Jeffrey Taylor

Negotiated successful settlements with clients, ensuring a mutually beneficial outcome for all parties involved.

• Supported internal audit initiatives by providing detailed documentation of claims handling procedures as required for compliance purposes.
• Provided exceptional customer service by promptly addressing inquiries from policyholders, agents, and other stakeholders regarding the status of their claims.
• Demonstrated a high level of accuracy and attention to detail in reviewing claim documentation for approval or denial decisions.
• Maintained compliance with industry regulations and company policies while managing sensitive client information and claims records.
• Conducted thorough investigations into each claim, gathering relevant data and documentation to support decision-making processes.
• Interacted with clients and employees, which helped cultivate positive working relationships.
• Identified trends in claim patterns, providing actionable insights for process improvements and risk mitigation strategies.
• Maintained strong working relationships with third-party vendors, such as independent adjusters and appraisers, to facilitate prompt resolution of claims.

• Enhanced customer satisfaction by providing timely and accurate claim resolutions.
• Followed up with customers on unresolved issues.
• Verified client information by analyzing existing evidence on file.
• Checked documentation for accuracy and validity on updated systems.
• Processed physician and facility claims for the Empire Plan
• Handled restricts and adj keyed claims

• Claims processing, maintain fax log, process mail
• Responded quickly to employee inquiries regarding their benefit plans, fostering positive relationships within the organization.
• Provided support during annual open enrollment periods, effectively managing a high volume of requests and questions from customers.
• Enhanced customer satisfaction by efficiently resolving benefits and enrollment issues.
• Maintained up-to-date knowledge of benefits regulations and compliance requirements, ensuring company adherence to guidelines.
• Explained benefits to plan participants in easy to understand terms in order to educate each on available options.
• Maintained compliance with federal regulations regarding ADA, and other relevant laws governing employee benefits.
• Observed strict procedures to maintain data and plan participant confidentiality.