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Claims Supervisor Resume Samples
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0-5 years of experience
- Supervised and oversaw the day-to-day workflow operations for a team of 26 claims examiners to ensure employees' production and standards were met and claims were processed timely
- Planned, organized and prioritized duties and assignments along with training while simultaneously meeting management duties and expectations
- Maintained daily communication with staff, scheduled telephonic conferences to perform one-on-one performance and progress feedback
- Tracked and monitored staff's daily attendance for payroll and accountability
- Evaluated staff and cross-trained examiners on processing other types of claims to include: dialysis, hospital, ambulatory service center and ambulance claims
- Provided telephonic remote support, troubleshot and resolved system error
6-10 years of experience
- Managed 6 Commercial Liability Claims Representatives, including all personnel functions
- Approved Coverage position letters and Liability denials to be submitted to the client
- Produced superior results in file reviews
- Provided exceptional training for less experienced Claim Representatives
- Achieved 96% 24 hour contact compliance
- Supervisory diary compliance within 90 days at 95%
- Received Top Talent and Exceeds Expectations on all performance reviews
0-5 years of experience
- Managed a team of 30 across all areas of VISA/CBSI claims teams
- Responsible for ensuring client timeframes were met or exceeded, that all claims were accurately addressed within a timely matter
- Handled escalations from banks and CBSI. Balanced client expectations with a positive experience for card holders
- Ensured all electronic and paper mail was processed efficiently and assigned to each claim within 12 hours
- Set training and development goals for each employee and followed up to track progress
- Identified and tracked claim related trends, gathered data, and communicated to leadership
- Created and maintained all claims related spreadsheets to efficiently resolve issues as they arise
- Maintained close relationships with all clients- set weekly client calls with underwriter to align and clarify policy
- Became main POC for client relations and our clients
6-10 years of experience
- Management of complex medical malpractice claims involving both hospital and physician claims
- Supervisory responsibilities for two field representatives to assure prompt and quality handling of claims
- Developed and implemented legal audit program aimed at controlling defense expense costs and informed selection of defense counsel
- Participated in training program on communication (Listening, the Forgotten Skill) to conduct the program for other employees.
- Chaired task force on healthcare reform involving coordinating meetings, assigning tasks for research, and management reporting
0-5 years of experience
- Reviewed claims files to ensure proper claims handling
- Developed and mentor adjusters to improve claims handling skills
- Motivated team members to achieve a personal and company goals
0-5 years of experience
Managing the day to day activities of six Leave coordinators, and two administrative assistants.
- Managing statistical data to ensure that claims met the desire turn around times and Metrics.
- Attending to clients meetings and calls to ensure the client's needs are being met.
- Advising FMLA staff in proper claims decision making
- Preparing Statistical reports for management reviews.
- Coaching and development of Leave coordinator via monthly One on One meeting and weekly team staff meetings.
0-5 years of experience
- Responsible for leading and managing a high performing Team of 9+ Personal Auto Claim Professionals in a dynamic, fast paced production environment.
- Provided effective leadership and coaching to ensure staff consistently met and exceeded claim handling metrics, quality standards and customer service expectations, while maintaining financial discipline.
- Facilitated a high performance culture by aligning individual goals, differentiating performance through evaluation and recognition, and managing performance improvement issues swiftly and appropriately.
- Harvest Champion for the Centralized Claims Services organization, responsible for instilling a culture of continuous improvement through collaboration with other departments to help the organization achieve and maintain superior performance.
- Earned The Hartford's "Communications" (Core, Supervisor) Capability Badge for the consistent use of various communication methods.
- Earned The Hartford's "Talent" (Core, Supervisor) Capability Badge for demonstrating an ability to maximize personal development and teammate's development through strategic mentoring and providing opportunities to develop staff for future roles.
0-5 years of experience
- Manage a staff of 19 examiners monitoring process to ensure accurate and timely handling of all claims
- Develop and implemented plans for claims operational process, procedures and optimization of workflow
- Assist in hiring and training new candidates in their job responsibilities
- Monitor individual performance and ensure it meets expected quality and performance objectives
- Responsible for reviewing and auditing files for compliance, results, coaching, learning and accuracy, assisting claims examiners
0-5 years of experience
Responsible for processing and managing claims.
- Authorized and processed insurance claims for customers who needed to utilize services due to vehicle discrepancies.
- Entered data into an inhouse database filing system.
- Assisted front desk in renting vehicles to customers and providing customer service.
- Performed accounts receivable and payable duties.
- Assisted in car transport from and to other locations.
- Executed administrative duties such as data entry, copy jobs, and faxing.
- Responsible for conducting vehicle inventory audits daily.
0-5 years of experience
- Supervise 8-10 Claims Representatives.
- Mentor, coach, and train personnel.
- Assess claims processes and develop strategies to maintain or improve performance.
- Conduct case reviews and evaluate adjuster's performance by continuous review of claims statistics, open and closed
- Monitor claims that meet a high exposure loss profile and /or files where the claims investigation has revealed
- Adhere to the Rules and Regulations set forth by the Department of Insurance, state specific.
6-10 years of experience
- Supervise a team of 10 medical claims examiners overseeing daily quality, production, and workload
- Subject Matter Expert on the claims processing system and processing guidelines
- Developed training material for new processing platform and conducted trainings for classes of up to 20 people
- Work closely with upper level management on operational projects and restructuring
- Manage employees' daily production spreadsheets and data base for monthly reporting
- Work directly with clients to meet their needs and resolve any escalated issues/questions
0-5 years of experience
- Analyzed claims inventory using Excel and Access
- Managed staff and assignments
- Hired, trained, disciplined staff
- Implemented best practices aids
- Engaged with providers to resolve claims issues
0-5 years of experience
- Hired as an Extended Claims Representative evaluating complex bodily injury claims
- Promoted to Claims Supervisor in October 2016 overseeing 5 claim representatives
- Excels in development of claim representatives by providing industry and claims knowledge while promoting self confidence
- Provides superior customer service to agents, policyholders and claimants
0-5 years of experience
Interview and train new staff on procedures and job-related functions.
- Communicated appropriate information to staff.
- Supervised 7 technical staff.
- Jurisdictions supervised; GA, TN, AL, NC and SC
0-5 years of experience
- Manages a team of nine employees handling disputed liability claims and small BI.
- Provides coaching and development for team throughout the claims process.
- Helps to resolve coverage and liability disputes escalated to my attention.
- Responsible for settlement approval.
0-5 years of experience
- Responsible for understanding and communicating client performance guarantees to staff.
- Supervise, provide direction and mentor assigned staff, providing feedback on performance and developing/implementing actions plans for improvement.
- Evaluate and control workflow within the team. Ensure processor assignments are appropriately aligned to ensure performance guarantees are met.
- Develop and implement action plans for improvement.
- Develop training programs to address specific individual and/or team needs.
- Effectively communicate with the client to create an implement any new/changing policies and pratices.
10+ years of experience
- Supervise 15 third party administrator claims staff to ensure consistent execution of claims practices
- Interview, select and train third party administrator claims staff; interpret and communicate work procedures and company policies
- Recognize and analyze trends across the claims portfolio at the adjuster, unit and account levels
- Assign and review unit functions to confirm appropriate claim reserves and accurate documentation
- Develop and facilitate ongoing professional and leadership development for TPA unit personnel
- Evaluate employees' job performance and conformance, identify causes and issues, recommend appropriate personnel action as needed
- Measure customer and store service satisfaction; develop improvement strategies and training
- Recommend, develop, and implement short range objectives in accordance with company goals, guidelines and programs to save time, money and resources
0-5 years of experience
- Supervision of 18-27 claims processors
- Focus on Medicaid Acute, Integrated, and Dental claims
- Communicate quality and production reports to processors and leadership
- Provide corrective action and improvement plans when required
- Partner with other departments to develop and maintain processes
- Utilized as Subject Matter Expert to analyze and resolve claims issues
- Distribute and manage work via reports and spreadsheets
0-5 years of experience
Transferred from a different department in Nationwide where I was a supervisor as well. Became familiar with claims processes and vendors that Nationwide used to service customers.
- Responsible for daily supervision of department direct reports.
- Responsible for intraday changes due to service levels.
- Assists associates with claims questions and escalations.
0-5 years of experience
Receive and process transit damage claims for high profile clients.
- Monitor claims from start to finish, verifying and updating information on submitted claims.
- Reviewing policy of Carrier's relating to transit damage to determine which charges are eligible for reimbursement or file of a formal claim.
- Configure the exact claim amount from the loss freight utilizing lbs. and CWT.
- Providing formal claims to Carriers to recover loss from damaged freight.
- Providing credits to high profile clients using SAP.
- Negotiate sale of damage freight to salvage companies for profit.
- Monitor, mentor, and train new associates.
- Approve submitted timecards.
0-5 years of experience
- Manage a team of 10 claims adjusters. Conduct monthly audits and file reviews to ensure that goals are in line with company and Department of Insurance standards. Daily meetings with divisional manager and director to discuss team development and goals. Handle escalated situations to diffuse and resolve situation.
- Conduct interviews for potential employees. Track and monitor attrition patterns to improve turnover ratios within the department. Attend college career fairs and job placement events looking for potential employees.
- Manage team leads with coordinating training for new hires. Track and monitor opportunities for representative development and growth. Adjust department training to meet the needs of new representatives within the company.
- Develop goals to reduce cost leakage to increase company profitability. Review reports monthly to ensure direct reports are containing cost and reducing claim cycle time.
0-5 years of experience
- Review and coordinate the investigation of fronted, multi-state casualty claims as reinsurer to the explosives industry
- Supervise claims handling by independent adjusters
- Perform insurance presentations for National Accounts
- Perform various administrative and personnel duties for the claims department
0-5 years of experience
- Packing, Shipping, and Distribution of Facility Claims
- Contact and Correspondence with Manufacturers
- Customer Service and Satisfaction
- Loss Prevention
0-5 years of experience
- Supervise, train, and evaluate BI and PD adjusting staff
- Prepare company reports
- Provide file handling guidance, and coaching to team members and new adjusters
- Complete audits routinely to ensure file quality
- Answer DOI complaints
- Handle and diffuse escalated calls and/or claims issues
- Identify, recognize and review files for possible fraudulent claim activity.
- Negotiate, settle, and prepare documentation for salvage on total loss vehicles
- Assist and prepare files for litigation and/or subrogation.
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