Proven expertise in insurance products, service and company needs. Familiar with analyzing documentation, liaising between parties and handling both routine and complex issues each day. Strong work ethic, adaptability and exceptional interpersonal skills. Adept at working effectively unsupervised and excepting any challenge given.
Overview
23
23
years of professional experience
1
1
Certification
Work History
Insurance Specialist
B&G Food Enterprises, LLC
Morgan City, LA
08.2012 - Current
Developed and implemented employee benefit plans, policies, and procedures.
Provided guidance to employees regarding their benefits package.
Managed the administration of all health, dental, and vision insurance plans.
Participated in open enrollment meetings with employees to discuss available options.
Conducted quarterly claim meeting with health insurance broker
Evaluated requests from employees for changes in their benefits plan coverage.
Coordinated benefits processing, including enrollments, terminations and claims.
Conducted investigations to gather evidence in support of claims resolution.
Analyzed claim data to identify trends and recommend process improvements.
Investigated fraudulent claims by gathering evidence from various
sources.
Gathered proper documentation and data to prepare claims for submission.
Reviewed coverage determinations, investigated and evaluated claims and negotiated settlements.
Saved data from surveillance footage for claims
Gathered and documented evidence to support court proceedings.
Reduced loss ratios through fair and prompt processing of claims.
Coordinated with external parties such as attorneys and adjusters during investigations and claim process.
Demonstrated leadership by making improvements to work processes and helping to train others.
Maintained updated knowledge through continuing education and advanced training.