Afroditi Mentoudaki Email & Phone Number

George Town, George Town, Ky

Cayman Islands

• Manage daily activities, provide support, training, and mentorship to the team.• Handle day-to-day administration of insurance claims for various lines of coverage including, but not limited to, Auto Liability, Property, Workers’ Compensation, Public Liability, Catastrophe, Contractor’s All Risk.• Develop and implement a comprehensive training program on digitized claims procedures and claims management tools.• Responsible for running reports, analyzing, and executing established strategy on available SLA’s and KPI’s.• Responsible for implementing and developing digital forms for streamlining claims.• Responsible for configuring, maintaining, monitoring, and ensuring the reliability of our CX system. • Ensure that the department follows standard operating procedures to reduce workflow constraints.• Assist the team with coverage investigation, liability determination, strategy, and settlement negotiation in accordance with policy terms and conditions.• Review and enhance best practices to optimize claim processing quality.• Update customers on the progress of reported claims when required.• Review medical documents and invoices to determine costs associated with claim. • Pay assessors, adjusters and other service providers as needed. • Review the accuracy and quality of our claim’s environment. • Ensure coverage and reserving is correctly set throughout the claim’s life cycle.• Create denial letters along with subrogation demands when needed.• Process claims related payments for the department.• Assist with claim projects and digital transformation as needed. • Report any instance or areas of possible fraud following department protocols. • Complete other related duties as assigned and or affiliated with the support of the company.

Caribbean Region

• Experienced in consulting insurance carriers in the North American and Caribbean region.• Track record of supporting process improvements, migration to digitized environment and implementing best practices.•Develop and implement a comprehensive training program on digitized claims procedures and claims management tools.•Responsible for setting up data capture, integrations, and reports.•Responsible for implementing and developing digital forms for streamlining claims processing, data capturing and producing reports. •Ensure that the department follows regulations and standard operating procedures.•Resolve workflow problems.•Assist the claim team in coverage investigation, liability analysis and settlement negotiation.•Develop best practices to optimize claim processing quality.• Monitoring all new and existing claims ensuring proper documentation as well as reviewing and maintaining evidence relating to the cases. • Proactively identify risks and provides proper escalation for high-level resolution.• Ensuring effectiveness of the claims payment processes.• Responsible for configuring, maintaining, monitoring, and ensuring the reliability of cloud-based help desk management systems and resolving problems to limit disruptions to organizational operations.• Review weekly loss run trends.•Run claim reports, analyze, and execute strategy on data provided.

Beijing, China

• Manage AI Data Services projects, ensuring timely and effective communication with vendors, collaborators, and management teams across multiple countries to facilitate smooth project execution, while focusing on building and optimizing human-centric intelligent digital platforms.• Ensure strict adherence to project specifications and procedures, promoting consistency and quality across all projects, with a focus on creating user-friendly, AI-driven solutions that prioritize human-centric design.• Guarantee that the quality of Pactera EDGE’s services and deliverables meets or exceeds client requirements, ensuring all intelligent digital platforms are optimized for user experience and efficiency.• Lead and support a diverse, global team of Project Managers and other roles across five countries, fostering collaboration and driving the successful delivery of AI Data Services and human-centric digital platforms.• Provide comprehensive support to the global team, ensuring full compliance with company procedures, account-established processes, and business goals, while managing cross-country coordination for optimized outcomes.• Assist in identifying gaps and areas for improvement in existing procedures, proposing actionable solutions to optimize processes and enhance the functionality of intelligent platforms, ensuring they are intuitive, effective, and scalable.• Collaborate closely with Vendor Management and Recruitment teams to ensure successful project completion and resource allocation for the development and optimization of user-centric AI-driven platforms.• Work alongside my team to drive process efficiencies and foster a culture of continuous improvement, with a particular focus on optimizing digital platforms to enhance user engagement and satisfaction across different regions.

Alpharetta, Georgia, United States

• Lead client due diligence efforts by reviewing and analyzing Know Your Customer (KYC) documentation, conducting in-depth screening, and identifying Politically Exposed Persons (PEPs), sanctions, and adverse media to mitigate compliance risks effectively.• Perform comprehensive risk assessments for all clients, evaluating potential threats and ensuring compliance with regulatory standards.• Analyze and investigate suspicious activity and complex fraud cases, proactively identifying emerging risks and issues, and providing recommendations for mitigation.• Track and assess entities across multiple high-risk categories (over 50), including Sanctions, Money Laundering, and State-Owned Enterprises, using advanced screening tools and methods.• Implement ongoing monitoring and re-assessment procedures, continuously reviewing changes to clients' profiles and adjusting risk ratings in line with regulatory requirements.• Stay informed on regulatory developments, adapting and enhancing due diligence processes to ensure full compliance and best practice alignment.

Heraklion-Crete

• Developed and executed strategic promotional and advertising campaigns tailored to client goals, ensuring high-impact delivery across multiple channels.• Determined optimal advertising media mix, selecting television, radio, online, billboards, or print formats to maximize reach and engagement for each client and project.• Coordinated seamlessly with programmers, third-party vendors, and internal teams to align objectives, ensuring efficient and effective campaign execution.• Led a team of 15 professionals, coordinating with four members based in different regions of Crete, ensuring cohesive collaboration across all advertising projects in all four regions.• Monitored project progress rigorously, delivering all campaigns on time, within scope, and within budget to meet client expectations and project benchmarks.• Cultivated and managed strong client and stakeholder relationships, while establishing and maintaining partnerships with key third-party vendors.• Led project planning and supervised production timelines to ensure consistent delivery within set deadlines and quality standards.• Created and executed comprehensive marketing plans, including multi-channel campaigns and targeted advertisements, resulting in enhanced brand visibility and engagement.• Drove service promotion and sales strategies, expanding service adoption among existing clients and identifying new customer opportunities.• Addressed client queries effectively, offering tailored solutions to maintain high satisfaction and support seamless project progression.• Negotiated and managed vendor and third-party contracts, fostering new business opportunities and maximizing value for ongoing collaborations.• Pioneered innovative promotional strategies, elevating brand presence and driving campaign performance across diverse media platforms.

Bristol, United Kingdom

• Conduct thorough investigations, evaluations, and settlements of claims to ensure accuracy and compliance with company policies.• Utilize database resources to gather background information on claimants and witnesses, including criminal records, prior claims history, and attempts at insurance fraud.• Verify and analyze data rigorously to validate claims, ensuring settlements adhere to company practices and regulatory standards.• Prepare detailed monthly reports on claims statistics, tracking accuracy and turnaround times to identify trends and improve efficiency.• Assist with various projects to support the Regulatory Affairs & Compliance department, contributing to adherence to industry regulations.• Maintain strict confidentiality of sensitive investigative information, safeguarding the integrity of the claims process.• Develop and sustain strong relationships with law enforcement, regulatory agencies, and task force members, as well as internal and external contacts involved in fraud investigations.

Bristol, United Kingdom

• Analyze, investigate, and evaluate losses to determine coverage and claim disposition, ensuring thorough assessments in alignment with policy guidelines.• Provide expert recommendations for claim settlements, leveraging detailed evaluations and industry best practices.• Proactively manage the case resolution process, facilitating timely and effective outcomes for all claims.• Prepare comprehensive reports as needed, highlighting specific claim trends and policy issues for management and underwriting teams.• Coordinate and process payments to clients efficiently, ensuring prompt resolution of claims.• Organize the repair or replacement of lost items, collaborating with vendors and clients to ensure satisfactory outcomes.• Maintain meticulous records and reports for management review, tracking claims filed and non-recoverable items to support strategic decision-making.• Follow up diligently on the payment of filed claims, ensuring transparency and accountability throughout the process.• Prepare comprehensive files for internal and external audits, ensuring compliance with regulatory requirements and company policies.

Bristol, United Kingdom

• Ensure timely and accurate processing of all claims, adhering to company policies and regulatory standards.• Act as a liaison between customers and insurers, fostering strong relationships to facilitate effective communication and resolution.• Promptly and courteously answer incoming telephone calls, providing exceptional customer service and support.• Efficiently respond to correspondence from customers, third parties, insurers, and brokers, ensuring all inquiries are addressed in a timely manner.• Handle customer telephone inquiries with professionalism, resolving queries and providing accurate information.• Manage third-party claims by establishing liability, appointing assessors when necessary, and obtaining police reports to support claim evaluations.• Update and maintain data accurately on various bespoke systems, ensuring the integrity of information for claims processing.• Provide comprehensive support to the Claims Manager as needed, contributing to the overall efficiency and effectiveness of the claims team.