Customer Service Claims Manager

SUSANA BAUTISTA

Calculated and driven insurance and claims litigation leader with 25+

years of experience, skilled in claims negotiations & contract management

Macon, GA 31210 • 478-***-**** •

******************@*****.***

Extensive experience in reviewing and interpreting medical documentation, business planning, mentoring new hires, property & casualty insurance, and contract negotiation.

Robust builder of long-term relationships with customers, staff, and leadership to ensure claims processing follows legal procedures.

Enthusiastic presenter who has facilitated ~200 settlement conferences both in-person and virtually in 10+ states.

Strong track record of excellent performance in the areas of leadership, customer service, problem-solving, and litigation with the ability to juggle competing priorities and meet stringent deadlines.

Presentation Skills Contract Management

Executive Leadership & Coaching Oral & Written Communication Skills Bilingual – English & Spanish Customer Obsessed

Bias for Action Extensive Work with Diverse Populations Negotiation Skills Planning & Collaboration

Litigation Claims Manager

09/2017 – Present

GEICO

Macon, GA

• Engage in robust management of claim personnel to include hiring, training, performance assessment, planning, delegation or workload, coaching and motivating to improve the quality and quantity of work performed

• Conduct audits of the claims process to include coverage analysis, investigation, valuation, scope, estimate, reserving, and the accurate disposition of claims

• Spearhead the development and maintenance of policies and procedures of the Claims Litigation Department and attend settlement conferences/trials serving as signatory authority and decision maker protecting company from bad faith

Liability & Bodily Injury Supervisor

02/2015 – 09/2017

GEICO

Macon, GA

• Served as Subject matter expert (SME) on auto estimating, bodily injury evaluation, internal tools, regulatory compliance, and claims payment processing

• Participated in decisions regarding hiring top talent, development, and performance management & facilitated training for new members

• Advised reporting staff on claim files and extended settlement authority as necessary after reviewing CAREER HIGHLIGHTS

JOB-RELATED SKILLS

PROFESSIONAL WORK HISTORY

files

• Reviewed and performed record analysis for all submitted medical bills/claims Property & Casualty Supervisor

04/2012 – 02/2015

GEICO

Macon, GA

• Drove efforts to consolidate all core P&C lines of business, including WC, GL, Auto, Property, and Lead Umbrella into a streamlined underwriting process

• Handpicked to build a team of 40 employees and trained them on claims handling, compliance and processes

• Effectively led more than 25 associates responsible for the experience of customers impacted by $3000 losses per year.

i

Licensure

Month/Year

Received

Awarding Agency

Property & Casualty 1998 GEICO

Claims Law Designation 2005 GEICO

Interpreting Medical Records &

CPT Codes

2006 GEICO

College/University

Bachelors of Arts, Economics University of Malaga, Malaga, Spain Bachelors of Science, Business Management Georgia College & State University Specific Job-Related Training

How to Run Inclusive Meetings, Digital Course provided by GEICO, June 2022 Supervisor Complaint – Handling Expectation Framework/Claims Call Escalation for Adjusters, Digital Course provided by GEICO, February 2022

Merit and Performance Training for Management (Map 1), Digital Course provided by GEICO, January 2022

COMPUTER JOB-SPECIFIC SOFTWARE

EDUCATION TRAINING

Conferencing Software – Zoom, MS Teams,

Google Meet

Microsoft Suite - Word, PowerPoint, Excel,

SharePoint & Outlook

Job Related Software - ATLAS

Marketing – Canva & MS Publisher

PROFESSIONAL LICENSURES

Contact this candidate