Experience

The IMA Group

• United States
• Hospitals and Health Care
• 200 - 300 Employee

• Case Manager Team Leader

  • Mar 2010 - Present



Harleysville Insurance

• United States
• Insurance
• 400 - 500 Employee

• Sr. Claims Specialist

  • Nov 2003 - Jan 2010

  An experienced claim representative with expertise in negotiating, problem solving and trouble shooting medical and life claims. Strong organizational, caseload management, and attention to detail skills. Excellent oral and written communication skills. An experienced claim representative with expertise in negotiating, problem solving and trouble shooting medical and life claims. Strong organizational, caseload management, and attention to detail skills. Excellent oral and written communication skills.



AIG

• United States
• Insurance
• 700 & Above Employee

• No-Fault Claim Representative

  • Apr 2001 - Nov 2003

  Responsible for managing No Fault medical payment claims involving two No-Fault states and six medical pay states. Managed a caseload of 130 pending claims within the eight state guidelines consistently exceeded goals for accuracy and payment deadlines. Negotiated claims with plaintiff attorneys and insureds to avoid the legal costs of arbitration and lawsuits. Investigated state statutes and interpreted medical records to assess claim liability. Collaborated with the Nurse Consultant, defense attorneys and the Special Investigation Unit to resolve claims. Successfully communicated technical and hard to deliver messages to customers and attorneys in writing and by phone. Recognize and gather information for subrogation department.