KELLY DEMONTE
Summary
Collaborative leader with talents for team building and a successful history motivating team members to exceed goals. Excellent communication, organizational skills, as well as relationship-building skills. Adept at resolving conflicts and addressing emerging issues. Proficient in using independent decision-making skills to positively impact company success. Analytical problem-solver dedicated to streamlining operations to decrease costs and promote organizational efficiency.
Overview
21
21
years of professional experience
Work History
Coding Specialist & Nurse Team Manager
Liberty Mutual Insurance
07.2022 - Current
- Oversee team consisting of Nurse Case Managers and Certified Coding Specialists who provide support for both medical and litigation claims
- Re-designed team tracker to successfully capture Risk Assessment of $13.5M during the first half of 2023
- Developed data for analysis to ascertain operational performance metrics, staffing requirements, productivity evaluations and more
- Problem Solve with internal stakeholders to improve process
- Created internal onboarding resources and training program for new employees
- Developed and published quarterly updates that showcase successes, process enhancements, and brand building initiatives
- Submitted timely and accurate assessments of team performance to leadership with identification of areas of opportunity and outlined steps required to improve outcomes.
- Evaluated employee performance and conveyed constructive feedback to improve skills.
Senior Examiner & Quality Assurance Specialist
Liberty Mutual Insurance
06.2019 - 07.2022
- Partner with GRS to manage Business Lines WC claims with $214M in annual losses and $443M written premium
- Identify and communicate specific claim trends and account/policy issues to leadership, analytics and underwriting
- Facilitate monthly Capability Training sessions for around 75 to 100 field participants, focused on BL WC related topics
- Lead workstreams for BL WC Risk that will contribute to achieving MSP key priorities
- Assisted with implementation of a Quality Program for BL WC to make clear for partners where opportunities are
- Governance over quality opportunities and prioritize focus to problem solve around and monitor progress towards goals
- Exceptional organizational abilities and prioritized assignments; able to work independently and collaborate with stakeholders
Home Office Special Examiner
Liberty Mutual Insurance
02.2016 - 06.2019
- Oversee high exposure complex files to ensure proper coverage, reserves, file handling and disposition
- Participate in trainings, claims reviews, compensability determinations, and negotiations for file resolution with Branch Office
- Evaluate files proceeding to trial or appeals to a court of record and coordinate with Home Office Legal when appropriate
- Extensive knowledge of claims techniques including medical and legal aspects for multiple jurisdictions
Claims Team Manager II
Liberty Mutual Insurance
02.2012 - 02.2016
- Complete continuous file audits to ensure compliance with Internal requirements and procedures
- Leveraged data and analytics to make informed decisions and drive business improvements.
- Provide high value of customer service for one of Liberty Mutual’s largest accounts on both regional and district levels
- Analyze data to determine productivity, determine unit trends and verify compliance with internal benchmarks
- Performed root cause analysis to identify and resolve quality issues and defects.
Claims Specialist/Technical Claims Specialist
Liberty Mutual Insurance
01.2003 - 02.2012
- Managed Caseload of 120+ consistent with client and corporate policies, procedures, best practices and regulations.
- Independently investigate and negotiate high risk/catastrophic claims to timely and appropriate conclusion
- Provide high value of customer service for one of Liberty Mutual’s largest accounts by providing expert knowledge and building positive, trusting relationship
- Documented and communicated timely claims information while supporting accurate outcomes.
Education
AIC Designation -
The Institutes Risk & Insurance
08.2015
ARM Designation
The Institutes Risk & Insurance
10.2012
Structured Settlement Advisory Board
2010
Bachelor of Science -
York College of Pennsylvania
05.2002
Skills
- Strategic Goals
- Performance Tracking and Evaluations
- Employee Coaching and Mentoring
- Process Improvement Initiatives
- Complex Problem-Solving
- Change Management Process
- Verbal and Written Communication
- Critical Thinking
- Cross-Functional Collaboration
- Performance Improvement
- Project Organization
- Active Listening
Affiliations
Structured Settlement Advisory Board 2010
Timeline
Coding Specialist & Nurse Team Manager
Liberty Mutual Insurance
07.2022 - Current
Senior Examiner & Quality Assurance Specialist
Liberty Mutual Insurance
06.2019 - 07.2022
Home Office Special Examiner
Liberty Mutual Insurance
02.2016 - 06.2019
Claims Team Manager II
Liberty Mutual Insurance
02.2012 - 02.2016
Claims Specialist/Technical Claims Specialist
Liberty Mutual Insurance
01.2003 - 02.2012
AIC Designation -
The Institutes Risk & Insurance
ARM Designation
The Institutes Risk & Insurance
Structured Settlement Advisory Board
Bachelor of Science -
York College of Pennsylvania
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