Sandy Luke
Sandy Springs,GA
Summary
Experienced insurance professional with a decade of industry knowledge, adept at navigating procedures and claims processes. Posses a strong foundation in insurance principles and risk assessment, with a keen interest in analyzing data and making informed decisions. Committed to continuous learning and growth. Excellent analytical and problem-solving skills, along with a strong ability to adapt to changing industry regulations and guidelines.
Overview
10
10
years of professional experience
7
7
years of post-secondary education
1
1
Certification
Work History
HCCS Stewardship Claim Specialist
State Farm
6 2022 - Current
- Manage 100+ high volume claims effectively by prioritizing tasks and demonstrating excellent organizational skills.
- Collaborate with management to resolve escalated cases by offering dispute resolution methods, resulting in positive outcomes.
- Align technology solutions with enterprise goals to support and enhance overall business operations.
- Streamlined the claims process by developing standardized document templates, improving overall efficiency and consistency
- Maintained compliance with industry regulations by staying up to date on changes in policies and procedures, ensuring proper handling of sensitive information
Express Claims Associate
State Farm
05.2017 - 06.2022
- Established strong reputation for delivering quality claim handling and outstanding customer service, ensuring customer satisfaction and positive experiences.
- Utilized specialized claims management software or systems to efficiently handle and process claims, ensuring accurate documentation, streamlined workflows, and generating insightful reports.
- Conducted thorough investigations for each claim, diligently evaluating facts, educating customers on relevant coverages, and ensuring prompt and accurate payment according to policy/contract terms.
- Led huddles within the enterprise, coaching team members on best claims practices, and providing training and mentorship to enhance their skills and knowledge.
- Served as team and division's Subrogation Champion, demonstrating expertise in subrogation efforts, and driving successful outcomes.
Licensed Health Insurance Agent
United Healthcare/Teleperformance
08.2015 - 05.2017
- Conducted thorough verification of insurance coverage by phone and online, ensuring accurate reimbursement of benefits and estimating patients' financial responsibilities.
- Efficiently managed scanning, receiving, and sending of faxes to insurance claims, co-pay assistance information, and patient documentation, ensuring timely and secure handling of sensitive information.
- Utilized customer relationship management (CRM) software, sales tracking tools, or analytics platforms to manage leads, track sales activities, and analyze performance data.
- Consistently exceeded company goals, achieving outstanding sales performance, and ranking as one of the top 50 producers.
ER Patient Administration Registrar Team Lead
Indian River Medical Center
03.2014 - 03.2015
- Communicated verification and authorization status updates with Utilization and Management department to facilitate decision-making for patient admissions and insurance coverage.
- Facilitated communication between patients and doctors while using multiple systems and working with high caseloads in complex environment.
- Motivated team members on how to apply administrative knowledge and ensured team effectively carried out organizational goals daily.
Education
Bachelor of Arts - Business- Organizational Management
Indian River State College
Ft. Pierce, FL 09.2013 - 05.2017
Associate of Arts - Nursing
Indian River State College
Ft. Pierce, FL 09.2009 - 05.2013
Skills
Attention to Detail
Accountability/Reliability
Critical Thinking
Organization
Leadership
Trend Analysis
Growth Mindset
Certification
AIC/ CPCU- Continuing Education, 2020, Present
Accomplishments
- Recognized for having the highest Subrogation referrals in the division-2019/2020.
- Successfully collaborated with a team of managers with the guidance and development of New Hires.
- Trained and mentored Auto Claims Associates -08/2020- 06/2022- Resulting in their claims success and promotions to advanced roles.
- Achieved On the Spot Awards (2017-2023) for quality claim handling and going above and beyond to impact the enterprise.
Volunteer Experience
State Farm, Women in Technology ERG Member, Organizing/participating in school supply/backpack drive
Timeline
Express Claims Associate
State Farm
05.2017 - 06.2022
Licensed Health Insurance Agent
United Healthcare/Teleperformance
08.2015 - 05.2017
ER Patient Administration Registrar Team Lead
Indian River Medical Center
03.2014 - 03.2015
Bachelor of Arts - Business- Organizational Management
Indian River State College
09.2013 - 05.2017
Associate of Arts - Nursing
Indian River State College
09.2009 - 05.2013
HCCS Stewardship Claim Specialist
State Farm
6 2022 - Current
Similar Profiles
ALBERTO ESCOBAR RUIZALBERTO ESCOBAR RUIZ
Claim Specialist; and Producer at State Farm Corporate & State Farm AgencyClaim Specialist; and Producer at State Farm Corporate & State Farm Agency
Bethany GandyBethany Gandy
Insurance Customer Service Specialist at Brian Moore State Farm & Brent Holman State FarmInsurance Customer Service Specialist at Brian Moore State Farm & Brent Holman State Farm
Celine ZhongCeline Zhong
Customer Service Representative at State FarmCustomer Service Representative at State Farm
Blake EnosBlake Enos
Underwriting Service Assistant at State FarmUnderwriting Service Assistant at State Farm
Jonathan BrandesJonathan Brandes
Multi-Unit General Manager at Sterling Culinary ManagementMulti-Unit General Manager at Sterling Culinary Management