Shawna Cartwright
Lawton
Summary
Dynamic Claims Manager with extensive experience at Wichita National Life Insurance Company, excelling in claims processing and regulatory compliance. Proven track record in dispute resolution and financial reporting, successfully reducing denial rates and enhancing operational efficiency. Proficient in strategic communication and relationship-building with stakeholders, driving significant outcomes
Overview
30
30
years of professional experience
Work History
Claims Manager
Wichita National Life Insurance Company
Lawton
11.2021 - Current
- Maintained accurate records of all claim activities including payments, denials and appeals.
- Prepared detailed reports on claim status and activities for management review.
- Reviewed and approved complex claim settlements, making sure they were within policy guidelines.
- Created processes for tracking open cases, monitoring progress towards resolution goals.
- Resolved escalated customer issues by providing effective solutions in a timely manner.
- Coordinated responses to regulatory inquiries and audits, ensuring timely and accurate compliance reporting.
- Negotiated with policyholders and third parties to resolve disputes, minimizing litigation risks and costs.
- Submitted clean claims to reduce denial rates, following payer reimbursement policies and procedures.
- Analyzed claims data to identify patterns, fraud risks, and areas for process improvement.
- Directed the application of reserves on claims, ensuring accurate financial reporting and compliance with regulatory requirements.
Underwriter
Wichita National Life Insurance Company
Lawton
07.1995 - 01.2009
- Consulted with legal counsel when necessary to resolve complex issues or disputes.
- Communicated effectively with lenders, brokers and other external partners involved in transactions.
- Verified accuracy of documentation such as income statements, tax returns, bank statements and other related documents.
- Provided guidance on underwriting procedures to junior staff members.
- Maintained accurate records of all transactions handled by the department.
- Utilized automated systems for processing large volumes of applications efficiently.
- Developed new underwriting strategies to reduce risks associated with issuing life insurance policies.
- Investigated potential claims involving high value cases requiring special handling.
- Participated in meetings with senior management personnel to discuss underwriting issues.
- Ensured compliance with state regulations regarding life insurance products.
- Verified accuracy of all documentation submitted by applicants for underwriting purposes.
- Reviewed and evaluated applications for life insurance policies to determine risk factors.
- Determined the amount of coverage based on applicant's age, health status, and lifestyle choices.
- Provided technical advice and guidance to agents concerning underwriting matters.
- Processed requests for policy changes such as increasing coverage amounts or changing beneficiaries.
- Maintained detailed records regarding completed underwriting assignments.
- Conducted interviews with applicants to clarify unclear or incomplete information.
- Analyzed medical records, financial data, and other pertinent information to assess applicants' insurability.
- Communicated decisions related to pending applications in a timely manner.
Education
All, Specialized in English, Spelling, Grammar
Eisenhower High Scholl
Lawton, OK05-1985
Skills
- Claims processing
- Regulatory compliance
- Customer service
- Effective communication
- Financial reporting
- Dispute resolution
- Audit coordination
- Disability claims process
- Insurance policy review
- Claims analysis
- Insurance regulations
- Coverage determination
- Reliability
- Task prioritization
- Written communication
- Payment authorization
- Multi-Tasking Capability
- Workload prioritization
Affiliations
- Extremely proficient in Microsoft Work, Excel, Microsoft Email, 10-key, Zoom, Microsoft Teams, verbal communication, and team building exercises.
- Able to work an 8-Line phone service, handling in-coming phone calls while taking messages and transferring calls.
- Able to maintain a professional relationship with customers, claimants, bankers, loan officers and co-workers.
References
References available upon request.
Timeline
Claims Manager
Wichita National Life Insurance Company
11.2021 - Current
Underwriter
Wichita National Life Insurance Company
07.1995 - 01.2009
All, Specialized in English, Spelling, Grammar
Eisenhower High Scholl
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