Laura Montpetit

Newmarket, ON

905-***-****; ac8jz7@r.postjobfree.com

www.linkedin.com/in/laura-j-montpetit-10678460

Summary

An experienced health insurance professional with over twenty years industry experience in the US and Canada including supervisory, quality, training, investigative and provider relations roles.

Highlights

Superior communication skills

Resolution-oriented

Staff training and development

Dependable and reliable

Superior organizational skills

Effective team player

Professional Experience

Europ Assistance – GCS

Claims Team Lead, 2014 to 2016

Supervised the activities of 9 team members

Handled escalated issues from clients, members and providers

Daily review of incoming claims queues to ensure agreed turn around times were met

Signed off on high dollar claims reviews; claims up to $1M

Reviewed and updated workflows within the department to ensure daily efficiency

Attended weekly meetings with department director

Assisted with claims administration as needed

Benefit and Audit Specialist, 2013 to 2014

Reviewed and analyzed new and renewing policies to determine benefits

Communicated with client to ensure timely receipt of renewals

Entry of group details and benefits into system

Daily audit of random claims sample

Daily review of eligibility import reports to ensure accuracy of data

Designed and developed policy and procedure documents within the department

Review and documentation of workflow within the department

Quality Specialist, 2009 to 2013

Worked with the Quality Assurance department to develop proper measurement tools and reporting formats

Worked with Claims and Repricing team to analyze workflow processes

Assisted in the development, implementation, documentation and evaluation of new and existing workflows and processes, including new client/service implementations

Performed random claim audits based on pre-determined criteria

Selected random calls to be evaluated

Prepared audit results

Worked closely with the departmental trainer to determine training requirements

Worked closely with team supervisor to develop KPIs

Participated in Quality Assurance meetings

Assisted with Claims Administration as needed

Senior Claims Administrator, 2001 to 2009

Reviewed insurance claims for relevant services and charges

Medical claims adjudication using AS400 system

Adjudication of travel insurance claims

Review of high dollar claims

Communication with clients, providers and insured members

Assisted other claims administrators as needed

Successfully carried out responsibilities of Claims Supervisor as needed

ServiceMaster Lawn Care

Office Manager, 1999 to 2000

Daily office administration

Responded to customer inquiries in person and by telephone

Helped to resolve customer concerns

Supervised and tracked the activities of four lawn specialists

Daily routing to ensure efficient completion of assigned properties

Professional Development

Claims Training Workshop

The Ultimate Supervisor’s Workshop

Manager’s Training Program

Situational Leadership

Building High Performing Teams

Achieving Extraordinary Customer Relations

Investigative Training – Detection of Medicare Fraud

Successfully completed the Ontario Apprenticeship Program for Customer Service

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