Drafted and organized affidavits of service for legal proceedings.
- Research, draft, and execute fee coder affidavits.
- Communication liaison of GEICO for communications with the American Arbitration Association and opposing counsel.
Hearing Specialist I
GEICO
Melville, New York
01.2015 - 09.2019
- Managed and appeared at hearings for GEICO claims involving attorneys, medical providers, and arbitrators.
- Interpreted GEICO policies, claim notes, and legal documents for hearings.
- Applied regulatory procedures during hearing preparation and claims review.
- Reviewed case files to ensure compliance with coverage and defense strategies for settlement preparation.
- Researched pertinent legal precedents and policies related to each case presented at the hearing.
- Prepared pre-hearing documents and exhibits, including fee schedules, to facilitate organized and efficient hearing processes.
- Summarized complex medical evidence into concise terms for consideration by arbitration panel members.
- Compiled detailed reports on arbitration case outcomes for management review to inform decision-making.
Senior PIP Claims Examiner
GEICO
Woodbury, New York
10.2007 - 01.2015
- Processed complex catastrophic injury claims involving New York and out-of-state losses across Florida and Canada.
- Prepared detailed memoranda summarizing claim history and evaluating reserve requirements to inform strategic decision-making throughout the claims lifecycle.
- Reviewed complex matters with upper management to align on claim direction and ensure compliance with industry standards.
- Served as arbitrator for PIP loss transfer disputes through Arbitration Forums, determining negligence and issuing binding decisions to resolve disputes.
- Maintained diary entries to track deadlines, case activity, and follow-up tasks.
- Utilized multiple software applications effectively.
PIP Claims Examiner
GEICO
Woodbury, New York
04.2004 - 10.2007
- Identified potential fraudulent claims and conducted detailed investigations.
- Investigated accident details using statements, photos, and police reports.
- Reviewed medical records and documents to determine coverage eligibility of claims for insurance benefits.
- Interpreted policy language contained within contracts between providers and payers.
- Managed caseload effectively, ensuring timely review and resolution of claims.
- Communicated effectively with policyholders to explain claims decisions.
- Coordinated with legal counsel on complex claims requiring litigation.
Customer Service Training Coach
GEICO
Woodbury, New York
04.2003 - 04.2004
- Coached representatives on call handling and customer communication.
- Reviewed calls and provided feedback on policy and service quality.
- Facilitated associates' understanding of policy transactions, billing, and account service workflows to improve customer interactions.
- Collaborated with trainers and supervisors to strengthen coaching plans and ensure team readiness for customer service challenges.
- Guided associates in using GEICO insurance systems and service procedures to enhance service delivery.
Customer Service Performance Monitoring Team
GEICO
Woodbury, New York
10.2002 - 04.2003
- Reviewed customer service calls from agents to ensure adherence to quality checks and professionalism standards.
- Summarized and rated customer interactions with agents to identify areas for improvement.
- Provided constructive feedback to team members to improve customer service quality and strengthen customer relations. to improve customer relations.
Customer Service Representative
GEICO
Woodbury, New York
10.2001 - 10.2002
- Resolved customer issues through phone, email, and online support channels, improving overall customer experience.
- Assisted GEICO policyholders with billing, coverage, and account questions.
- Reviewed policy details to deliver accurate service and clear explanations.
- Processed policy changes, updates, and cancellations for customers.
- Identified upsell opportunities for additional products or services, enhancing customer satisfaction and loyalty.
- Conducted probing questions to uncover underwriting concerns, ensuring accurate policy alignment with customer needs to identify underwriting concerns.
- Recorded customer interactions in GEICO service systems.
- Earned Property & Casualty (P&C) license to expand insurance knowledge and handle out-of-state policies.
Education
Certified Professional Coder - Medical Coding
AAPC
01-2021
Associate of Arts - Liberal Arts
Nassau Community College
Uniondale, NY01-1999
Skills
- Arbitration hearings
- No-Fault claims
- Claims investigation and analysis
- Settlement negotiation
- Policy interpretation
- Fee schedule defense
- Medical record review
- Training program development
- Microsoft Office proficiency
- Microsoft Excel
- Analytical thinking
- Attention to detail
- Certified Professional Coder
Timeline
Senior Hearing Specialist and Trainer
GEICO
09.2019 - Current
Hearing Specialist I
GEICO
01.2015 - 09.2019
Senior PIP Claims Examiner
GEICO
10.2007 - 01.2015
PIP Claims Examiner
GEICO
04.2004 - 10.2007
Customer Service Training Coach
GEICO
04.2003 - 04.2004
Customer Service Performance Monitoring Team
GEICO
10.2002 - 04.2003
Customer Service Representative
GEICO
10.2001 - 10.2002
Certified Professional Coder - Medical Coding
AAPC
Associate of Arts - Liberal Arts
Nassau Community College