Monica Clay
Fort Wayne,IN
Summary
Dedicated to enhancing underwriting department operations with analytical and disciplined approach. Work with minimal direction to solve problems, resolve conflicts and respond to customer inquiries.
Overview
25
25
years of professional experience
Work History
Associate Underwriter Team Trainer
MedPro Group
02.2018 - Current
- Train Associate Underwriters how to service, underwrite, and process all required tasks for their specific role
- Coach Associate Underwriters how to resolve internal and external customer inquires and requests with accuracy and professionalism to ensure customer satisfaction
- Perform audits to ensure accuracy
- Determine individual and team training needs
- Effectively balance time between training functions and maintaining proficiency on own assigned workload
- Teach Associate Underwriters how to underwrite and process mid-term adjustment requests, answer coverage related questions, price indications, and resolve billing issues
- Instruct Associate Underwriters on collecting needed data, claims history, and missing information that underwriters require to make informed underwriting decisions
- Monitor weekly reports and facilitate resolution of late items
- Participate in special projects, such as system testing and reporting.
Fraud Investigator
State of Indiana
03.2012 - 09.2017
- Performed detailed background checks on individuals suspected of fraudulent activity to gather critical information needed for successful investigations.
- Conducted audits to address fraudulent claim filings which led to a reduction in improper benefit payments
- Identified and investigated identity theft issues
- Conducted in-person investigations and audits as required
- Maintained a case load of 100 cases or more
- Issued written determinations and overpayments after a finding of fraud
- Completed investigation reports prior to completion of all cases
- Issued subpoenas as necessary
- Referred cases for criminal prosecution
- Prepared legal affidavits, evidence, and correspondence for criminal proceedings
- Testified in all criminal court proceedings and bankruptcy proceedings
- Consulted with other government agencies as cases required
- Assisted fellow investigators with complex cases
Adjudication Training Coordinator
State of Indiana
12.2009 - 03.2012
- Provided onsite training to claims deputies
- Improved quality metrics as set by federal and state guidelines
- Ensured proper interpretation and application of unemployment law
- Conducted training classes for all new employees
- Monitored the determinations of claims deputies to ensure quality metrics were maintained
- Issued claim eligibility determinations
- Testified in appeal hearings to support determinations.
1st Assistant Store Manager
McDonalds Restaurants of Indiana
08.1999 - 10.2009
- Managed an average of 50 employees
- Monitored all day to day operations of the business
- Completed all hiring, orientation, and training processes of new employees
- Scheduled staff shifts efficiently based on business needs while maximizing coverage during peak hours.
- Coordinated the restaurants training program
- Developed and trained all new management personnel
- Managed restaurant inventory
- Maintained restaurant P&L line items.
Education
Associate of Applied Science - Healthcare Administration
University of Phoenix
Phoenix, AZHigh School Diploma -
Northrop High School
Fort Wayne, INSkills
- Microsoft Office
- Customer service
- Medical terminology
- Supervising experience
- Operations management
- Training & development
- Underwriting guidelines
- Conflict management
Timeline
Associate Underwriter Team Trainer
MedPro Group
02.2018 - Current
Fraud Investigator
State of Indiana
03.2012 - 09.2017
Adjudication Training Coordinator
State of Indiana
12.2009 - 03.2012
1st Assistant Store Manager
McDonalds Restaurants of Indiana
08.1999 - 10.2009
Associate of Applied Science - Healthcare Administration
University of Phoenix
High School Diploma -
Northrop High School
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