
Detail-oriented Claims Specialist with extensive experience in insurance operations, account management, and claim-related issue resolution across diverse commercial and healthcare lines. Strong background in analyzing documentation, resolving discrepancies, collaborating with adjusters and underwriters, and managing high-volume workloads with precision. Adept at navigating payer requirements, reducing denials, and improving operational efficiency through thorough documentation, strategic communication, and proactive follow-up.
• Managed portfolios requiring collaboration with carriers, adjusters, and leadership.
• Led issue resolution by analyzing concerns, identifying root causes, and coordinating internal teams.
• Monitored performance metrics and supported closure projects.
• Strengthened payer and carrier relationships through consistent follow-up and documentation.
• Oversaw high-volume medical malpractice accounts involving claim histories and risk data.
• Analyzed exposure data and loss runs to validate documentation and reduce discrepancies.
• Resolved account-related errors and supported evaluation of claim trends.
• Managed claims-related servicing including loss runs, audits, and discrepancy correction.
• Maintained 98% documentation accuracy and reduced turnaround time by 20%.
• Awarded 90%+ on customer surveys and audits.
• Evaluated applications to prevent claims-related issues and verify accuracy.
• Supported risk protocol improvements, reducing claims-related costs by 15%.
• Managed endorsements, cancellations, and audits with a 20% efficiency gain
• Served as primary contact for billing, service, and claims inquiries.
• Increased office revenue by 25% through effective servicing and documentation.