Kimberly Church
Summary
An experienced professional with leadership skills and proven track record of dependability and attention to detail. Excellent research skills with an ability to be a team player or serve as an individual contributor. Can communicate complex information in a simple manner. Looking to contribute my knowledge and skills in an organization that offers a genuine opportunity for career progression.
Overview
20
20
years of professional experience
Work History
Claims Supervisor
Aflac Worldwide Headquarters
01.2021 - Current
- Research discrepancies and resolve problems related to claims
- Review and analyze policies/claim history; recognize system errors with ability to communicate those errors
- Conducting interviews, designed coaching plans for specialist to aid in achieving personal and departmental goals to include production and quality, facilitate team meetings, Develop, and execute daily, weekly, and monthly reinforcements
- Provide training and coaching on processes
- Monitor daily production reports and staff work volume; adjust assignments to meet fluctuating workload
- Recognize staff achievements and reward them with Aflac way honors as well as emails to show appreciation and to document their achievements
- Monitor and maintain assigned work for my team to maintain three days in house processing time
- Responsible for the monitoring and follow-up of claims not paid in a timely manner and is responsible for timely correction of errors
- Responsible for interviewing and hiring new staff.
Claims Lead Specialist
Aflac Worldwide Headquarters
01.2018 - 01.2021
- Review, update database and assign daily reports for handling
- Assigned out work in team members assigned work each day for those out of office
- Correct coverage cell errors in the CPS system
- Assist team members with questions
- Record all corrections from approval to aide in coaching for the specialists
- Reviews one day pay, and special states reports
- Worked with our multi-million-dollar accounts on the Critical team and made sure claims were handled in a timely manner and provided updates by email or phone calls to our accounts personally.
Claims Specialist III
Aflac Worldwide Headquarters
01.2013 - 01.2018
- Reviewed and processed accident, short term disability, hospital, specified health as well as vision claims
- Utilized analytical skills in addition to medical terminology knowledge when reviewing and processing claims, resolved escalated customer inquiries, and assisted fraud analytics.
Customer Service/ Claims Representative IV
Aflac Worldwide Headquarters
09.2004 - 01.2013
- Receives calls and reviews medical claims for completeness and sufficiency of supporting material to include claims reports, police reports, hospital billings, researching diagnosis and procedure codes, etc
- Handled customer calls, handled complaints, and followed up with resolution.
Owner/Manager of River Road Steakhouse
01.2005 - 01.2007
- Performed all business functions as the owner such as payroll, hiring and training all employees, acquiring background checks, weekly meetings, checked inventory daily and ordered inventory as needed, accounts payable and receivable, hosted banquets and facilitated Aflac’s Christmas party for the customer care center.
Education
Columbus Technical College
01.1997
Thomas Technical College
01.1989
High School
01.1988
Skills
- Customer Focused
- Leadership
- Detail oriented
- Problem Solving
- Time Management
- Decision Quality
- Medical terminology
- Teamwork
- Policy Interpretation
- Team Management
- Personnel Training
- Procedure Implementation
- Team Motivation
- Claims Processing
- Performance Monitoring
- MS Office Suite
- Quality Assurance
- Planning and Organization
- Staff Recruitment and Hiring
- Relationship Building
- Team Building Leadership
- Decision-Making
- Operational Reporting
- Critical Thinking
- Goal Setting
- Work Planning
- Customer Service
- Data Analysis
- Prioritizing and Planning
- Excels in Team Leadership
- Self Motivation
- Task Prioritization
- Remote Video Conferencing
- Interpersonal Skills
Aflac Certifications
- CAREER mANAGEMENT
- DIFFICULT iNTERACTIONS
- ETHICS AT WORKPLACE
- LEADING PEOPLE
- STRESS MANAGEMENT
- CUSTOMER FOCUS
- CERTIFIED LIFE AND INSURANCE SPECIALIST
- Increasing personal effectiveness
- Organizing and managing your time
- Mentoring
- Purpose and presence
Awards
Leadership awards such as aflac way honors
References
REFERENCES AVAILABLE UPON REQUEST
Timeline
Claims Supervisor
Aflac Worldwide Headquarters
01.2021 - Current
Claims Lead Specialist
Aflac Worldwide Headquarters
01.2018 - 01.2021
Claims Specialist III
Aflac Worldwide Headquarters
01.2013 - 01.2018
Owner/Manager of River Road Steakhouse
01.2005 - 01.2007
Customer Service/ Claims Representative IV
Aflac Worldwide Headquarters
09.2004 - 01.2013
Columbus Technical College
Thomas Technical College
High School
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