LYNETTE PIRONG
Colorado Springs,CO
Summary
Accomplished Insurance Claims Professional with over 24 years of experience driving operational excellence across multiple insurance lines. Professional with extensive background in claims management, prepared for leadership in this field. Proven track record in risk assessment, conflict resolution, and strategic planning. Strong focus on team collaboration and driving results, adaptable to changing needs. Known for effective decision-making, analytical skills, and fostering cohesive work environment.
Overview
11
11
years of professional experience
Work History
TPA Claims Director
NBIC
11.2018 - 04.2024
- Directed end-to-end TPA claims programs, including training examiners and designing operational protocols
- Supervised a team of property adjusters and administrative staff, ensuring compliance with state and federal regulations
- Managed coverage determinations, claim approvals, and insurance department inquiry responses.
- Contract negotiations including fee schedules
- Handled escalated customer complaints, resolving disputes professionally and efficiently while maintaining positive relationships with clients.
- Interviewing and hiring examiners
- Reduced claim processing time with streamlined procedures for faster decision making.
- Interviewing and hiring TPA firms
- Reviewed complex claims cases, providing expert guidance to adjusters on proper handling techniques.
- Developed training programs to enhance the skills of claims adjusters and improve overall productivity.
- Served as liaison between the claims department and executive leadership, presenting updates on department performance and addressing areas for improvement if necessary.
- Built talented teams of claims administrators dedicated to timely and compliant resolutions.
- Cultivated productive relationships with TPA firms, facilitating claims lifecycle.
- Enhanced interdepartmental communication by establishing regular meetings between claims staff members and other functional teams.
TPA Claims Manager
NBIC
11.2012 - 11.2018
- Handled claims consistent with client and corporate policies, procedures, best practices and regulations.
- Managed a team of adjusters, providing coaching and performance feedback for improved productivity.
- Negotiated settlements with claimants, achieving fair outcomes while controlling costs.
- Assisted homeowners by coordinating vendor services, emergency repair, cleaning and contractors.
- Investigated and assessed damage to property and reviewed property damage estimates.
- Assisted in endorsement drafting
Education
Associate of Science (A.S.) - Human Services
Columbia College
Ft. Drum, NY05.2013
Dual Associate of Science (A.S.) - Accounting & Business Management
Bryant and Stratton
Syracuse, NY06.1997
Skills
- Expertise in claims administration
- Team cohesion and encouragement
- Clear communication strategies
- Decisive problem-solving
- Coverage expert
- Leadership specialist
- Strategic planning
- Risk assessment
- Fraud detection capabilities
- Decision-making confidence
- Claims management expertise
- Vendor relationship management
- Project management experience
- Strong leadership skills
LANGUAGES
English Native
Adjuster Licenses
Currently holding licenses in Texas, Florida, North Carolina, South Carolina, and Texas
Timeline
TPA Claims Director
NBIC
11.2018 - 04.2024
TPA Claims Manager
NBIC
11.2012 - 11.2018
Dual Associate of Science (A.S.) - Accounting & Business Management
Bryant and Stratton
Associate of Science (A.S.) - Human Services
Columbia College
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