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Progressive Insurance - Medical Claims Leader and Claims Representative Resume Example

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Alexa Coleman
  • XXXXX XXXX XXXXXXXX XXXXX, New Port Richey, FL 34653
  • H: XXXXX XXXXXXXX
  • XXXXXXXXXXXXXXXX
Summary

Outstanding background of leadership in medical and property claims with a record of success revitalizing and restructuring Medical Claims operations. Extensive experience implementing cultural change, training staff and driving dramatically improved customer satisfaction statistics. History of achieving exceeds expectation audit ratings.


Skills
  • Appraise Service
  • Monitor Progress
  • Negotiation
  • Audit Records
  • Speak in Public
  • Facilitate Meetings            
  • Resolve Complaints                           
  • Meet Deadlines
  • Check for Accuracy                           
  • Mentor Others                                    
  • Set Goals/Objectives
  • Create Procedures                              
  • Interview People
  • Decrease Costs
  • Identify Solutions


Experience
Medical Claims Leader and Claims Representative, 01/1997 to 01/2013
Progressive Insurance Salt Lake City, UT
  • Led a team of 8 representatives handling Utah Personal Injury Protection (PIP) benefits. Department handled multiple jurisdictions as needed, including MEDPAY.
  • Primary roles included risk management, quality assurance, and performance management. Wrote and administered performance management reviews.
  • Consulted with Human Resources regarding team performance issues.
  • Responsibilities included anticipating claims issues, developing actions likely to increase revenue/profits, and implementing ideas to resolve performance issues.
  • Provided feedback in daily reviews, monthly coaching and yearly appraisals.
  • Held production meetings, monitored customer service, and negotiated independent medical exams with independent vendors.
  • Participated in hiring process.
  • Handled an inventory of complex PIP medical claims with an inventory up to 130.
  • Resolved liability and damages for motor vehicle loss claims.
  • Achieved outstanding annual corporate audit results with a perfect team score.
  • Resolved substantial short staffing due to long-term employee medical leaves.
  • Trained new employees, wrote and presented seminar on performance management.
  • Launched and pursued a change in subrogation that resulted in substantial cost-savings.
  • Created Great West Business Unit operating procedures for handling claims.
Event Services Specialist, 01/2002 to 02/2002
Salt Lake Organizing Committee for the 2002 Olympic Winter Games Salt Lake City, UT
  • Provided customer service for athletes, International Olympic Committee officials and the NBC broadcast team.
  • Trained in dealing with persons of other cultures, languages and with disabilities.
  • Assisted United States Secret Service with security screening at the Salt Lake Ice Center, the venue for figure skating and short track speed skating.
Assistant Claims Supervisor and Sr. Claims Examiner, 01/1992 to 01/1996
Principal Financial Group Salt Lake City, UT
  • Supervisory role included hiring and performance appraisals.
  • Claims payments by the team exceeded $15 million annually.
  • Volunteered for teams handling scheduling and budgeting.
  • Did daily claim reviews that improved team accuracy.
  • Processed medical bills, met daily quotas.
Education
Bachelor of Arts: English, Jan 1995 State University of New York - Buffalo, NY
Community Service

Volunteer and Contributor, Utah Dream Center, an outreach to immigrant and impoverished groups in the Salt Lake City metro area, 2004-2014.

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Resume Details

This is a real resume for a Medical Claims Leader and Claims Representative in New Port Richey, Florida with experience working for such companies as Progressive Insurance, Salt Lake Organizing Committee For The 2002 Olympic Winter Games, Principal Financial Group. This is one of the hundreds of Medical Claims Leader and Claims Representative resumes available on our site for free. Use these resumes as templates to get help creating the best Medical Claims Leader and Claims Representative resume.

Previous Companies:

  • Progressive Insurance
  • Salt Lake Organizing Committee for the 2002 Olympic Winter Games
  • Principal Financial Group

Previous Job Positions:

  • Medical Claims Leader and Claims Representative
  • Event Services Specialist
  • Assistant Claims Supervisor and Sr Claims Examiner

Schools:

  • State University of New York

Level of Education:

  • Bachelor of Arts

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