An experienced Managed Care Insurance Specialist with a wide ranging background; inclusive of complaint processing, customer service and patient coordination. In my years of work experience, I have built excellent relationships with internal and external customers. Also, I have consistently been acknowledged for my ability to work effectively independently, as well as on teams. ✓ Dedicated insurance professional with more than 16 years of experience in investigating and processing insurance claims, appeals & grievances/ CTM processing, utilization review and customer service✓ Excellent in analyzing the damage and the cause, efficiently manage multi-projects, prioritize work and provide exemplary service to customers✓ Good at risk assessment and mitigation✓ Exceptional in evaluation of liability exposure✓ Extensive knowledge of insurance regulations✓ Good at policy interpretation✓ Strong work ethic and a thorough professional✓ Comfortable at working effectively in a changing work environment