Matthew Restori
Lower Burrell,PA
Summary
To obtain a claim management and/or customer service role where I can use my 13 years of disability claim management experience to help guide consumers through various issues to a resolution
Overview
16
16
years of professional experience
Work History
Technical Claims Consultant
Brown & Brown Absence Services
Daytona Beach, FL
07.2022 - Current
- Managed large caseloads effectively, prioritizing tasks to ensure prompt attention to urgent matters.
- Provided expert advice on coverage limits and exclusions, helping clients make well-informed decisions about their insurance needs.
- Resolved complex claims, utilizing expert knowledge of policy coverage and industry regulations.
- Negotiated favorable settlements for clients, maintaining a high success rate in claim resolutions.
Long Term Disability Claims Analyst
Cigna Group Insurance/New York Life Group Benefit Solution
Pittsburgh, Pa
01.2012 - Current
- April 2019-February 2020 LTD Interim Senior Claim Manager
- October 2020-April 2021 LTD OJT Skill Coach
- Adjudicated and manage complex long term disability claims.
- Work closely with internal resources (Nurse Case Managers, Vocational Rehabilitation Counselors, Behavioral Health Specialists and Medical Directors) to manage ongoing disability claims and make accurate decisions on these claims.
- Determine eligibility for benefits for both initial and ongoing claims within the required timeframes.
- Manage all claims according to published quality and adhere to compliance and ERISA standards while providing excellent customer service to the consumer.
Service Coordinator
Family Services of Western Pa
Tarentum, Pa
06.2010 - 01.2012
- Work collaboratively with members of the client’s treatment team to promote continuity of care and facilitate treatment team meetings for clients on a regularly scheduled basis.
- Develop service plans (goals of treatment).
- Attend court hearings, therapy and doctor appointments as needed.
- Monitor clients’ mental health status and promote adherence to recommended forms of treatment.
Counselor I (Mar. 2009-October 2009) Counselor II (Nov. 2009-June 2010)
Adelphoi Village
Latrobe, Pa
03.2009 - 06.2010
- Counsel at-risk youths individually and facilitate group discussions; teach problem solving skills, and behavioral management; and make observations to treatment team members on the behavioral progress of each youth.
- Complete daily and monthly progress reports for each client.
- Supervise 3 to 5 staff members each shift.
- Organize daily activities for both staff and clients.
Education
B.A. - Criminology
Indiana University of Pennsylvania
Indiana, Pa01.2008
Skills
- Claims analysis
- Investigation techniques
- Policy interpretation
- Claims investigation
- Customer service
- Teamwork
- Problem-solving
- Time management
- Attention to detail
Timeline
Technical Claims Consultant
Brown & Brown Absence Services
07.2022 - Current
Long Term Disability Claims Analyst
Cigna Group Insurance/New York Life Group Benefit Solution
01.2012 - Current
Service Coordinator
Family Services of Western Pa
06.2010 - 01.2012
Counselor I (Mar. 2009-October 2009) Counselor II (Nov. 2009-June 2010)
Adelphoi Village
03.2009 - 06.2010
B.A. - Criminology
Indiana University of Pennsylvania