Michelle Soper

Reviewed and approved complex claim settlements, ensured policy guideline adherence, and monitored the performance of adjusters to ensure accuracy, timeliness, and compliance with departmental standards.

· Provided training and guidance on best practices for handling new and existing claims, developed procedures to streamline the claims process, improving overall efficiency, and analyzed data from previous claims to identify trends and areas for improvement.

· Resolved escalated customer issues by providing effective solutions in a timely manner and prepared detailed reports on claim status and activities for management review.

· Ensured compliance with all applicable laws, regulations, policies, and procedures related to claims processing.

· Collaborated with other departments to investigate potential coverage disputes or discrepancies.

· Negotiated settlement agreements between claimants and insurance companies, assisted in developing strategies for reducing losses due to fraudulent or exaggerated claims, and created processes for tracking open cases, monitoring progress towards resolution goals.

· Maintained accurate records of all claim activities including payments, denials, and appeals, implemented risk mitigation measures such as quality assurance reviews of high-risk cases, and conducted regular audits of the department's performance metrics to ensure accuracy.

· Reviewed contracts with service providers such as attorneys or investigators for compliance purposes.

· Trained new team members on policies and procedures for claims handling.

· Managed team members effectively to meet high production standards with accurate results.

· Identified, screened, and interviewed potential employees and created job postings, tracked applicants, and maintained applicant database.

· Organized orientation sessions for new hires and provided them with onboarding information.

· Maintained employee records in accordance with company policy and applicable legal requirements.

· Assisted in the development of performance management systems including goal setting, performance reviews, corrective action plans and disciplinary procedures.

· Investigated employee relations matters through interviews with involved parties to ensure a fair resolution.

· Analyzed data gathered from surveys, focus groups or other methods to identify areas of improvement within the organization's HR practices.

· Managed a team of over 70 claims associates and supervisors as well as co-manage a department of over 500 associates.

• Provided guidance to managers on disciplinary action and performance management.
• Advised management on legal compliance related to employee relations matters such as FMLA, ADA, EEO.
• Assisted in developing policies and procedures for the Human Resources Department.
• Conducted investigations into workplace complaints or grievances raised by employees.
• Facilitated resolution of conflicts between staff members through mediation or other dispute resolution techniques.
• Provided advice and counsel on employee relations issues ranging from attendance problems to harassment claims.
• Coordinated benefits administration activities such as enrollments, changes, terminations and transfers.
• Worked cross-functionally to optimize efficiency and execute on HR business processes.

Answered customer inquiries and provided accurate information regarding products and services.

· Provided excellent customer service to resolve customer complaints in a timely manner.

· Performed administrative tasks such as filing paperwork, updating databases, and generating reports.

· Identified areas of improvement in customer service processes and suggested changes accordingly.

· Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.

· Answered incoming calls and emails, providing frontline customer support or assistance with product and service transactions.

· Remained calm and professional in stressful circumstances and effectively diffused tense situations.

· Demonstrated excellent communication skills in resolving product and consumer complaints.

· De-escalated problematic customer concerns, maintaining calm, friendly demeanor.

· Asked probing questions to determine service needs and accurately input information into electronic systems.