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Customer Service Management

Location:
United States
Posted:
December 31, 2014

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Resume:

LuAnne Hughes

***** **** ** *., *******, fl *****

941-***-**** acg7g0@r.postjobfree.com

EXPERIENCE

SEPTEMBER 2012-OCT. MCIM SARASOTA, FL

2014

CLAIMS MANAGER

RESPONSIBLE FOR DEPARTMENT OF 20 ADJUSTERS AND ADMINISTRATIVE

STAFF, TO INCLUDE OVERSIGHT, PERFORMANCE EVALUATIONS, HIRING,

TRAINING AND COACHING.

Performed in depth and ongoing claim file reviews.

Drove litigation management, results and strategies.

Managed all aspects of reinsurance reporting.

Designed and implemented policies and procedures to enhance and

drive efficiencies and results. Continued the ongoing pursuit of

process improvement.

Brought company reserves in line with exposures and maintained

reserve integrity.

Restructured and relocated/centralized claims administrative staff

to reduce company expense and overhead. Recruited and interviewed

candidates for cross functional company restructure.

Actively collaborated with members of the underwriting and loss

prevention departments in all aspects of book of business

profitability. Participated in new business and renewal committee

meetings; bringing needed expertise from a claims and exposure

perspective.

Participated in high level strategic planning, budgeting and

project management.

Represented MCIM in marketing efforts to include agency,

policyholder and industry related conference attendance and

presentations.

April 2002 - September EMPLOYERS/AmCOMP Brookfield, WI

2012 ASSURANCE CO.

Claims Supervisor 2005-2012

RESPONSIBLE FOR DIRECT SUPERVISION OF THE CLAIMS DEPARTMENT

PERSONNEL AND CLAIM FILES.

Performed in depth claim file reviews on an ongoing basis to ensure

best practices and reserving policies were adhered to. Maintained

reserve accuracy of within 10% and audit scores of 95% or higher on

average.

Interviewed, trained, coached and conducted all performance related

functions including annual reviews, goal development, improvement

plans and terminations.

Oversaw and managed all vendor relationships to include defense

firms, case management, surveillance, etc.

Participated in claims reviews with policyholders as well as

prospect presentations.

SENIOR CLAIMS ADJUSTER 2002-2005

Aggressively managed a full case load of lost time and litigated

files to timely and cost effective resolution.

Worked closely with legal counsel, case managers, SIU vendors as

well other cost containment entities to mitigate overall claims

exposures.

Composed reports on high level claims for upper management.

Represented AmCOMP at prospect calls and agency visits.

Participated in all local hearings in person.

Provided outstanding customer service to agents, policyholders,

injured workers and internal customers in all departments.

Actively participated in monthly risk review meetings to analyze

book of business and form action plans.

January 1990 - April CNA Insurance Companies Brookfield, WI

2002

Claims Specialist

DURING THE LAST SEVERAL YEARS AT CNA MY RESPONSIBILITIES MIRRORED

THE ADJUSTER POSITION OUTLINED ABOVE.

Prior to becoming a claims adjuster, I held numerous positions to

include medical only examiner, underwriting secretary, human

resources technician and transcriptionist.

Education

1988-1990 Waukesha Co. Technical Waukesha, WI

College

Various Studies

COMPLETED NUMEROUS CLASSES INCLUDING MEDICAL TERMINOLOGY, SURGICAL

TECHNOLOGY, HUMAN ANATOMY AND COMPUTER SKILLS TRAINING.

Engaged in ongoing continuing education classes throughout my

career.

Licensed Florida Claims Adjuster, All Lines

References

References are available on request.



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