OBJECTIVE: To work in an environment that allows me to use my twenty years of experience in improving efficiencies, minimizing risk and decreasing expenses utilizing six sigma practices.
EXPERIENCE
CNA – Long Term Care Horsham, PA
Risk Management Professional March ’16 – November ‘17
Risk management professional responsible for reviewing and analyzing processes and policies to ensure efficient and accurate payout of long term care claims.
Worked on Project that involved the merging of system platforms from an outside vendor to internal CNA claim platforms.
Worked on the rewrite of claims system which allowed me to utilize my Six Sigma background to ensure we were achieving ultimate efficiency with in the claim organization.
Responsible for handling Long Term Care Claims. Ultimate goal to control and minimize payout to control expenses both legal and indemnity and bring optimum outcome for the benefit of the company and client.
I was one of the Chair people on Employee Recognition Committee that worked closely with Home Office and Management to ensure recognition was given to those who achieved excellence.
Bankers Life & Casualty King of Prussia, PA
Insurance Agent/Producer December ’13 – December ‘16
Insurance agent responsible for retirement planning for Seniors which involves educating prospective clients on wide variety of products. These products include Annuities, Life Insurance, Long Term Care, Critical Illness, Medicare supplements. Main purpose was to secure products for clients that would eliminate exposure to potential losses that would impact their investments and savings.
Responsible for field underwriting and the securing of new prospective clients for our full solution offerings including: Long-Term Care, Short Term Care, Critical Illness, Life Insurance, Annuities, Medicare Supplements and Medicare Advantage Plans.
Responsible for monitoring and assisting clients through the entire process associated with the filing of claims against their policies.
Responsible for maintaining a book of business which involves keeping diary for follow up with clients monthly, quarterly, bi annually and annually in order to review updates and changes that may impact their policy and coverages.
Responsible for setting up and running seminars at various community and town hall venues in order to educate and promote the company’s philosophy and wide array of retirement solutions.
Responsible for conducting training seminars for incoming newly hired agents regarding prospecting and selling.
I was fortunate enough to receive several accolades which included achieving Productive Agent, being nominated to Winners Edge and invited to Top Gun in Chicago to join top Agent/Producers in the Company.
Sedgwick / The Hartford King of Prussia, PA
Team Leader January ’07 – December ‘13
Responsible for managing a team of Litigation Consultants. Primary responsibility was to manage Loss Control through in depth investigations on ways to deliver a service safely and effectively while minimizing losses and liabilities to both individual and physical properties. This was achieved through extensive metrics and processes utilizing Six Sigma practices.
Responsible for managing a team of litigation representatives, which entails motivating, training and developing employees to enable them to deliver high quality claims handling on General Liability, Auto Liability, Aviation, Marine, Employment Liability, Waste Management Commercial Liability and Jones Act claims for the client.
Attend and present our Liability Services offered at prospective sales meetings.
Work closely with our sales force on retaining our existing client base.
Responsible for assuring that all claims are being handled in compliance with Best Practices and fulfill the obligations
set forth in the Performance Guarantee and Client Expectations guidelines.
Responsible for monitoring any and all reports that relate to the of handling of claims with quality, accuracy and
efficiency in mind.
Prepare and administer performance reviews and development plans in accordance with the Human Resources policy.
Travel and participate in mediations and trials on high exposure cases.
Prepare defense counsel for mediations, settlement conferences and trials.
Securing and reviewing defense counsel budgets for accuracy and relevancy; closely monitor and control defense expenses
Responsible for coordinating, preparing and presenting claim reviews to all clients on a quarterly basis
Progressive Insurance Plymouth Meeting, PA
Senior Litigation Specialist May ’03 - January ‘07
Responsible for handling Commercial and Personal Lines Litigation claims. Ultimate goal to control and minimize payout to control expenses both legal and indemnity and bring optimum outcome for the benefit of the company and client.
Responsible for handling commercial and personal lines litigation claims by verifying applicable coverage, determine exposures, liability, damages and negotiate settlements.
Securing and reviewing defense counsel budgets for accuracy and relevancy; closely monitor and control defense expenses
Coordinate files with defense counsel in which suit has been initiated. This involved attending arbitrations, mediations, depositions and trials.
Conducted outside investigations by obtaining scene investigations, witness canvas and statements.
Richard A. Bongiovanni & Ambler, PA
Associates, LTD. June ‘02 - May-03
Claims Manager
Responsible for managing claims office for Third Party Administrator for Lloyd's of London. This included all interviewing hiring of administrative staff as well as claims adjuster. Ultimate goal was to minimize payout on losses and control expenses so that claims were settled efficiently and effectively.
Responsible for managing claims office for a third party administrator for Lloyd’s of London, which consisted of Commercial Lines, Casualty, In Land Marine and Property claims, both pre-litigation and litigation.
Responsible for managing and cultivating relationships with Lloyd’s of London Underwriters, Insurance Brokers and
Agents. .
Responsible for motivating, training and developing both claims and clerical employees.
Prepare reports regarding Billing Hours, Reserves, Production and Severity’s.
Responsible for assuring that all claims are being handled in compliance with established company
practices, policies, state laws and state regulations.
GE Financial Assurance Fort Washington, Pa
Claims Supervisor April ’96 - June ‘02
Responsible for managing a team of Consultants. Primary responsibility was to manage Loss Control through in depth investigations on ways to deliver a service safely and effectively while minimizing losses and liabilities to both individual and physical properties. This was achieved through extensive metrics and processes utilizing Six Sigma practices
Responsible for managing, motivating, training and developing a team of litigation and bodily injury representatives on Personal Lines Auto claims.
Prepare and administer performance reviews in accordance with the Human Resources policy.
Responsible for ensuring that proper investigation, evaluation and negotiations have been completed for claims within my unit.
Assuring that claims are in compliance with established Company practices and policies, state laws and regulations.
USF&G Corporation Blue Bell, Pa
Claims Adjuster June ’93 - April ‘96
Responsible for handling Commercial and Personal Lines Litigation claims. Ultimate goal to control and minimize payout to control expenses both legal and indemnity and bring optimum outcome for the benefit of the company and client.
Adjust Commercial and Personal Lines Liability claims both litigation and non-litigation, by verifying applicable coverage determine exposures, liability damages and negotiate settlements.
Coordinate files with defense counsel in which suit has been initiated. This involved attending arbitrations, mediations, depositions and trials.
Conducted outside investigations by obtaining scene investigations, witness canvas and statements.
Serve as a claims liaison to agents in the field, which included quarterly agent visits and presentations to agents regarding the company’s claim handling practices in efforts to recruit more business.
Metropolitan Property and Casualty King of Prussia, Pa
Claims Representative June ’90 - June ‘93
Responsible for handling Commercial and Personal Lines Litigation claims. Ultimate goal to control and minimize payout to control expenses both legal and indemnity and bring optimum outcome for the benefit of the company and client.
Adjusted multi line claims including automobile and homeowner property and liability as well as Personal Injury Protection.
Established timely initial contact, verified applicable coverage, investigated claims, determined liability, negotiated settlements and dispersed payments.
Participated on settlement teams as well as Catastrophic Teams, which required traveling to different offices to aid them in their claims handling.
EDUCATION
West Chester University B.S. Criminal Justice
REFERENCES
John Humes – 856-***-****
Mary Linda Drain – 610-***-****
Barry Dershaw – 561-***-****