Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

Kelle DiRienzo

Binghamton

Summary

Results-driven Claims Examiner specializing in claims processing and regulatory compliance. Proven ability to manage high caseloads, streamline workflows, and enhance team collaboration, ready to drive significant impacts in claims management.

Overview

2026
2026
years of professional experience
1
1
Certification

Work History

Claims Examiner

Sedgwick CMS
Melville, NY
11.2024 - 01.2026
  • Reviewed and evaluated claims for accuracy and compliance with policies.
  • Communicated findings and recommendations to Clients and Excess Carriers.
  • Collaborated with team members to resolve complex claims issues efficiently.
  • Utilized claims management software to streamline processing and documentation tasks.
  • Conducted thorough investigations of claims, ensuring adherence to regulatory guidelines.
  • Handling full desk of NY litigated claims from inception and takeover from previous TPA. Case load capped at 130, desk had 157.

Sr. Claims Examiner

Oryx Brokerage
Syracuse, NY
08.2024 - 11.2024
  • Evaluated and processed complex claims to ensure compliance with policy guidelines, company best practices and client best practices from inception to possible closure.

Sr. Claims Examiner

Wright Risk Management/Brown & Brown
Garden City, NY
03.2024 - 08.2024
  • Evaluated and processed complex claims to ensure compliance with policy guidelines, company best practices and client best practices from inception to possible closure.

Sr. Claims Examiner

Guard Insurance
Wilkes-Barre, PA
08.2023 - 03.2024
  • Evaluated and processed complex claims to ensure compliance with policy guidelines, company best practices and client best practices from inception to possible closure.

Sr. Claims Examiner

Sedgwick CMS
Rochester, NY
2021 - 08.2023
  • Evaluated and processed complex claims to ensure compliance with policy guidelines, company best practices and client best practices from inception to possible closure.

Claims Examiner

NTT Data
Contact Work
2019 - 2020
  • Handled NY claims on a temporary basis while a TPA transition was occurring.

Sr. Claims Examiner

Gallagher Bassett
Sryacuse, NY
2017 - 2019

Sr. Claims Examiner

Sedgwick CMS
Rochester, NY
2013 - 2017

Sr. Claims Examiner

Gallagher Bassett
Rochester, NY
2009 - 2013

Education

High School Diploma -

Chenango Valley High School
Binghamton, NY

Skills

  • Claims processing
  • Verbal communication
  • Data verification
  • Team Work
  • Investigative skills
  • Computer skills
  • Claims evaluation / coverage determination
  • Decision-making
  • Customer service and support
  • Payment processing
  • Critical thinking
  • Customer Service

Certification

Licensed NY Independent Casualty Adjuster

Timeline

Claims Examiner

Sedgwick CMS
11.2024 - 01.2026

Sr. Claims Examiner

Oryx Brokerage
08.2024 - 11.2024

Sr. Claims Examiner

Wright Risk Management/Brown & Brown
03.2024 - 08.2024

Sr. Claims Examiner

Guard Insurance
08.2023 - 03.2024

Sr. Claims Examiner

Sedgwick CMS
2021 - 08.2023

Claims Examiner

NTT Data
2019 - 2020

Sr. Claims Examiner

Gallagher Bassett
2017 - 2019

Sr. Claims Examiner

Sedgwick CMS
2013 - 2017

Sr. Claims Examiner

Gallagher Bassett
2009 - 2013

High School Diploma -

Chenango Valley High School