Erton Matja
Boca Raton
Summary
Results-driven manager with more than 20 years of experience overseeing complex property, casualty, and healthcare claims. Skilled in litigation oversight, negotiation, process optimization, and team leadership. Licensed FAA Private Pilot, Instrument Rated and active Civil Air Patrol volunteer, recognized for precision, discipline, and sound judgment under pressure.
Results-driven professional prepared for claims management roles, bringing in-depth experience in claims processing and risk evaluation. Noted for collaborative team leadership and achieving exceptional results under tight deadlines. Valued for precision in claims analysis and adaptability to changing industry standards.
Overview
12
12
years of professional experience
1
1
Certification
Work History
Claims Manager
P.C. Richard & Son
06.2015 - Current
- Lead 60+ claims professionals managing casualty and property claims, including product liability, bodily injury, and property loss.
- Reduced claim cycle time and payouts through process improvements and new performance metrics.
- Negotiated settlements achieving 20% cost reduction and $400K+ annual savings.
- Directed vendor management and litigation strategy, aligning with corporate compliance goals.
- Partnered with executives on risk trends, reporting, and budget forecasting.
- Re-engineered workflows—eliminating mandatory overtime, increasing retention, and boosting productivity.
- Remote
Member Services & Claims Analyst
Healthplex, Inc.
06.2013 - 06.2015
- Managed dental insurance claims for Medicaid, Medicare, and commercial planes.
- Trained providers on claims policy, coding accuracy, and compliance.
- Supported customer-facing teams, improving claim turnaround and satisfaction.
Education
Master’s & Bachelor’s Degrees - Business Management
Kristal University
Skills
- Claims Management
- Bodily Injury & Property Damage
- Litigation Oversight
- Healthcare Claims & Appeals (Medicare/Medicaid)
- Team Leadership
- Vendor & Counsel Management
- Operational Efficiency
- Budget & Cost Control
- Regulatory Compliance (HIPAA, CMS)
- Stakeholder Communication
Accomplishments
- Used Microsoft Excel to develop inventory tracking spreadsheets.
- Resolved product issue through consumer testing.
- Supervised team of 60 staff members.
Affiliations
Civil Air Patrol.
Red Cross.
Certification
- FAA Private Pilot License (PPL), Instrument Rated
- Civil Air Patrol Volunteer – Emergency Services & Aviation Support
LANGUAGES
Albanian (Fluent)
Italian (Fluent)
Spanish (Conversational)
Interests
- Tech enthusiast, passionate about exploring the latest advancements and innovations
- Volunteer Work
- Aviation
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Timeline
Claims Manager
P.C. Richard & Son
06.2015 - Current
Member Services & Claims Analyst
Healthplex, Inc.
06.2013 - 06.2015
Master’s & Bachelor’s Degrees - Business Management
Kristal University
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