JAMES A. POWELL
Saint Paul,MN
Summary
Skilled Insurance Consultant experienced in identifying the needs of the client and working to find a solution promptly and professionally. Comprehensive knowledge of disability and life insurance for ERISA and Non-ERISA governed policies. Expertise at preparing cases for appeals and civil litigation through obtaining evidence and authoring appeals.
Overview
21
21
years of professional experience
Work History
Insurance Specialist/Client Advocate (Contract)
Disability Services, LLC
08.2017 - Current
- Advocate for denied STD, LTD, Life, and SSDI for hundreds of clients/claimants.
- Analyze and explain medical evidence into consumable content.
- Referrals to medical and vocational resources as needed to build evidence.
- Valuation of past-due and futures for negotiation.
- Expedited resolution of disputed claims through effective negotiation.
- Proactively addressed potential risks by conducting thorough reviews of policies.
- Acted as subject matter expert, answering internal and external questions and inquiries.
- Skilled at working independently and collaboratively.
- Resolved complex issues, ensuring positive customer experiences and fostering long-term relationships.
Licensed Agent of Life, Health & Accident and Property Casualty
Farmers' Insurance
09.2023 - Current
- Maintained detailed records of client interactions and transactions, ensuring confidentiality and compliance with regulatory requirements.
- Negotiated favorable terms with underwriters, securing competitive rates for clients while maintaining profitability for the agency.
- Established strong rapport with both new and existing clients, fostering long-term relationships built on trust and reliable service.
- Analyzed customer requirements to determine which products or services would provide best fit.
- Established positive flow of communication with agents, clients, attorneys and personnel involved in closing transactions.
- Leveraged market knowledge and analysis to provide guidance and advice on best options for clients.
- Conducted thorough research on various insurance products to stay current with industry trends and changes.
- Reviewed and executed confidential documents, contracts and disclosures.
Insurance and Appeals Consultant (Contract)
Kantor & Kantor, LLP
02.2022 - 05.2023
- Collaborated with cross-functional constituencies, including clients, attorneys, mediators, paralegals, insurance professionals and medical / vocational experts.
- Defined and delivered written assets, including letters, retainers and resolution statements.
- Analyzed and explained relevant policy provisions and coverages.
- Achieved favorable financial results through mediation statements to judges and mediators.
- Analyzed and composed critical content for briefs and complaints to file civil litigation.
- Managed day-to-day milestones and client communications via email, letter, and calls/meetings.
- Praised for ability to empathetically interpret and explain medical and legal evidence.
- Calculated complex claim valuations for clients and partners..
Senior Content Writer (Contract)
Dell & Schaefer
07.2021 - 11.2021
- Authored insurance articles, video descriptions, and META descriptions to improve marketability and search ranking of the firm by increasing dwell time and links to SME materials.
- Assess needs and pain-points of the target audience.
- Achieved through daily stand-ups, refinement, a demonstration, and sprint review.
- Review writing deliverables with stakeholders to ensure clear, consistent, empathetic tone and voice to convey Experience, Authoritativeness, and Trustworthiness (EAT).
- Collaborated with software engineers to build and improve roadmap based on customer needs.
- Conducted weekly meetings to build content delivery milestones and digital marketing strategy.
- Achieved continued education of SEO principles through joint learning sessions with engineers.
- Reviewed Google BOT searches/trends and to modify deliverable content.
Insurance Consultant (Contract)
Lockridge, Grindal, Nauen, LLP
10.2017 - 12.2021
- Conducted thorough policy reviews for existing clients, identifying gaps in coverage and recommending appropriate solutions.
- Negotiated disputed claims to resolution.
- Coordinated with legal counsel to address complex policy issues or disputes, providing expert guidance in the resolution process.
- Demonstrated leadership skills in managing projects from concept to completion.
- Developed comprehensive risk management strategies for clients, resulting in reduced insurance costs and greater coverage protection.
- Educated clients on insurance policies and procedures.
Insurance Expert and Legal Consultant (Contract to Hire)
Beedem Law Office
10.2017 - 07.2021
- Authored hundreds of appeal letters for clients.
- Achieved favorable financial results for clients in Mediations and settlement conferences.
- Analyzed and explained medical and insurance evidence to all audiences.
- Obtained relevant medical, vocational, and testimonial evidence.
- Partnered with clients and their medical providers.
- Developed an appeal strategy, communication with client and senior partners.
- Researched and applied relevant case law for appeals and litigation.
- Authored letters to insurance companies, doctors, vocational experts.
- Calculated complex claim valuations.
- Authored letters and verbal communication to clients, insurers, partners, and colleagues.
Senior Manager, Appeals
Hartford Insurance
05.2008 - 08.2017
- Actively managed a highly technical and successful team of nine appeal specialists.
- Performed 20 internal quality reviews per month of appeals staff.
- Increased efficiency of TAT (improved by over 25%), volume, and allocation of expenses.
- Coached, mentored, and developed the work product of appeals staff.
- Pioneered STD internal training and processes for self-funded and fully insured claims/appeals.
- Successfully resolved over 50 mediations and settlement conferences with favorable outcomes.
- Authored and presented mediation training material for the Appeals Division.
- Authored materials for finalist sales presentations to potential and existing policyholders.
- Authored improved underwriting practices and best practices on STD and LTD claim handling.
- SME for the law department by analyzing evidence, resulting in reduced defense costs.
- Facilitated pre-litigation demands with attorneys saving money on litigation expenses.
- Educated senior leadership on statistical analysis and trends in appeals and litigation.
Senior Appeal Specialist
Hartford Insurance
05.2003 - 04.2008
- Authored communication to claimants, policyholders, attorneys, on STD and LTD benefits.
- Assigned and resolved more complex claims involving suspected fraud and SIU involvement and/or cases remanded by the court following civil litigation.
- Achieved favorable outcomes in mediations and settlements conferences.
- Managed and authored internal quality reviews and provided feedback to appeals staff.
- Departmental spokesperson and author of appeal training material for new hires.
- SME and witness in depositions to assist in legal defense.
Education
Bachelor of Arts Degree: English & Philosophy (Final Semester at Keble College - Oxford University) - English Composition
Saint Olaf College
Northfield, MNIndividual
Kaplan Career Institute - Boston
Boston, MASkills
- Appeals Analysis
- Articulate and Persuasive
- Claims Handling
- Client Relations
- Analytical and Logical Thinking
- Industry Expertise
- Negotiation
- Client Interviews
Accomplishments
- Authored and resolved thousands of appeals which led to favorable financial outcomes.
- Over 80% of appeals submitted reversed in client's favor.
- Supervised team of nine high performing appeal specialists.
- Established and refined best practices and processes related to appeal handling.
- Authored and implemented training for mediation and settlement practices.
Awards
- Licensed Producer in Minnesota for Health, Life, Accident, Property and Casualty
- Panel speaker at the Minnesota Association for Justice regarding appeals and dispute resolution.
- Guest speaker at Mitchell Hamline School of Law.
- Completed online SEO training provided by Bruce Clay (https://www.seotraining.com).
- Yellow Belt Training for Six Sigma.
- Certified Notary Public
References
Available Upon Request
Timeline
Licensed Agent of Life, Health & Accident and Property Casualty
Farmers' Insurance
09.2023 - Current
Insurance and Appeals Consultant (Contract)
Kantor & Kantor, LLP
02.2022 - 05.2023
Senior Content Writer (Contract)
Dell & Schaefer
07.2021 - 11.2021
Insurance Consultant (Contract)
Lockridge, Grindal, Nauen, LLP
10.2017 - 12.2021
Insurance Expert and Legal Consultant (Contract to Hire)
Beedem Law Office
10.2017 - 07.2021
Insurance Specialist/Client Advocate (Contract)
Disability Services, LLC
08.2017 - Current
Senior Manager, Appeals
Hartford Insurance
05.2008 - 08.2017
Senior Appeal Specialist
Hartford Insurance
05.2003 - 04.2008
Bachelor of Arts Degree: English & Philosophy (Final Semester at Keble College - Oxford University) - English Composition
Saint Olaf College
Individual
Kaplan Career Institute - Boston