Customer Service Insurance
Resume:
NORMAN K. PRUSA
Home:440-***-****
Highland Heights, Ohio 44143 E-mail: ******@*******.*** Cell:
Insurance Claims Executive
V Motivational leader and team builder with proven track record of success.
V Adept at making significant process improvements and cost savings.
V Listens well and keeps everyone focused on the big picture. Led as many
as 640 associates.
V Superb analytical, research, organizational, presentation, PC and
written communication skills.
AREAS OF EXPERTISE
Process Improvement / Change Claim Audits
Management Profit / Loss Responsibility
Multi-Office Management Customer Service / Litigation
Budget / Policies & Procedures Control
Claims Management - Reserving, Personnel Administration / HR
Payment Processing, Investigations . Strategic Planning
. .
Work Comp. . . Auto. . .Property. . .Casualty. . .
SELECTED ACCOMPLISHMENTS and EXPERIENCE
> Developed easy to implement file diary system at Fireman's Fund.
Utilized same system successfully at Meridian Insurance.
> Introduced Autotech auto and property claims estimating to Ohio Region
of Meridian Insurance. Program adopted throughout company.
> Successfully introduced claims office litigation control at Meridian
Insurance.
> Produced savings in excess of $195,000 over one year and increased
productivity 20% - reduced use of independent adjusters, eliminated
unnecessary staff and related expenses, and reduced litigation expenses
at the Ohio Regional Office of Meridian Insurance.
> Implemented quiet time for inside claims adjusters at Meridian and Gates
McDonald, allowing adjusters time to review claim files, medical reports
and complete reports to file.
> Saved $175 million through successful rollout of Claims Management
Project - established highly effective claims management procedures;
planned, staffed, and organized physical facility; and put project in
place, all within 60 days at Ohio BWC.
> Reduced $30 million budget by $2 million without reducing staff -
effectively coordinated budget requests of 5 offices including
Underwriting, Claims, and Employer Services - utilized "sharing" of
clerical staff, staggered hiring dates, and made technical improvements
at Ohio BWC.
> Responsible for personnel administration (staffing authorization) for as
many as 640 employees, including claims, marketing, customer service and
underwriting professionals.
> Appeared before Ohio State Controlling Board to request additional
funding for various claims projects initiated at Ohio BWC.
> Generated ability to handle 42,000 lost-time and 135,000 medical-only
claims while reducing staff by 5, with no loss of service - identified
criteria for claims workload standards at Gates McDonald.
> Eliminated 30,000-claim backlog 60 days ahead of schedule - initiated
2nd shift of claims examiners to clear up backlog in Cleveland BWC
office.
> Improved employee accountability and work product - assembled teams that
identified and clarified work processes and procedures for underwriting,
claims and customer service at Ohio BWC.
> Markedly improved services, reduced complaints, and dramatically
improved morale - initiated and implemented team concept of handling
claims for various associations including NFIB, Chamber of Commerce,
Ohio School Board, etc at Gates McDonald.
> Improved employee review process - identified and established workload
standards for claims examiners, underwriting and customer service,
allowing for more objective annual reviews.
> Eliminated significant downtime, input errors and duplication of effort
- with assistance of technical staff, developed a well-received computer-
training course for claims staff.
> Represented BWC at legislative hearings regarding new claim management
projects. Appeared before state controlling board to request funding of
various projects.
(See Page Two)
NORMAN K. PRUSA Page Two
EMPLOYMENT SUMMARY
INDEPENDENT CONSULTANT
2004 - Present
Conducted investigations, claim audits and coverage reviews regarding work
comp, auto and general liability for various businesses. Made
recommendations as to settlement, course of continued claim handling by
TPA's and the purchase or exclusion of coverage.
NORMAN R. PRUSA, LPA, Cleveland, OH 1998
-2004
Research Analyst / Investigator (Interim position)
> Assisted in arbitration and mediation practice by conducting
preliminary legal research, findings, and summarizing cited cases for
legal arbitration and mediation hearings.
> Conducted confidential investigations on behalf of law firms and their
clients regarding auto, general liability and workers' compensation
claims.
MOR-FLO INDUSTRIES
1996 - 1998
Insurance Risk/Claims Director
Directed all insurance programs for company, including workers'
compensation,
commercial auto, property and product liability. Ensured all
inventory was covered in
owned and leased facilities. Directed TPA's in the handling and
adjudication of work
comp and health claims. Assisted and directed counsel in the
handling of lawsuits against
company.
> Maintained relationships with brokers and TPA's regarding changing of
coverage, status of claims, payments, status of litigation etc.
GATES MCDONALD COMPANY, Columbus, OH 1994 -
1995
State Fund Claims Operations Director
> Responsible for budget, staffing, training, and personnel
administration for 78 employees including 55 claim representatives, 3
supervisors, and 20 clerical associates handling lost-time and medical-
only managed care claims for 12,000 employers.
> Managed technical and procedural adherence of all claims.
> Contact and made presentations to both prospective and active clients
with regard to claim services and available reports.
BUREAU OF WORKERS' COMPENSATION, Cleveland, OH 1991 -
1994
Regional Director of Claims Operations
> Directed overall operations including budget, facilities, employer
services, claims handling and investigation, and claim payment
processing for 5 district offices in northeast Ohio.
> Responsible for staffing and personnel administration of 1200
employees, including claims, rehab, auditing, marketing and
underwriting professionals.
> Planned, staffed and implemented the various claims pilot programs in
Northeast Ohio. All programs later rolled out to 22 service offices.
> Made process improvements and implemented pilot projects earmarked to
improve services in claims, underwriting and customer services.
> Represented BWC at legislative hearings regarding new claim management
projects. Appeared before State Controlling Board to request funding
of various projects.
MERIDIAN INSURANCE, Columbus, OH 1987 -
1991
Ohio Regional Claims Director
> Directed all claims service activity in Ohio. 60% commercial and 40%
personal.
> Managed personnel administration, budgeting, training coordination and
staffing for Region. A total of two supervisory, 35 professional and
support associates.
> Initiated inside claims handling in the Ohio Region. Program adopted
throughout company.
> Introduced Autotech computer auto and property estimating to company,
adopted throughout company.
> Introduced litigation control at the regional office level, program
adopted throughout company.
EDUCATION, TRAINING, and AFFILIATION
Bachelor of Arts in Government and Public Administration, Baldwin-Wallace
College, Berea, OH
Associate in Risk Management (ARM), Insurance Institute of America,
Malvern, PA
Alternative Risk Financing and Risk Management, Wharton School of Finance,
University of PA
Inter Company Arbitration Panel, Cleveland Chapter
Columbus Claims Managers Association (CCMA)
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