Project Manager Sales

Jane Poole

Email: *********@********.***

Address: *** *. ****** **.

City: Hartford

State: IL

Zip: 62048

Country: USA

Phone: 618-***-****

Skill Level: Experienced

Salary Range: $65,000

Primary Skills/Experience:

See Resume

Educational Background:

See Resume

Job History / Details:

JANE M. POOLE

107 E. Cherry St., Hartford, IL 62048

Phone: 618- 830-9290 Email: *********@********.***

SUMMARY

Experienced Claims Operations/Claims Analysis and Compliance Professional with over 10 years in healthcare industry. In healthcare, experienced in data analysis and reporting, risk management, malpractice claims investigation, coverage analysis, evaluation, and negotiation. Project Manager for SPSS (statistical software): Presented ROI for SPSS to Board of Directors within healthcare. Obtained approval from Board and managed the entire project to implement SPSS. Proactive, strategic initiatives in claims reduction approach through data analysis. Settled 95% of claims below authorized amount. Employee of the Year 2x within healthcare organization. Completed MBA April, 2010.

PROFESSIONAL EXPERIENCE

American Association of Orthodontists Insurance Company, Creve Coeur, MO 2000-Present

Claims Adjuster

* Collect and analyze data to spot trends in claims in geographical areas and trends in allegations

* Gather and report qualitative/quantitative statistical information to improve decision-making in sales and rating

* Interview insureds to improve product offerings/needs analysis

* Business process improvement (ex: change scanning to frontend instead of backend of process)

* Month-end reports, contributing ideas to on-going risk management articles and programs.

* Take part in hiring decisions and train new staff

* Counsel insured's regarding claims and potential claims, take loss reports, determine policy coverages, establish liability and damages, negotiate settlements when settlement is applicable, work with attorneys on litigation as well as the orthodontists.

* Responsible for negotiating and settling 95% of the non-litigated claims below the authorized number given by the Claims Committee.

* Number of claims to insured as of 12/2000 was .042. As of 7/2010, it is .017 which is a considerable drop since the number of insured has risen from 3,000-4,500.

* Write risk management articles, plan and produce PowerPoint programs, plan and participate at bi-annual Defense Counsel Seminar, arranging travel and accommodations for attorneys and writing meticulous case summaries to fulfill reporting requirements to the Claims Committee, which is made up of three experienced orthodontists.

* Write articles for quarterly e-newsletter: Latest article, "The National Practitioner's Databank".

* Manage the department when the claims manager away and manage certain aspects such as reporting

* Extensive use of SPSS, Microsoft Office Suite (i.e. Excel, MSWord, Access, and PowerPoint) and insurance database

EDUCATION & AWARDS

MBA

Missouri Baptist University (graduated April, 2010) GPA 3.67

Bachelor of Science in Organizational Leadership and Development (cum laude)

Greenville College, Greenville, IL (graduated 2008) GPA 3.71

A.A. Degree in Information Systems and Analysis

Lewis & Clark College, 5800 Godfrey Road, Godfrey, IL

GPA 3.71, Dean`s List 1998-1999, President`s List 1995-2003, Phi Theta Kappa, National Honor Society 1997

OTHER

Nomination for Employee of the Year 2003-American Association of Orthodontists

Member of Association for Information and Image Management (AIIM) St. Louis

Former Board member of AIIM, duties including taking minutes, sales, assisting with sales displays.

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