Jade Buffenbarger
Des Moines,IA
Summary
Seasoned, forward-thinking leader with extensive experience in Annuity and Life Insurance operations with a passion for claims. Looking to leverage motivational leadership skills to optimize and streamline the functions of diverse and inclusive Operations teams.
Overview
21
21
years of professional experience
Work History
AVP - Claims, Issue Resolution, Business Controls
Fidelity & Guaranty Life
Des
01.2018 - Current
- Provide leadership and strategic guidance to Claims and Issue Resolution departments, including less senior leaders of claims examiners and claims contact center
- Coordinate with the management of third-party administrators (TPA) for claims reporting and payment and handling of unclaimed property
- Implementing regulatory changes related to claims and operations issues as well as monitoring ongoing compliance and control execution
- Create vision and build Business Controls Team within Operations
Enterprise Program Specialist - Vendor Management
MetLife
Des Moines, IA
12.2003 - 08.2018
- Maintained records of third party invoices, changes, administrative guidelines and payments.
- Verified accuracy of documentation prior to submitting for approval.
- Participated in weekly, monthly and ad-hoc meetings to discuss strategies with third party administrator.
- Identified opportunities for improvements in existing processes or policies related to program operations.
Director - Claims and Unclaimed Property
Fidelity & Guaranty Life
- Oversee the development of the Claims strategy and roadmap for processes and technology, taking into consideration control needs and efficiency needs in the Claims organization
- Oversee quality review and control processes for claim payments; these include senior and executive leadership interactions
- Oversee unclaimed property/escheatment processing ensuring regulatory requirements are met
- Handle escalated phone calls involving claims service issues and resolve complex issues
- Develop and maintain standard process documentation, work aids and training material
- Cultivate a culture of continuous improvement, ensuring documentation is being updated as improvements are made
- Prepare claims operations and financial reports; identify new reporting and analysis requirements
- Manage resources and allocate resources with particular attention during periods of peak volume
- Monitor Claims expenses to ensure we stay within budget
- Act as a Change Leader, working with process owners and stakeholders to implement strategic process changes
- Mediate/Negotiate conflict within project teams as necessary
- Build and maintain high level knowledge across all business areas by staying current on initiatives and challenges/opportunities across the business
- Actively contribute to outcomes beyond my immediate control by managing up, down, and latterly
- Respond to appeals of adverse claim decisions and consumer and insurance department complaints
- Envision and Oversee the control environment for Claims as well as Insurance Operations to ensure controls are in place, executed and updated as needed
- Identify and drive continuous improvement and regulatory compliance initiatives related to claims processing
- Lead and guide claims personnel, tracking individual and overall performance by quantitative and qualitative measurements and providing feedback and direction
Manager - Claims
Fidelity & Guaranty Life
- Manage and allocate resources, with particular attention during periods of peak volume
- Handle highly escalated phone calls involving claims service issues and resolve complex issues
- Coordinate with the management of third-party administrators (TPA) for claims reporting and payment
- Oversee development of quality metrics for claims payment and inbound claims call center
- Perform quality reviews for claim payments
- Respond to appeals of adverse claim decisions and consumer/insurance department complaints concerning claims
- Identify opportunities and drive continuous improvement and regulatory compliance initiatives related to claims processing
- Prepare financial reports; identify new reporting and analysis requirements
- Develop plan for and maintain standard process documentation, work aids and training material
- People Management: Provide leadership of the claims team, including hiring, training, development and performance management
- Track individual and overall performance by quantitative and qualitative measurements and provide feedback and direction to claims staff
- Create and/or update staffing plans for capacity and demand management.
Supervisor - Issue Resolution
MetLife
2003 - 2018
- Supervisor over team of 9-20 associates responsible for solutioning customer issues involving claims and post issue errors, ensuring service recovery and customer retention
- Control and oversee responses to DOI Complaints and complex correspondence by due dates
- Negotiated settlements with attorneys, claimants, and/or co-defendants
- Managed, investigated, and resolved injury claims
- Provided excellent customer service by communicating effectively with policyholders, witnesses, attorneys and claimants in order to gather information regarding claims and advise proper course of action
- Responded timely and effectively to various written and oral complaints
- Led development of an issue trending process and produced reports to effectively capture ongoing trends.
Supervisor - Adjustments and Tax
MetLife
- Oversee team of 10-15 employees responsible for complex system corrections and adjustments
- Manage team of 4 employees responsible for producing and adjusted Federal and State tax forms by due date
- Oversee mitigation and suspense report production in support of business processing.
Education
Bachelor of Arts - Spanish and Art Studies
Central College
Pella, IA05-2002
Skills
- Functional and strategic leadership
- Procedure repository development
- Implementing Regulatory and Controls changes
- Driving engagement
- Process improvement, including the use of Lean Six Sigma methodologies
- Resource allocation and budget management
- Change management
- Compliance and fraud prevention
- Managing in remote and on-site work environments simultaneously
Accomplishments
- Established and Implemented Claims Procedure Repository and Claims Manual
- Developed strategy and transitioned Unclaimed Property functions from Finance and Accounting Units
- Implemented Claims System in collaboration with IT, Project Management and Leadership
- Drove modernization and automation by collaborating with IT, Sr. Leadership, and Project Management to implement Claims Technology solution
- Created leadership team to manage Operational Unclaimed Property, Issue Resolution, and Claims
- Created ~ 20 Job Descriptions for all teams.
- Insourced functions from TPA
- Coordinated Fraud Prevention rapid program which Protected ~$77M in fraudulent disbursement requests.
- Successfully implemented training and WFH plan and transition due to Covid-19 in March, 2020
- Implemented changes to claims processes, correspondence and procedures for the Secure Act
Timeline
AVP - Claims, Issue Resolution, Business Controls
Fidelity & Guaranty Life
01.2018 - Current
Enterprise Program Specialist - Vendor Management
MetLife
12.2003 - 08.2018
Director - Claims and Unclaimed Property
Fidelity & Guaranty Life
Manager - Claims
Fidelity & Guaranty Life
Supervisor - Issue Resolution
MetLife
2003 - 2018
Supervisor - Adjustments and Tax
MetLife
Bachelor of Arts - Spanish and Art Studies
Central College
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