Customer Service Manager

Susan K. Regan

Cumming, GA ***** Cell: 770-***-****

***********@*****.***

Seeking a challenging career opportunity in which my business strengths and

excellent interpersonal skills and integrity can enhance the growth and

development of the organization.

Areas of Expertise

*Leadership & Staff Development *Strategic Planning *Multi-line Claims

Adjudication

*Process Development & *Financial *Client Retention

Execution Discipline

*Operating Initiatives *Business Growth *Program Development

Professional Experience

Chartis Insurance (AIG) 2008-present Alpharetta, GA

Manager, Accident & Health Division

Effectively implemented newly developed Accident & Health claims

organization to include: Medical, Occupational Accident, Critical Illness,

Trip Cancellation/Interruption and Indemnity business lines.

Ownership for average claims volume of 13,000 claims per year

Continuously lead staff to exceed service level objectives, while

maintaining a quality score of 90% or greater.

Develop and maintain relationships with internal and external customers

(Brokers, Agents, Vendors, DME, Nurse Case Managers, IME/FCE referrals,

translations services etc.) to build and enhance organizational value and

customer retention.

Coach, develop and mentor staff in areas of claims handling, cost

containment, relationship development, client retention, personal growth

and skill enhancement.

Participated as subject matter expert in development of claims auto-

adjudication process.

Perform quality audits to ensure compliance with state and federal

regulations.

Maintain Property & Casualty and Accident & Health license in multiple

states.

Sedgwick CMS 2006-2007 Atlanta, GA

Operations Manager

Leadership and ongoing execution for all of the key responsibilities

involved in a "start-up" implementation consisting of four business lines.

Also, successfully integrated 3rd party administrator business into the new

organization.

Responsible for approx. 90 claims professionals administering four business

lines: Worker's Compensation, Short Term Disability, Long Term Disability

and Family Medical Leave Act (FMLA), as well as 13 client specific Leave of

Absence programs.

Developed a staffing model and training initiatives throughout

implementation process.

Development and execution of efficient processes and procedures aimed at

meeting and/or exceeding client expectations to include: hiring and

oversight of contracted Physicians, R.N.s and vocational rehabilitation

experts.

Development of a claims triaging process and targeted review process to

enhance employee knowledge and skills resulting in a reduction in claims

cycle time.

Consistently led negotiations between the CWA Union Representatives, Client

Representatives and Claimants resulting in development of efficient claims

handling processes, superior customer service and client retention.

Hartford Accident & Life 2000-2006 Alpharetta, GA

Director of Claims, Asst. Director of Claims, Manager, Team Leader

Grew organization from "start-up" team of nine Examiners to four teams

consisting of 49 highly experienced claim professionals in four offices

across the country.

Responsible for a diverse workforce consisting of claims professionals,

administrative staff, medical and vocational professionals and management

staff.

Developed and mentored remote, inexperienced managerial staff, resulting in

highly skilled, independent leaders.

Responsible for development and execution of best practices for

adjudication of Long Term Disability (LTD) claims on which benefits had

been paid in excess of five years. Succeeded in a consistent 15% closure

rate on this book of business which previously had nominal closures.

Implemented aggressive growth strategy combined with consistent change

management techniques resulting in tremendous expansion in claims

throughput.

Increased employee morale and individual contributions through innovative

rewards and recognition programs and commitment to work-life balance

strategies.

Focused on development of efficient processes to determine initial claim

liability to include: development of preexisting claims investigation

program, which resulted in appropriate liability determinations.

Consistently surpassed defined objectives, by producing high volume, high

quality claims determinations.

UNUM Provident 1996-2000 Alpharetta, GA

Claims Manager, Disability Benefits Specialist

Led team of twelve LTD claims professionals with varying degrees of

experience.

Focused on efficient processes to determine initial claim liability.

Development and execution of effective pre-existing investigation training

program which lead to appropriate initial claims decisions.

Consistently surpassed individual contributor expectations as measured by

managerial reporting and audit reviews.

GA Dept. of Human Resources Decatur, GA

Social Security Benefit Specialist/Medicaid Specialist/ Senior Caseworker

Responsible for strict adherence to state regulations combined with

appropriate resource utilization to determine liability relative to

government sponsored disability programs; exceeded production expectations

consistently.

Accurately determined eligibility for government funded needs-based medical

and financial programs (AFDC & Medicaid) resulting in proper and timely

payments to those who qualify.

Developed superb customer service, interviewing and communication skills.

Adherence to state policies and procedures.

Developed superb interviewing and communications skills.

Foxhall Apartments Forest Park, GA

Property Manager

Responsible for daily maintenance of 49 unit apartment homes; increased and

maintained occupancy from 85%to over 95%through a variety of marketing

techniques.

Duties included accounts receivable, accounts payable and rent collections,

vendor relations, scheduling and supervision of a variety or service

providers

Offered superb customer service to disabled and elderly residents

Established neighborhood cohesiveness and increased quality of life through

development and execution of a Neighborhood Watch Committee, creation and

maintenance of a community newsletter. Assisted residents in locating

appropriate community resources based on personal needs

Sheltering Arms/United Way-Family Support Jonesboro, GA

Assistant Director

Responsible for tuition collection and follow up resulting in increased

income and timely payments.

Interviewed customers to determine eligibility for needs-based daycare

assistance.

Developed community outreach, networking services for 80+ families based on

individual needs.

Responsible for hiring and management of approximately twenty day-care

providers.

Managed day to day operations inclusive of hiring outside vendors,

community outreach, and fund raising.

Developed and executed a variety of staff development workshops.

Education

Shorter College Masters Degree, Business GPA

3.67

S.U.N.Y. StonyBrook University Bachelors Degree, Social Welfare

GPA 3.89

Clayton State College Medical Terminology- Continuing Education

Nassau Community College Associates, Liberal Arts

GPA 3.6

Volunteer Experience Additional Activities

Habitat for Humanity ToastMasters

Dekalb County Juvenile Court Public Speakers Association

Hands on Atlanta/Hands on Forsyth

Hosea Feed the Hungry

Boy Scouts of America

Professional & Personal References Available Upon Request

Contact this candidate