Tammie Thompson
Middletown,CT
Summary
Highly-motivated employee with desire to take on new challenges. Strong work ethic, adaptability, and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills.
Overview
19
19
years of professional experience
Work History
Senior Long Term Disability Claims Specialist
MetLife
Oriskany, NY
11.2021 - 03.2024
- Review & evaluate new and ongoing Short-Term & Long-Term Disability claims to determine liability
- Make accurate, timely decisions on claims based on contract/ plan provisions, guidelines and through analysis of information/ documentation provided by claimants, employers and physicians
- Identifies and forwards appropriate claims for development by specialized internal & external resources in such areas as rehabilitation, investigations, medical examinations/ consultations
- Applies disability management principles within established guidelines
- Investigates any questionable aspects of claims
- Promptly respond to telephone and written inquiries from claimants, physicians & policyholders while maintaining favorable rapport with internal and external customers
Claims Analyst
Travel insured International
Hebron, CT
02.2019 - 11.2021
- Knowledge of principles and processes for claim examination and evaluation
- Collect information, effectively review and evaluate claims
- Using results of an evaluation to determine an appropriate resolution to the claim based on the policy provisions
- Demonstrate mastery of customer service call scripts within specified timeframes
Concierge Service Specialist
ConnectiCare
Farmington, CT
09.2018 - 11.2018
- Give accurate and appropriate information to answer inbound call questions, troubleshoot issues, and resolve concerns
- Facilitate information flow between customer service and various departments to guarantee call center objectives are met
- Build member loyalty by placing follow-ups calls for those reporting healthcare issues
- Demonstrate mastery of customer service call scripts within specified timeframes
Claims Reconciliation Analyst: Short Term Disability Claims Manager
MetLife
Bloomfield, CT
07.2016 - 12.2017
- Review & evaluate new and ongoing Short-Term & Long Term Disability claims to determine liability
- Make accurate, timely decisions on claims based on contract/ plan provisions, guidelines and through analysis of information/ documentation provided by claimants, employers and physicians
- Identifies and forwards appropriate claims for development by specialized internal & external resources in such areas as rehabilitation, investigations, medical examinations/ consultations
- Applies disability management principles within established guidelines
- Investigates any questionable aspects of claims
- Promptly respond to telephone and written inquiries from claimants, physicians & policyholders while maintaining favorable rapport with internal and external customers
- Knowledge of principles and processes for claim examination and evaluation
- Collect information, effectively review and evaluate claims
- Using results of an evaluation to determine an appropriate resolution to the claim based on the policy provisions
- Demonstrate mastery of customer service call scripts within specified timeframes
- Give accurate and appropriate information to answer inbound call questions, troubleshoot issues, and resolve concerns
- Facilitate information flow between customer service and various departments to guarantee call center objectives are met
- Build member loyalty by placing follow-ups calls for those reporting healthcare issues
- Demonstrate mastery of customer service call scripts within specified timeframes.
Claims Reconciliation Analyst: Call Support Specialist
MetLife
Bloomfield, CT
10.2013 - 07.2016
- Outbound / inbound calls to physician offices and hospitals
- Send approved correspondence to customers or appropriate parties as needed
- Remain accessible to achieve appropriate service levels
- Clarify the needs of the customer, answer customer inquiries, and assist in the resolution of concerns
- Document customer contacts and claims, as appropriate
- Maintain common online files regarding specific activities
- Back-up Workers' Compensation, Unival and Surveillance Investigation Team
- Mentor/ cross-trained new hires, Interns and temporary employees.
Claims Reconciliation Analyst: Benefits Claim Manager
MetLife
Bloomfield, CT
05.2007 - 10.2013
- Researching problem claims and gather additional eligibility information when needed
- Structure Short-Term, Long Term and No Lost Time Restriction Claims
- Provide information to internal and external customers/ Conference calls
- Mentor/Train new hires or interns on the BCM process
- Weekly and quarterly reports for independent medical examinations
- Coordinate requests for independent medical examinations with Unival
- Diary Worker's Compensation notifications
- Back-up Payroll Team.
Short Term Disability Case Manager
MetLife
Bloomfield, CT
09.2006 - 05.2007
- Review & evaluate new and ongoing Short-Term Disability claims to determine liability
- Make accurate, timely decisions on claims based on contract/ plan provisions, guidelines and through analysis of information/ documentation provided by claimants, employers and physicians
- Identifies and forwards appropriate claims for development by specialized internal & external resources in such areas as rehabilitation, investigations, medical examinations/ consultations
- Applies disability management principles within established guidelines
- Investigates any questionable aspects of claims
- Promptly respond to telephone and written inquiries from claimants, physicians & policyholders while maintaining favorable rapport with internal and external customers
PFS New Business Service Rep II/ NOGO Team Specialist
MetLife
Hartford, CT
09.2005 - 09.2006
- Serves as a key member of the Primerica Financial New Business Team
Accurately process incoming Variable Annuity New Business applications - Call agents for any additional information that is needed for processing
Respond to request for status, acknowledge underwriting requirements and issue new business policies according to state requirements and ensure compliance by obtaining all required forms and adhering to SEC - NASD and Citigroup requirements
- Ensured accurate balancing and tallying of split sales for the team
Education
Bachelor of Science - Psychology
Charter Oak State College
Skills
- Analytical
- Communication
- Customer Service
- Empathetic
- Information Technology
- Numeracy
- Organizational skills
- Problem Solving
- Team Player
- Timeliness
References
References available upon request.
Timeline
Senior Long Term Disability Claims Specialist
MetLife
11.2021 - 03.2024
Claims Analyst
Travel insured International
02.2019 - 11.2021
Concierge Service Specialist
ConnectiCare
09.2018 - 11.2018
Claims Reconciliation Analyst: Short Term Disability Claims Manager
MetLife
07.2016 - 12.2017
Claims Reconciliation Analyst: Call Support Specialist
MetLife
10.2013 - 07.2016
Claims Reconciliation Analyst: Benefits Claim Manager
MetLife
05.2007 - 10.2013
Short Term Disability Case Manager
MetLife
09.2006 - 05.2007
PFS New Business Service Rep II/ NOGO Team Specialist
MetLife
09.2005 - 09.2006
Bachelor of Science - Psychology
Charter Oak State College
Similar Profiles
Khalan TolsonKhalan Tolson
Senior Risk Analyst & Policy Underwriter at MetlifeSenior Risk Analyst & Policy Underwriter at Metlife
Rup RoyRup Roy
Senior Data Engineer at MetLifeSenior Data Engineer at MetLife
Brock BurdexBrock Burdex
Sr Customer Care Consultant at MetlifeSr Customer Care Consultant at Metlife
HITESH JHAHITESH JHA
Specialist at MetLifeSpecialist at MetLife
Kaylah ChapmanKaylah Chapman
Dietary Aide at Middlesex HospitalDietary Aide at Middlesex Hospital