Edward Ransom Jr

*** ********* ***** -*** *, Monroeville, PA 15146

Phone: 240-***-****

ad3sx5@r.postjobfree.com

Objective:

Find a position within an insurance company in claims. customer service or administration. Improve my skill set and help the company improve their objectives.

Ability Summary

Excellent experience working as a Claims Examiner and Claims Processor handling Life Claims, Accidental Death Claims and Disability claims.

Good experience of processing individual, group disability claims, in addition to other claims exposure with small group, life, travel accident, group LTD/STD and LTC.

Expertise in evaluating claimant eligibility. Knowledge of secondary processing claims once verified Excellent verbal and written communication skills

Experience also includes interacting with policyholders, doctors, attorneys and hospital administrators resolving claims Licensing and Contracting Experience.

Customer Service Experience

Medical Terminology

Skills:

Skilled with complex LTD and STD cases, MS Office, Word, Excel, Management Skills, ALHC

Employment History

Senior Customer Care Advocate Met Life Insurance Co. Omaha, Ne 10/2018-08/2023

Respond to customer request via telephone, providing excellent service to MetLife’s customers who have insurance or other financial questions regarding their policy needs.

Research requests regarding various product aspects, policy provisions, claim status, basic procedures, etc.

Efficiently process transactions and refer requests for other policy modifications to appropriate areas. Track responses to ensure completeness.

Enhance and strengthen the relationship between the customer and MetLife using strong communication skills, active listening skills and support special product and/or service campaigns as needed, or if solicited by the customer.

Efficiently access and navigate multiple electronic systems to provide a complete and integrated response to the customer’s inquiry.

Perform these responsibilities in a consistent, professional manner while exercising strong verbal, interpersonal and high quality service.

Sr. Long Term Disability Claims Examiner Mutual of Omaha Insurance Co. Omaha, NE

09/2016-04/2018

Processed Long Term Disability Claims

Performed outcalls and received in bound calls and follow-ups as required servicing policyholder requests.

Provided general policy analysis to provide explanation and information to customers, employers, policyholders and/or agents, brokers regarding appropriate coverages for long term disability policies

Managed a caseload of disability claims

Processed claims for payment and or denials

Life Claims Processor Mutual of Omaha Insurance, CO Omaha, NE

08/2015-9/2016

Processing life insurance death claims

Providing customer service to beneficiaries

Calculating death benefits

Communicating with agents, funeral homes, assignment companies

Agent Licensing Clerk

03/2013 - 06/2015 AAA Life Insurance Omaha, NE

Completed vendor invoices, paid renewal licenses with required states

Processed agent appointment applications, terminations, AML verifications, processed declination letters and did agent license renewals

Updated agent's licenses, requested agent background reports, reinstatements

Conducted customer service responsibilities with all agents/agencies with AAA Motor Club

Documented the agency system with AAA system (AS400) regarding phone calls, terminations, appointments, licenses and AML verifications.

Followed up customer service requirements via fax, email and phone.

Licensing and Contract Specialist

07/2012 - 02/2013 Aviva (via Celebrity Staffing) Des Moines, IA

Completed all transactions for all distributions accurately for agents not limited to initial contracting, address changes, license updates, hierarchy changes, reinstatements, terminations and AML verifications.

Initiate and process all necessary background for appointment consideration including approving or recommending declination of agent /agency based on established guidelines.

Accurately transact state appointments and or terminations based on state (s) guidelines.

Appropriately documented the agency system regarding the handling of the call, email or fax any next steps that needed to be taken.

Senior Life Claims Examiner

02/2007 - 06/2011 Banner Life Insurance Company Rockville, MD

Responsible for processing contestable life death claims, initiated all investigations, made the decision if the claim was payable or needed to be denied.

Handled reinsurance with or reinsurers, worked closely with all vendors during domestic and international claims investigations.

Processed all waiver of premium claims associated with the life insurance policies.

Communicated via written and telephone with attorneys, beneficiaries, agents, brokers.

Worked on all projects assigned to me by the claims manager Facilitated life claim team meetings.

Education and Training

Completion Date Issuing Institution Location Qualification Course of Study

12/1979 Edinboro State College Edinboro, PA Bachelor's Degree Social Work

Occupational Licenses & Certificates

Certification Title Issuing Organization Completion Date

ALHC LOMA 01/2008

Detailed References

Ernest White, Vice President

American National Bank

402-***-**** Personal reference known for 30 year(s).

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