Oversee the daily operations of the entire claims processing area to ensure that time frames, corporate goals, and performance guarantees are attained and upheld.•Provide direct leadership to four claims supervisors and a staff of 45 personnel.•Work closely with the senior director to develop and implement incentive programs.•Identify areas of deficiencies and apply workable solutions. •Prepare and execute work plans to upgrade and streamline processes within the claims department.•Manage the adjudication functions in the claims department to ensure accuracy and performance standards are achieved and maintained.•Hire and train examiners to provide effective handling of claims inventory.•Monitor reports, identify problem areas, and successfully introduce workflow to assure timely and accurate claims processing.•Implement a system of providing monthly scorecards to staff regarding quality, productivity, and overall individual performance, as measured against corporate and departmental standards.

Recruited, trained, supervised, and provided leadership to a staff of 10 in the claims processing department.•Created programs and procedures that successfully reduced the claims inventory from 20,000 to 8,000.•Organized and coordinated the transfer of claims and related functions from a centralized region to the South Florida regional office.

Provided leadership for the Coordination of Benefits (COB)/Subrogation and Quality Control Departments.•Recruited, trained and administered performance appraisals. •Established techniques to obtain maximum recoveries through (COB) and subrogation initiatives.•Supervised the quality audits of all claims prior to reimbursement to ensure adherence to accurate procedures, protocols, and guidelines. •Established techniques and controls to maintain overall department accuracy rating of 98%.•Formulated and designed an effective COB/Subrogation program that successfully provided annual recoveries of $1.5 million.•Participated as a member of Total Quality Management projects.•Coordinated the company's feasibility study regarding Worker's Compensation.

Redesigned the customer service department with an effective tracking system for customer inquiries and complaints to measure quality of service. •Supervised and monitored the performance of six customer service representatives. •Set production goals and standard for the staff.

Performed claims data entry and edit resolution to provide timely and accurate processing of all claims.•Screened, researched and updated files prior to entering and applying appropriate benefits.•Consistently exceeded the department accuracy goal of 98%

Hired, trained, and provided support to the clerical staff.•Ensured that data entry was accurately completed by the staff.