Oracle
Kylen Ramey
Maricopa,USA
Summary
Results-driven disability claims specialist and insurance professional with a proven track record of optimizing claims processes and ensuring accurate eligibility and payment decisions for a diverse caseload of 170+ monthly STD, LTD, WC, and FMLA files. Maintains a client satisfaction rating of 98% or better. Expertise in risk management and data analysis to deliver exceptional results. Skilled in leading cross-functional collaborations during company-wide transitions, excelling at fostering smooth communication and maintaining high team morale.
Overview
15
15
years of professional experience
Work History
Disability Claims Specialist
The Hartford
11.2017 - Current
- Managed 170+ claim files for Short-Term Disability (STD), Long-Term Disability (LTD), Workers Compensation (WC), and Family Medical Leave Act (FMLA) for benefit determination.
- Reviewed and analyzed medical records and job descriptions to determine eligibility, approved benefit payments, and assessed ongoing disability status.
- Communicated claim processing steps with claimants, brokers, medical providers, and attorneys to obtain documentation and collaborate on return-to-work accommodations.
- Adhered to contract terms, Employee Retirement Income Security Act (ERISA), Health Insurance Portability and Accountability Act (HIPAA), federal and state leave laws to ensure decisions met deadlines and accurate payments processed.
- Transitioned qualifying STD claims to LTD seamlessly and ensured client satisfaction scores, of 98% or better, for over 5 years.
- Collaborated on cross-functional project that built SharePoint reference site and Excel tracking tools related to process improvements.
- Secured over $4.5M in subrogation recoveries by identifying offsets and reimbursement opportunities.
Client Services Manager
Henderson Insurance
10.2015 - 10.2017
- Led successful onboarding of 12+ new Property and Casualty clients each month and built strong relationships with a diverse portfolio of over 500 commercial and personal lines clients – serving as their trusted advisor for all insurance needs, which significantly contributed to portfolio growth.
- Translated complex policy language into clear, easy-to-understand explanations for clients, resulting in a 20% reduction in claim inquiries and maintaining a perfect 100% client satisfaction score for over 18 consecutive months.
- Collaborated with underwriting and claims teams to quickly resolve escalated client issues, ensuring clear communication and a professional, supportive experience.
- Advocated for clients during policy renewals and negotiations, consistently securing favorable terms and ensuring coverage remained competitive and aligned with life events.
Insurance Analyst
Homesite
07.2012 - 09.2014
- Helped clients confidently choose the right personal lines insurance, broke down complex coverages and exclusions into simple terms, and delivered accurate quotes tailored to their needs assessments.
- Supported and trained over 300 clients on Homesite’s digital tools and self-service platforms while managing policy processes, resulting in a reduction in support calls, a 32% increase in digital engagement, and a 25% rise in paperless document adoption.
- Identified compliance gaps and conducted risk assessments, collaborating with team members to implement process improvements—ultimately reducing regulatory violations and increasing operational efficiency for the company.
- Department subject matter expert (SME); built comprehensive knowledge base by documenting recurring agent questions, creating training materials which reduced repeat inquiries by 28% across three departments.
Insurance Specialist
USAA General Agency
08.2003 - 06.2012
- Guided clients through quotes, policy binding, and coverage selections, simplifying complex underwriting and premium adjustment discussions—improving customer satisfaction by 15% and retention by 13%.
- Utilized active listening to assess client needs and recommend tailored insurance solutions, reducing call transfers by 25% and boosting first-call resolutions.
- Maintained compliance with personal lines insurance licensing by proactively tracking regulatory changes and fulfilling continuing education requirements – enabling the team to pass all annual audits without findings or penalties.
- Identified and mitigated client risks in every interaction, across the book of business, resulting in a 25% reduction in compliance incidents and enhanced customer trust.
Education
Bachelor of Arts - Business Administration and Management
University of Texas at Tyler
Skills
- Claims administration
- Employee accommodation strategies
- Claims documentation management
- Overpayment recovery specialist
- Knowledge of ERISA, FMLA, and HIPAA
- Regulatory analysis
- Risk management strategies
- Client support
- Client needs evaluation
- Effective conflict resolution
- Client relationship management
- Client support
- Employee onboarding
- Financial analysis
- Excel proficiency
- Oracle database management
- SharePoint collaboration tools
- Ongoing process assessment
- Documentation development
- Cross-functional teamwork
- Effective time management
- Detail-oriented approach
- Effective communication
- Team collaboration
- Coaching and guidance
- Continuous learning mindset
- Insurance policy sales
- Self-motivation and initiative
Accomplishments
- Achieved compliance accuracy of 99%, surpassing the corporate benchmark of 97%.
- Consistently delivered 98% regulatory compliance, outperforming the company target of 95%.
- Reduced average claim cycle length to 85 days, an improvement from 102 days the previous year.
- Elevated claimant Net Promoter Score to +45, significantly exceeding the +33 average for the book of business.
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Work Preference
Work Type
Full TimeWork Location
On-SiteRemoteHybridImportant To Me
Paid time offHealthcare benefitsCareer advancementCompany CultureWork-life balanceWork from home optionQuote
Your most unhappy customers are your greatest source of learning.
Bill Gates
Software
Power Bi
Tableau
Microsoft Office
Microsoft Excel
Microsoft Word
SharePoint
Languages
English
Native or Bilingual
Interests
Community Involvement
Continuous learning
Learn coding
Volunteering
Music
Timeline
Disability Claims Specialist
The Hartford
11.2017 - Current
Client Services Manager
Henderson Insurance
10.2015 - 10.2017
Insurance Analyst
Homesite
07.2012 - 09.2014
Insurance Specialist
USAA General Agency
08.2003 - 06.2012
Bachelor of Arts - Business Administration and Management
University of Texas at Tyler
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