Compiles file documentation and correspondence requiring extensive policy and factual detail. Analyzes information to determine if additional information is needed to make a reasonable and logical claims determination based off the information available
Evaluate facts supplied by investigation to determine coverage, if any, and the extent of the company’s obligation to the claimant under the policy or plan document and in accordance with government guidelines
Demonstrated attention to detail when reviewing medical records, enabling accurate assessment of functional limitations caused by disabilities.
Mentored junior team members in handling complex cases, resulting in better decision-making and improved overall team performance.
Collaborated with healthcare providers to obtain crucial information, leading to more accurate and faster decision-making on claims as well as establishing a strong knowledge of basic medical terminology.
Provided exceptional service to clients through prompt response times, clear explanations of policy terms, and compassionate support throughout the claims process.
Managed high caseloads effectively, ensuring all disability claims were processed promptly and accurately.
Scenic City Bootcamp
Hixson, TN
Head Fitness Instructor
10.2014 - 03.2022
Job overview
Responsible for developing and implementing adaptable science based weightlifting high intensity interval training (HIIT) style classes for clients ranging in physical ability to accomplish goals of fat loss, muscle gain, and increased cardiac capacity
Introduced solution to meet market need of smaller group training classes, which contributes a monthly profit of $22,000
Expanded reach and breadth of small group classes, increasing availability by 300% and now taught by multiple instructors
Personally strategize nutrition and fitness goals with each of my 32 current clients, requiring customized communication and reporting mechanisms that will best serve each client as an accountability tool for long term success
Responsible and proficient at training new employees in all business areas and overseeing their progression until all training units are completed to business standards
Obtained and maintained a nationally accredited personal training certification through Action Sports, which required 20 hours a year of continuing education on how to train, educate and motivate my clients
Demonstrated ability to resolve conflicts and negotiate to reach successful resolution of issues as a liaison between staff fitness instructors and gym management
Cape Fox Professional Services
Contracts Administrator
02.2011 - 11.2011
Job overview
Demonstrated effective written and verbal communication skills through development and analysis of contracts and subcontracts regarding motorcycle safety courses for the Department of the Navy and Marine Corps
Built and leveraged strong partnerships with Government and subcontractor liaisons to identify and facilitate contract change request, service resolutions, and supplier contract compliance
Maintained an accurate and up-to-date contract database system in order to ensure efficiency at both the company and contract level
English as a Second Language
International Instructor
01.2012 - 05.2014
Job overview
Responsible for planning and instructing engaging lessons, often with minimal financial resources and learning materials available, to children from 3-18 years
Created monthly progress reports to and executed quarterly parent teacher conferences
Reviewed program reports with the school oversight committee to ensure school’s overall compliance with program initiatives and goals
Highest Award on Cambridge University Teaching Knowledge Test
Navy Engineering Logistics Office (NELO)
Arlington , VA
Security Specialist
05.2006 - 02.2011
Job overview
Maintained the highest level of Top Secret/SCI Clearance given to civilians
Acted as a liaison to provide federally regulated, multifaceted security and advisory oversight to current and bidding contractors on a variety of Top-Secret Naval contracts
Served as a team leader on the Security Inspection Audit Team, which verified that all aspects of a contractor’s security were in compliance with federal regulations
Developed reports and ratings based on contractor audit findings and implemented a corrective action plan to mitigate federal regulation compliance concerns
Made high-level decisions by adjudicating personnel against multiple program requirements for access to sensitive information
Revised and delivered general security training course that was required by all NELO employees
Education
East Tennessee State University
Johnson City, TN
Bachelor of Business Administration
05.2007
University Overview
Cum Laude
GPA: 3.65
Skills
Continuous learning mindset
Medical terminology knowledge
Documentation proficiency
Critical-thinking abilities
Claims Investigation and management
Policy analysis and implementation
Communication Skills
Timeline
Disability Claims Specialist
Unum Insurance
04.2022 - Current
Head Fitness Instructor
Scenic City Bootcamp
10.2014 - 03.2022
International Instructor
English as a Second Language
01.2012 - 05.2014
Contracts Administrator
Cape Fox Professional Services
02.2011 - 11.2011
Security Specialist
Navy Engineering Logistics Office (NELO)
05.2006 - 02.2011
East Tennessee State University
Bachelor of Business Administration
Similar Profiles
LUKE FOGGLUKE FOGG
Long-Term Disability Benefit Specialist at Unum InsuranceLong-Term Disability Benefit Specialist at Unum Insurance