Stacy Coulter
Gibbsboro
Summary
Claims professional with extensive experience excelling in policy interpretation and claims auditing. Proven track record of enhancing team performance and customer satisfaction through problem-solving and communication. Skilled in analyzing claims, resolving discrepancies, and ensuring compliance with regulations. Reliable and adaptable, consistently meeting evolving needs and challenges. Effective communicator with a proactive approach to problem-solving.
Overview
12
12
years of professional experience
Work History
Personal Injury Claims Supervisor
GEICO
Marlton, NJ
11.2024 - Current
- Supervised daily claims processing to ensure adherence to company policies and procedures.
- Mentored team members, fostering skill development and enhancing overall performance.
- Implemented workflow improvements that increased efficiency in claims handling operations.
- Analyzed claim trends to identify areas for process enhancement and risk mitigation.
- Resolved high-level customer escalations, balancing customer satisfaction with policy and compliance requirements.
- Performed detailed audits of claim files to ensure regulatory compliance and adherence to company standards.
- Conducted performance evaluations, providing constructive feedback to improve team effectiveness.
- Monitored performance metrics regularly, identifying areas for improvement and implementing corrective measures accordingly.
Senior Medical Claims Examiner
GEICO
Marlton, NJ
04.2016 - 11.2024
- Analyzed medical claims for accuracy and compliance with company policies.
- Reviewed and adjudicated complex high dollar claims with severe injuries and complex medical management with in New Jersey as well as combination New Jersey PIP and out of state claims.
- Worked closely with fraud investigation teams to identify suspicious patterns in submitted claims.
- Developed strong relationships with healthcare professionals, and attorneys fostering trust and cooperation for smoother claims processing.
- Managed a high volume of complex cases, ensuring timely resolutions while maintaining attention to detail.
- Consistently met or exceeded performance targets related to claim turnaround times, accuracy rates, and customer satisfaction metrics.
- Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
- Collaborated with healthcare providers to resolve discrepancies in claim submissions.
- Mentored other associates in the department on best practices for claim reviews and processing.
- Maintained state required licenses and CE courses
Replacement Account Representative
Hertz
Mt. Laurel, NJ
12.2013 - 04.2016
- Managed customer inquiries and resolved issues to enhance service satisfaction.
- Coordinated rental agreements and ensured compliance with company policies.
- Developed and strengthened existing business partnerships to foster loyalty and client retention.
- Analyzed customer feedback to identify areas for service improvement and training needs.
- Trained client employees on best practices to provide our mutual customers the best rental experience.
Education
Bachelor of Arts - Communications
The University of Arizona
Tucson, AZMaster of Arts - Organizational Leadership
Saint Joseph's University
Philadelphia, PASkills
- Claims management
- Policy interpretation
- Claims auditing
- Claims processing
- Teamwork
- Customer service
- Problem-solving
- Multitasking
- Excellent communication
Timeline
Personal Injury Claims Supervisor
GEICO
11.2024 - Current
Senior Medical Claims Examiner
GEICO
04.2016 - 11.2024
Replacement Account Representative
Hertz
12.2013 - 04.2016
Bachelor of Arts - Communications
The University of Arizona
Master of Arts - Organizational Leadership
Saint Joseph's University