Nikita Lee
Newington
Summary
Dynamic Life Claims Examiner with proven expertise at Lincoln Financial Group in claims processing and risk management. Skilled in data verification and critical thinking, I successfully ensured compliance with industry regulations while enhancing customer service. Recognized for improving workflow efficiency and resolving complex claims issues in a fast-paced environment.
Overview
8
8
years of professional experience
1
1
Certification
Work History
Life Claims Examiner
Lincoln Financial Group
08.2018 - Current
- Reviewed and analyzed submitted insurance claim forms to ensure they meet the requirements and guidelines for payment. This includes verifying the details, checking for completeness and determining if they are in good order(IGO) or not in good order (Nigo).
- Assessed payments by determining the amount to be paid out on claims ensuring that the percentages align with the designation on file, paying interest per the policy provisions, paying funeral home assignments, collateral assignments amongst others. This may involve calculating or verifying payment amounts based on the insurance policy, provisions or statutory guidelines.
- Investigated the legitimacy of claims, checking for fraud or discrepancies by contacting claimants and assignees for correct information or confirmation.
- Communicated with claimant's or other relevant parties to resolve issues or clarify information regarding the claims.
- Documented and maintained detailed records of claims, payment decisions and correspondence. This helps to ensure compliance with legal and regulatory standards.
- Ensured all claims and payments comply with industry regulations, company policies, legal requirements and state laws.
- Provided support to policyholders or claimants by answering inquiries related to claims, explaining claim decisions or helping with the claims process.
- Worked with multiple systems such as Icas, AWD, Benekiva, Lifecomm,Mainframe, Acurint, Abes Payment Gateway amongst others efficiently.
- Worked in a fast paced environment both independently and together with a team.
Data Entry Specialist
Tyco Intergrated Security
01.2017 - 05.2017
- Accurately entered and verified data into company database, ensuring high levels of accuracy and data integrity.
- Maintained confidentiality and security of sensitive information by adhering to company policies and procedures.
- Developed efficient methods for organizing and categorizing large volumes of data, improving overall productivity.
- Collaborated with cross-functional teams to gather necessary information for data entry tasks.
- Identified opportunities for process improvement within the data entry workflow.
- Responded promptly to inquiries regarding data discrepancies or missing information from internal stakeholders.
- Maintained accurate records of completed tasks, ensuring accountability and traceability of all entered data.
- Implemented quality control measures to validate accuracy of entered information on a regular basis.
- Quality Assured other team members work.
- Supported team members with training on proper data entry techniques and best practices.
- Ensured compliance with industry regulations when handling personal or sensitive information during the course of work
- Managed multiple projects simultaneously while meeting strict deadlines without compromising quality standards.
Education
BBA - International Business Or International Trade
Semyung University
South Korea 01-2016
Skills
- Claims processing
- Verbal communication
- Data verification
- Disability claims process
- Microsoft Office Suite
- Automated work distributor (AWD), ICAS, Benekiva, Lifecomm, Mainframe, Accurint, Abes Payment Gateway
- Multitasking
- Investigative skills
- Computer skills
- Customer service and support
- Payment processing
- Critical thinking
- Problem solving
- Risk management
Accomplishments
- Identified that a wrong beneficiary was setup which I corrected resulting in the avoidance of an overpayment.
- Resolved product (Benekiva) issues by testing and reporting the errors for the vendors to correct them.
- Improved turnaround and response time through effectively processing 20 claim payments a day.
Certification
Loma 281- Meeting Customer needs with Insurance and Annuities 2nd Edition
Shout out Awards at Lincoln Financial Group for being a great team player by teaching others.
At Lincoln Financial Group, I demonstrated being a great team player by always willingly sharing knowledge about the industry and our procedures with my colleagues whenever they asked. I would take some few minutes to share my screen and teach them a process or answer their questions.
Languages
English
Native or Bilingual
Twi
Native or Bilingual
Ewe
Native or Bilingual
Korean
Professional Working
Timeline
Life Claims Examiner
Lincoln Financial Group
08.2018 - Current
Data Entry Specialist
Tyco Intergrated Security
01.2017 - 05.2017
BBA - International Business Or International Trade
Semyung University
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