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Account Mgt Sr Claims Adjuster Complex,Sales Eutive Customer Service

Location:
Albany, NY
Posted:
July 25, 2022

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Resume:

Gina M Clarke

* ****** ****

Albany, NY *****

518-***-****

Account Management/Sales Executive – Dynamic, results-oriented Professional with extensive knowledge, experience and established contacts within multiple segments of the Workers’ Compensation/Liability, Occupational Health and Medical Industries. Demonstrated success in generating sales, managing operational budgets and client retention. Experienced in analyzing issues and concerns to increase customer satisfaction with quality and efficiency. Highly adept at training and coaching new personnel. Able to develop effective problem resolutions. Able to work independently with a phenomenal work ethic. Exemplary Customer Service resulting in above average client satisfaction. Sr claims adjuster handling all aspects of the claim file including medical reviews, attorney negotiations and rehab assignments.

Technically proficient in Microsoft Word, Power Point, Salesforce Database, ITT, IBM and the Internet.

Career Related Experience & Accomplishments

Optum – Regional Sales Executive & Account Manager – New York and New England

11/10/15 to 10/2/2022 – National Ancillary Medical Services Provider for seven service lines : Pharmacy, DME, Home Health, Catastrophic Care, Diagnostic, Translation and Transportation. Customer base included Carriers, Third party Administrator, Self Insured Entities, and Self Administered Employers. Desk level to High Level Executive Teams. Established, developed and maintained Northeast Regional Territory. Expertise in fact finding, persuasive and technical selling, handling objections and deal negotiations.

11/8/2013 – 11/8/2014 – Held to a One Year Non Compete

TechHealth, Inc – Tampa, Fl – Regional Sales Director – NY, MASS, RI, CT, NH & Maine

Feb 2002 – 11-8-2013

National Ancillary Medical Services Provider - Pharmacy, DME, Home Health, Catastrophic Care, Diagnostic, Translation and Transportation. Customer base included Carriers, Third party Administrator, Self Insured Entities, and Self Administered Employers. Desk level to High Level Executive Teams. Established, developed and maintained Northeast Regional Territory. Expertise in fact finding, persuasive and technical selling, handling objections and deal negotiations. Maintained and exceeded all sales quotas and job requirements. Coordinated meetings and presentations to validate sales and marketing strategies. Provide leadership, direction and focus to key managers on the execution of sales. 100% retention of clients. Company was purchased.

Gina Clarke – page 2

RMSCO – Albany, NY – Sales and marketing Rep, Sr Claims Examiner & Account Manager

February 1995 – February 2002

Successfully marketed and sold over 8 new accounts(full programs) in part time roll. Extensive experience in Self Insured Self Administered Programs and TPA environments – specializing in Municipal Groups, School Consortiums with Workers Compensation, along w 207 A & 207C benefits.

Sr claims adjuster handling all aspects of the claim file including medical reviews, attorney negotiations and rehab assignments.

Successfully aided in the prosecution of the first felony WC Fraud case in the State of NY. Testified at Grand Jury and Criminal trial.

Negotiated Settlements and assisted in the handling of Section 71 termination. Met monthly with Chiefs of Police and Fire Depts to strategize.

Brokered TPA Services, Excess Insurance, SI Medical & Disability Policies along w Section 125 benefits.

Education & Licensures

Maria College – 1979 – Albany, NY major – Nursing

HVCC – Troy, NY – 1993 –Certified Emergency Medical Technician

Insurance Related –

NYS Licensed WC and NF Adjuster – License # IA-753613

AIC -34 Workers Compensation Medical Claims Certification

Property & Casualty Brokers License – NYS - Inactive

Life Accident & Health Agents license – NYS - Inactive

Active memberships – Albany Claims Association, Syracuse Claims Assoc, Buffalo Claims Assoc and the Self Insured Assoc of the Niagara Frontier. The NYS Association of Self Insured Counties and the NYS Self Insured Employers.



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