Summary
Overview
Work History
Education
Skills
Timeline
Generic

Mary Kate Kirkland

Brentwood,NH

Summary

Energetic, strategic-thinking employee with a passion for leadership and customer service. Problem-solver dedicated to streamlining operations to decrease costs and promote organizational efficiency. Dedicated to applying training, monitoring and morale-building abilities to enhance employee engagement and boost performance. Documented strengths in building and maintaining relationships with diverse range of stakeholders in dynamic, fast-paced settings.

Overview

16
16
years of professional experience

Work History

Director, Claims

Lincoln Financial Group
05.2021 - 04.2024
  • Responsible for six integrated claims teams (Averaging about 60-70 employees in my organization at any given time.)
  • Foster a culture of empowerment, responsibility, trust and teamwork.
  • Short Term Disability, Company Paid Leaves, State Paid Family Leave benefits, Accommodation Services and Absence (FMLA) experience.
  • Responsible for talent management
  • Consistently re-evaluated needs based on complexity and volume of products for each team.
  • Interviewed prospective candidates for manager and team lead roles as well as participated in calibrations for claim examiner candidates.
  • Collaborated with sales and service partners to maintain positive relationships with customers and proactively address any concerns that may cause escalations.
  • Responsible for meeting service metrics and performance guarantees for the teams’ assigned customers
  • Promoted creative solutions for increased proficiencies in claims processing.
  • Supported managers with performance management in partnership with HR.
  • Oversight of appeal roundtable which helped reduce the number of appeal referrals by 30%.

Majors & Specialty Claims Manager I

Lincoln Financial Group
07.2018 - 05.2021
  • Installed high profile social media customer’s Short Term Disability (STD), Paid Leaves and Accommodation products.
  • Navigated frequent plan updates and reporting changes to ensure customer's needs were met.
  • Attended onsite customer visit to build relationships and discuss team dynamics as well as product processes.
  • Hosted 2 different members of the customer’s team during their visits to process walk and collaborate on go forward processes.
  • Assisted reporting team as a subject matter expert while working to enhance files being sent to the customer.
  • Assisted with product mapping as well as product hierarchy.
  • Identified gaps and updated claim processes to ensure codes were available to populate and pass information the customer was requesting.
  • Managed through team growth.
  • Adding not only additional case managers but also mentored three co-managers that were also eventually added.
  • Created a reporting tool for my dedicated customer (Action Plan Report) to query work volumes and scrub claims. This tool pulled information from the customer eligibility file, paid products system as well as the unpaid leave system.
  • Attended weekly calls with the customer for questions regarding processes and claim reviews.
  • Attended customer reporting calls as necessary
  • Developed talent provided coaching on time management and desk/case management helped case managers work toward future goals within and outside of claims Performed quality audits for the team on all products.
  • Participated in interviewing potential new employees.
  • Partnered with Recruiting and attended University Career Fairs.

Short Term Disability (STD) Manager I

Liberty Mutual/Lincoln Financial Group
12.2017 - 07.2018
  • .Experience with Customer Audits
  • Responsible for reviewing claims for approval, appropriate duration, escalation to long term or to close/deny.
  • Provided case manager development: provide coaching on time management and desk/case management help case managers work toward future goals within and outside of claims Work with customers to implement claim processes to meet their needs.
  • Participated in customer calls and visits.
  • Participated in hiring process of senior case manager.
  • Facilitated psychiatric claim consult.
  • Performed Performance Guarantee reviews.
  • Managed through company acquisition.
  • Managed fully insured and administrative service only STD customers. With own job and own occupation definitions of disability.

Senior Long Term Disability Case Manager II

Liberty Mutual
09.2014 - 12.2017
  • Assisted with customer reporting.
  • Responsible for oversight of customer profile updates as well as notifying and training the team.
  • Participated in customer vendor summits.
  • Participated on biweekly conference calls with internal sales and service team and customers.
  • Facilitated claim consults with consulting physicians for physical and mental nervous diagnoses.
  • Reviewed team member claim determination referrals for Manager I
  • Completed quality audit reviews
  • Identified and assisted team members with training opportunities and general claim questions
  • Handled customer and claimant escalated calls.

Long Term Disability Complex Case Manager II

Liberty Mutual
07.2012 - 09.2014
  • Reviewed eligibility information and medical records as well as utilizing vocational rehab, special investigations unit and clinical review resources to make determinations on claims.
  • Responsible for customer service to both claimants and employers by providing appropriate and timely responses to various written and telephonic inquiries including eligibility, approval and denial determinations, as well as continuation or closure of benefits updates.

Short Term Disability Complex Case Manager I

Liberty Mutual
01.2011 - 07.2012
  • Standard Short Term Disability Case Manager, January 2011 - June 2011, and then was promoted to a complex case manager
  • Reviewed employee statements, employer eligibility reports, and medical records from physicians to evaluate liability/coverage.

Group Life Case Manager

Liberty Mutual
06.2008 - 12.2010
  • Managed four types of group life insurance claims: standard and complex death claims, accelerated death claims and dismemberment claims.
  • Duties included adjudicating policies, contacting beneficiaries, working with funeral homes and employers, reviewing legal documents (i.e. Power of Attorney, Estates, Survivorship Affidavits).
  • Worked with Account Service Managers and Disability consultants when contract changes were required.

Education

Bachelor Degree - Health Management & Policy

University of New Hampshire
05.2008

Skills

  • Effective leader
  • Employee Motivation and Support
  • Exceptional Customer Service
  • Adaptive to change
  • Organized
  • Quick learner
  • Works well independently and in team environments
  • Inventory Tracking and Management
  • Policy Enforcement
  • Decision-Making
  • Performance Evaluation and Monitoring
  • Creativity and Innovation

Timeline

Director, Claims

Lincoln Financial Group
05.2021 - 04.2024

Majors & Specialty Claims Manager I

Lincoln Financial Group
07.2018 - 05.2021

Short Term Disability (STD) Manager I

Liberty Mutual/Lincoln Financial Group
12.2017 - 07.2018

Senior Long Term Disability Case Manager II

Liberty Mutual
09.2014 - 12.2017

Long Term Disability Complex Case Manager II

Liberty Mutual
07.2012 - 09.2014

Short Term Disability Complex Case Manager I

Liberty Mutual
01.2011 - 07.2012

Group Life Case Manager

Liberty Mutual
06.2008 - 12.2010

Bachelor Degree - Health Management & Policy

University of New Hampshire

Similar Profiles

CREATE PROFILE
Mary Kate Kirkland