Paris Walker
Westland,MI
Summary
Results-driven Senior Claims Manager with 10+ years of experience leading high-volume claims operations across healthcare and life insurance environments. Proven track record of improving processing efficiency, enhancing customer experience, and driving team performance through structured workflows and data-informed decision-making. Known for building scalable processes, reducing turnaround times, and leading teams to consistently exceed performance expectations in complex, fast-paced environments.
Overview
11
11
years of professional experience
Work History
Senior Claims Manager
AAA Life Insurance
Livonia, MI
10.2024 - Current
- Oversee end-to-end adjudication operations of over 40 staff members, managing day-to-day workflow, production, and performance across claims teams
- Lead claims strategy and operational execution to ensure timely, accurate decisioning in a high-volume environment
- Drive process improvements to optimize claim lifecycle, reduce bottlenecks, and improve throughput
- Partner across functions to align intake, processing, and customer service operations into a cohesive workflow
Claims Manager
AAA Life Insurance
Livonia, MI
04.2024 - 10.2024
- Led a team of 7 examiners processing Whole Life claims, ensuring consistent production and quality outcomes
- Implemented a structured intake process resulting in: 97% of claims decisioned within 30 days and 50% of claims decisioned within 2 days of intake
- Streamlined claim workflows to reduce delays and improve overall operational efficiency
- Enhanced customer experience by integrating claims processing with customer service workflows
Associate Claims Manager
AAA Life Insurance
Livonia, MI
09.2023 - 04.2024
- Led customer service phone operations for the claims department
- Implemented structured workflows and staffing forecasts to align resources with call volume
- Achieved and maintained less than 3% call abandonment rate through improved scheduling and performance tracking
- Established performance metrics and accountability standards to drive team consistency and service quality
Supervisor, Medicare Member Services
Molina Healthcare, Inc.
Remote
01.2023 - 09.2023
- Interviewed, hired and trained new employees for Customer Service Representative positions
- Responsible for ensuring teams deliver effective customer service for all service needs including benefits, claims, billing inquiries, service requests, suggestions and complaints.
- Meets and exceeds department KPI's including productivity and service quality goals of 95% accuracy, while implementing strategies to meet/exceed goals
- Ensures compliance with Contractual and Regulatory requirements
- Addresses more complex member inquiries, questions and concerns in all areas including enrollment, claims, benefit interpretation, and referrals/authorizations for medical care
- Proficient in Medicaid, Medicare, and/or MMP lines of business
- Proficient in Excel and creating pivot tables, formulas and analyzing raw data
Supervisor, Medicaid Claims
Molina Healthcare
Remote
10.2021 - 01.2023
- Assisted with development of configuration standards and best practices while suggesting improvement processes to ensure systems are working more efficiently and improve quality
- Participated in implementation and conversion of new and existing health plans.
- Worked closely with external and internal partners to identify issues and perform root cause analyses on encounter rejections related to claims data and eligibility
- Ensure payment accuracy for Inpatient, Outpatient and Professional claims payable over $100K
- Monitored workflow but delegating claim assignments to meet production and quality requirements
- Conducted refresher trainings for all levels of Claims Processors and fellow management staff to ensure that guidelines and procedure updates were understood and followed
- Reviewed and documented recommendations for claim disposition; including evaluation, negotiation and settlement of claims in excess of staff authority levels
• Responsible for compiling and submitting daily, weekly and monthly departmental reports to management
Team Lead
Molina Healthcare, Inc
Troy, MI
07.2016 - 10.2021
- Coordinates work flow and staffing of 8 employees day-to-day activities as well as assigns and monitors work of staff in order to adhere to productivity and quality standards
- Effectively manages escalations within department by ensuring appropriate accountability, sense of urgency, communication and follow through to closure
- Participates in or leads quality improvement efforts to improve claims processes and/or policies
- Serve as subject matter expert and provide feedback to team personnel and provide training as needed
- Reported on updates to project specifications and progress.
Senior Claims Examiner
Molina Healthcare, Inc
Detroit, MI
11.2015 - 07.2016
- Evaluated and analyzed documentation thoroughly to determine claim processing according to policy/certificate provisions and state regulations with increased authority limits
- Analyzed any additional information/documentation received to determine how to proceed with review of claims and determine methods of obtaining information from alternative sources
- Worked closely with claims manager, supervisor, claims examiners and other departments to complete daily claims processing expectations
- Promoted from Claims Examiner II (November 2014 - November 2015)
Education
Bachelor of Science - Clinical Psychology
Central Michigan University
Mount Pleasant, MI12.2026
Associate of Science - Psychology
Henry Ford College
Dearborn, MI11.2024
Skills
- Claims Operations Management
- Workflow Optimization
- High-Volume Production Management
- Process improvement strategies
- Regulatory Compliance
- Performance & Metrics Tracking
- Customer Experience Strategy
- Team Leadership & Development
- Cross-Functional Coordination
- Data Analysis & Reporting (PowerBI, Excel, Pivot Tables)
Accomplishments
- Reduced claim turnaround times through intake process redesign
- Maintained sub-3% call abandonment rate through workforce planning and forecasting
- Improved claim decision timelines with measurable efficiency gains and regulatory compliance
- Developed reporting frameworks to track team performance and operational trends
Timeline
Senior Claims Manager
AAA Life Insurance
10.2024 - Current
Claims Manager
AAA Life Insurance
04.2024 - 10.2024
Associate Claims Manager
AAA Life Insurance
09.2023 - 04.2024
Supervisor, Medicare Member Services
Molina Healthcare, Inc.
01.2023 - 09.2023
Supervisor, Medicaid Claims
Molina Healthcare
10.2021 - 01.2023
Team Lead
Molina Healthcare, Inc
07.2016 - 10.2021
Senior Claims Examiner
Molina Healthcare, Inc
11.2015 - 07.2016
Bachelor of Science - Clinical Psychology
Central Michigan University
Associate of Science - Psychology
Henry Ford College