Medical Insurance Executive with 20+ years of experience in planning and directing all aspects of an organization's insurance claims function. Implementing claims programs for different lines of insurance, settlement of complex or high dollar claims, coordinating legal investigations and leading internal and external claim audits. Developing procedures and policies to enhance the claims operations to meet or exceed SLA’s (maximizing profits). Optimizing performance by utilizing staffing models, data & trend analysis, cost containment for medical claims, training and quality assurance. Utilizing the project management and medical coding knowledge, medical school training and operations experience, I am usually found engaged with claims system developments for process efficiencies or new strategies supporting the organizational efforts to stay on forefront of technology and service delivery.