- Provide advice to claims reception department and registration officers to segregate claims properly based on policy.
- Provide expertise to claims entry officers to ajudicate claims as per polciy terms and conditions.
- Coordinate with insurance company for health care providers payments
- Conduct weekly meeting with Claims entry officers to enhance the quality of daily task and improve daily productions.
- Prepare cliams processed reports and dispatch processed claims to insurance company for payments.
- Notify claims processed report and payment bank trnafer copy to providers.
- Generate and report weekly and monthly production reports to Claims manager.
- Led a team of 5 – 7 claims representatives
- Reviewed claims for proper coverage, evaluation and disposition.
- Trained new representatives in all aspects of claims handling, software usage, evaluation, negotiation and settlement practices.
- Interviewed prospective applicants for open positions when applicable.
- Created individualized performance improvement plans when necessary.
- Verified customer details and lodged claim as a process initiation.
- Interviewed insured, claimants, and witnesses and collected information
- Approved and processed assessment reports and invoices for motor and property.
- Identified the possibilities of coverage and taken cogitative decisions.
- Arranged emergency assistance for the customers in a religious manner.
- Developed and maintained working relationships with other claims professionals.
- Organize and coordinate work activities to maximize resources and exceed production standards
- Identify and Recommend process improvements to streamline operations and create efficiencies
- Prepare stats and summaries for monthly / quarterly reports
- Demonstrate creativity in evaluating alternatives and recommending solutions in order to exceed customer expectations
- Increase efficiency and promote opportunities for cost savings by collaborating with other departments on process improvement projects
- Trained, supervised, and monitored performance of examiners processing property claims filed against the City of New York.
- represented the Comptroller in court and moderated 50-H in house hearings with claimants.
- Reviewed auto and property loss appraisals, photographic evidence, police incident reports, in order to determined liability, and would authorize equitable settlements with carriers subrogating for the loss or directly with claimants when applicable to prevent costly litigation expenditures.
- Applied proficient technical skills in operating PenPro appraisal application, Windows XP, Word, and OAISIS claims management database.