Wendy Kay
Sacramento,USA
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
9
9
years of professional experience
Work History
Claims Specialist 1
Helmsman
10.2024 - Current
- Promoted within first year to Claim Specialist 1
- Create and implement resolution strategies for the investigations of claims to confirm coverage and to determine liability, compensability and damages.
- Enhanced customer satisfaction with timely communication, empathy, and clear explanations of claim outcomes.
- Managed a high volume of claims effectively by prioritizing tasks and maintaining excellent organizational skills of over 160 claims at times.
- Developed strong working relationships with external partners such as adjusters, legal counsel, and medical professionals to facilitate efficient claim resolution processes.
- Determines and establishes reserve as claim facts support, adjusting reserves, as claim facts change during the processing of the claim, refers claims to the subrogation group or Special Investigations Unit as appropriate and work closely with nurse case managers when needed.
- Priced out claims and conducts negotiations, within assigned authority limits, to settle claims and working with team manager on claims outside my assigned authority authorization to ensure timely settlements. Working closely with legal counsel on litigated claims to ensure settlements are offered timely and appropriately priced out.
- Involved in Advocacy Improvement Team committee that helps present across teams in my unit to improve and create more ways to improve injury workers experience.
- Analyzed claims to ensure compliance with policies and procedures. Collaborated with cross-functional teams to resolve complex claim issues effectively.
Leaves and Claim Specialist
The Larkin Company
11.2022 - Current
- Streamlined claims processing for multiple clients, enhancing operational efficiency.
- Administered leave of absence and workers compensation claims, ensuring compliance and communication.
- Coordinated ADA accommodation requests and light duty assignments for affected employees.
- Oversaw leave processes, maintaining communication with employees and external parties.
- Managed data collection and reporting within HRIS, ensuring accurate payroll coordination.
- Conducted eligibility research for claims, ensuring compliance with regulations and policies.
Home Loan Specialist
Golden 1 Credit Union
07.2021 - 11.2022
- Ensured timely ordering of title reports and appraisal follow-ups.
- Verified documentation accuracy, identifying gaps in research and required submissions.
- Maintained compliance with federal and state credit union regulations and laws.
- Calculated income and verified assets per investor guidelines and internal policies.
- Interpreted Desktop Underwriter findings for accurate loan processing.
- Updated Loan Origination System with current calculations before underwriting submission.
Teacher and Mentor
National Holistic Institute College Of Massage Therapy
01.2019 - 03.2022
- Enhanced student understanding through engaging anatomy and kinesiology instruction.
- Promoted HIPAA awareness, ensuring students understood essential healthcare regulations.
- Boosted student retention by actively participating in recruitment and retention events.
- Tracked student progress by grading projects, exams, and assignments effectively.
- Implemented focused instructional strategies to improve material comprehension among students.
- Maintained confidentiality while recording attendance, grades, and progress reports.
Compliance Advertising Specialist
American Pacific Mortgage
01.2017 - 12.2019
- Strengthened communication with marketing to enhance cross-departmental relationships.
- Regularly consulted specialists to ensure compliance with multi-state marketing requirements.
- Evaluated marketing strategies to identify potential liabilities and compliance actions.
- Implemented regulatory policies across various branches and programs effectively.
Education
Nationally Certified Massage Therapist - Neuromuscular Massage Therapy
Southern School of Neuromuscular Massage Therapy
Charlotte, NCSkills
- Policy Interpretation
- Claims Management
- Settlement Negotiations
Timeline
Claims Specialist 1
Helmsman
10.2024 - Current
Leaves and Claim Specialist
The Larkin Company
11.2022 - Current
Home Loan Specialist
Golden 1 Credit Union
07.2021 - 11.2022
Teacher and Mentor
National Holistic Institute College Of Massage Therapy
01.2019 - 03.2022
Compliance Advertising Specialist
American Pacific Mortgage
01.2017 - 12.2019
Nationally Certified Massage Therapist - Neuromuscular Massage Therapy
Southern School of Neuromuscular Massage Therapy