Hi, I’m
Ronald D. Pope, M.B.A.
Quality Assurance Manager And Excess Loss Analyst
San Diego ,California
Summary
Professional in insurance sector with robust background in claims analysis. Known for meticulous approach to examining claims and supporting team objectives through effective collaboration. Reliable and adaptable, consistently contributing to process improvements and accurate claims resolutions. Proficient in problem-solving and critical thinking.
Overview
1
Certification
Work History
TransGeneral Life Insurance Co.
Manager of Claims and Quality Assurance
03 2009 - 08 2018
Job overview
- Managed and motivated employees to be productive and engaged in work.
- Enhanced customer satisfaction by resolving disputes promptly, maintaining open lines of communication, and ensuring high-quality service delivery.
- Controlled costs to keep business operating within budget and increase profits.
- Resolved staff member conflicts, actively listening to concerns and finding appropriate middle ground.
- Managed budgets effectively, ensuring optimal financial performance while investing in necessary resources for business growth.
HealthAmerica, Inc.
Claims Analyst
02 2003 - 12 2008
Job overview
- Managed a team of junior examiners, providing guidance and training for improved productivity.
- Reduced claim resolution time by conducting thorough investigations and timely decisionmaking.
- Coordinated with medical professionals to obtain necessary documentation for evaluating injury claims accurately.
- Mitigated company risk by identifying fraudulent activities and implementing preventative measures.
- Contributed to company growth by consistently meeting or exceeding productivity targets without sacrificing quality standards.
- Collaborated with legal counsel on complex claims, ensuring compliance with regulatory guidelines.
- Played an integral role in upgrading company software systems to streamline daily operations efficiently.
- Negotiated settlements with claimants, balancing fairness with fiscal responsibility to the company.
- Worked with private investigators and attorneys on preparation of evidence, witness statements, and other documentation in preparation for trial.
Education
Waynesburg CollegeWaynesburg, Pennsylvania
Baccalaureate Degree from Education And Advanced Biological Sciences
Duquesne University Pittsburgh, Pennsylvania
Masters Degree from Healthcare Analytics And Business Administration
Skills
Document workflow
Team leadership
Operations management
Strategic planning
Decision-making
Performance management
Time management
Staff development
Workforce management
Customer service
Financial management
Business development
Project management
Business administration
Customer relationship management (CRM)
Staff management
Relationship building
Contract management
Cross-functional teamwork
Documentation and reporting
Verbal and written communication
Staff training and development
Negotiation
Goal setting
Sales management
Complex Problem-solving
Budget control
Task delegation
Performance evaluations
Multitasking Abilities
MS office
Teamwork and collaboration
Problem-solving abilities
Cross-functional team management
Disciplinary techniques
Networking strategies
Innovation management
Adaptability and flexibility
Excellent communication
Effective communication
Work Planning and Prioritization
Time management abilities
Analytical skills
Adaptability
Managing operations and efficiency
Attention to detail
Active listening
Certification
Certified Professional Coder - California and Pennsylvania 2025
Personal Information
Timeline
Waynesburg College
Baccalaureate Degree from Education And Advanced Biological Sciences
06.1993
Duquesne University
Masters Degree from Healthcare Analytics And Business Administration
01.2010
Manager of Claims and Quality Assurance
TransGeneral Life Insurance Co.
03 2009 - 08 2018
Claims Analyst
HealthAmerica, Inc.
02 2003 - 12 2008