As a New York Life Claims officer, I'm in a position charged with continually raising the standard of claims achievements across our business, ultimately enhancing our customer's satisfaction, loyalty and retention of our customer base. Effectively managing within a highly regulated industry by meeting and exceeding regulatory and compliance standards. Setting the overall strategic plan to deliver a high level of service to our customers and create raving experiences in every interaction. Continually developing and training this team to more effectively manage death claims for our varied life and annuity products and disability claims for waiver of premium on our life policies. Identifying and applying best practices to enhance the customer experience, effectively manage risk and improve operating efficiencies.Cooperating and collaborating within our Claims team and across the larger Service organization, underwriting, product development, field force, etc. to deliver a best in class product.

Manage the daily operations of group life and disability claims teams. Responsible for achieving and maintaining financial and customer service objectives, as well as, specified performance guarantees for notable client accounts. Mentor and develop staff to deliver a high level of customer satisfaction. Review and approve high dollar limit claims, complex claims and denials. Support new business efforts via RFP process and finalist presentations. Strong relationships with internal partners [account management, actuarial, legal, etc.] Maintain strong relationships with brokers and major group clients. Monitor and maintain compliance with all Model Audit Rule controls for all lines of business [individual life, group life, waiver of premium and group disability] as well as state and federal regulatory requirements. Oversee and manage budget expenses for several cost centers.

Responsible for planning, coordinating and overseeing all day-to-day claims administration of life and annuity death claims and waiver of premium claims. Provided guidance on most complex claims, including contestable and reinsured claims. Ensured compliance with all applicable regulatory and legal requirements. In addition, oversaw the day-to-day operations of the ownership/beneficiary change team. Expanded quality control review to previously excluded functions to insure greater accuracy and improve customer experience. Expanded efforts in department leading to more quality sales leads for agents through delivery of beneficiary proceeds. Revised and expanded expedited claims processing for "small dollar" life claims to reduce workloads and improve customer satisfaction. Led project to re-vamp waiver of premium claims processing which resulted in increased premium receipts.

Senior project manager for developing the claims component of an insurance administration system. Developed business rules and criteria for building processing logic and functionality of claims component. Performed primary testing for all aspects of the claims system. Developed and wrote business requirements for major client implementation.

Oversaw the entire day-to-day operations of the claims department. Including, claim adjudication, auditing, appeals/complaints, fraud and training. Developed and implemented department-wide metrics for examining staff. Led effort for process improvement changes to process, systems and personnel resulting in reduction of incoming calls and volume of open claims. Recommended and won approval of claims staff career ladder. Developed departmental intranet system and oversaw development of numerous written procedural documentation.

Managed the state product filing process by overseeing compliance supervisor and analysts. Negotiated with state department's of insurance. Provided input on marketing materials and ensured compliance with applicable laws and filing requirements. Supported efforts to quickly make newly approved products available to sales staff. In addition, oversaw the rate unit supervisors and staff responsible for rate increase implementations. Oversaw development of training/procedural manual. Department liaison for corporate system replacement initiative and led product conversion process.

Project manager on team of five developing business requirements for CIGNA Linked Benefits initiative incorporating managed disability products in the existing life and accident products.Lead representative for the billing and reconciliation re-engineering project.Supported and led implementation efforts for several of the service center's largest clients.Partnered with key internal and external partners to resolve group client's ongoing service issues and requests for process improvements.

Primary analyst responsible for filing long-term care and life insurance products with state insurance departments.Maintained "Special Situations" file to track state specific regulations to minimize impact on policy from submissions.

Directed staff of claims examiners processing health claims [Medicare Supplement] who maintained accuracy rates of 95% or greater while averaging payment of $5.1MM on more than 23,750 claim transactions per month.Improved work processes and increased productivity by 15% while maintaining quality and customer service standards.Led pre-existing procedure changes via multi-phase re-training and re-auditing of staff, which resulted in thousands of dollars in cost savings for the company.Leader on corporate audit team for two years resulting in improved results, streamlining and elimination of unnecessary or redundant processes.