D Testone Location: Brewster, NY 10509 ... WNER OF DATA CLAIM SERVICES. A MEDICAL BENEFITS RECOVERY SERVICE. BREWSTER, NY * ASSIST INDIVIDUALS WITH FILING OF CLAIMS AND APPEAL OF DENIED CLAIMS. * ASSIST INDIVIDUALS WITH FILING OF SOCIAL SECURITY BENEFITS. * NEGOTIATE BENEFIT BUYOUTS * EXPERT WITNESS 1/05 TO 8/06QUADRINO & SCHWARTZ, LLP GARDEN CITY, NY CLAIMS CONSULTANT * KNOWLEDGE OF STD AND LTD POLICIES AND PROCEDURES. * REVIEW AND FORMULATE CLAIMS SUBMISSION AND APPEAL STRATEGIES. * COMMUNICATE WITH CLIENT'S MEDICAL PROVIDERS AND INSURERS. * ASSIST ATTORNEYS WITH FORMAL CLAIMS HANDLING INCLUDING ATTENDING INDEPENDENT MEDICAL EXAMINATIONS AND SETTLEMENT DISCUSSIONS. 5/02 TO 1/05CULTURAL INSURANCE SERVICES INTERNATIONAL STAMFO ...
97 hits
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P Bosco Location: Glenville, NY 12302 ... ting, and customer service. SUMMARY OF QUALIFICATIONS Exceptional customer service skills; solid claims negotiation skills; Understand the importance of maintaining current knowledge of industry trends, concepts, products in the field of claims financial practices. Highly organized: excellent interpersonal, communication and networking skills: interact effectively with people both one on one and in a committee or team environment. Proficient in using computers for business applications including Lotus, Microsoft Word, Excel, Outlook Express, PowerPoint, as well as claims work bench. EDUCATION Plattsburgh State College Bachelors Degree in Science with concentration water resourc ...
95 hits
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J Skinner Location: Colden, NY 14033 ... service experience. Strong investigative capabilities and well respected within the legal community for technical knowledge and due diligence along with the ability to follow through to resolve issues efficiently. Recognized for high degree of professionalism and dedication to core values that include integrity, confidentiality, and compassion towards others.KEY COMPETENCIESResu lts OrientedDue DiligenceRelatio nship ManagementLegal Research & DocumentationNeg otiation/Mediati onCustomer Service Written & Verbal Communication SkillsCompliance Training & Mentoring PROFESSIONAL EXPERIENCEAix Group -Nova Casualty Company 08/06 to Presen ...
93 hits
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C Grimm Location: Baldwin, NY 11510 ... ements, investigations and all phases of liability in a high volume environment. Detail oriented and excellent investigative skills. Proven ability to meet and exceed all goals. ________________ ________________ ________________ ________________ _______ Summary of Qualifications: 4 years experience in all areas of claims from incoming reports to analyzing medical records Skilled in negotiations with other carriers and attorneys to make fair and sound decisions based on evidence presented and extensive investigations. Handled large volumes of claims in a timely fashion to preserve rights Opened all appropriate features based on exposure. Settled over 70 % of claims under reserve values ...
91 hits
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K Colombo Location: New Rochelle, NY 10801 ... l Assistants Participate on I.T. Working Committees as liaison between systems and business to facilitate changes in processing systems. Assist with development, testing and implementation of new programs and systems. Participate on various special projects related to Compliance, Sarbanes and I.T. Arrange various social and business gatherings for SPC Department and NY office. Provide scheduling, travel and various administrative support to CUO. Hanover Insurance Company Worcester, MA 10/95 - 9/2003 Subrogation Claims Manager 10/02 – 9/93 Oversee 22 subrogation and 13 administrative staff members handling 36 states in reaching $56M goal. Conduct quarterly audits of subrogation an ...
89 hits
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T Strokosz Location: Staten Island, NY 10314 ... EREXPERIEN CE: GAB Robins N.A., New York 5/04-PresentSENI OR CLAIMS ADJUSTERHandling bodily injury, general liability, property damage and uninsured motorist claims.Presentat ion of cases in Arbitration Forum, Mediation and Small Claim Court.Full handling of Litigation Files.Working knowledge of New York State Regulation 64 and 68Handling all aspects of automobile claims including investigation, SIU referrals, negotiation, settlement, reporting and reserving.Pendin g caseload 300 filesSettlement authority: $ 35,000.Robert Plan, Inc, Bethpage, New York4/02-5/04MUL TI PERIL CLAIM EXAMINERHandling New York, Connecticut and New Hampshire Litigated automobile bodily injury, property d ...
87 hits
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R Lewis Location: Katonah, NY 10536 ... velopment contribute to successful business results. PROFESSIONAL EXPERIENCEAllsta te Insurance CompanyAugust 2007 - PresentStaff Claims Service RepresentativeCa sualty ClaimsInvestigat ion and evaluation of Bodily injury claims. Duties include discussions with attorneys and lawsuit handling resulting in a fair settlement of claims being brought by plaintiffs against the policyholder. Other duties Cost containment and expense control while delivering optimumcustomer service to our policyholders as well as others who interact with company.Humana Insurance Company, Inc, Cincinnati, OhJuly 2005-June 2006 Operations Manager, Grievance and AppealsAs the Grievance and Appeals Manager for the Cinc ...
85 hits
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M Clune Location: Smithtown, NY 11787 ... zed and assigned claims that require additional investigationRes ponsible for investigating potentially fraudulent claims in New York State and New England and for remaining in compliance with all respective Insurance Department regulations Created training programs for all Claims and Underwriting personnel in New York State in the recognition and referral of claims to the Special Investigative UnitPresented fraud awareness programs to civic organizations and law enforcement personnelClaims Reinspector May 1996 - February 1998Reviewed claim files for trends and patterns that deviated from the Company's policies Implemented training programs to correct those deficiencies found during file rev ...
83 hits
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S Zampi Location: Apalachin, NY 13732 ... care physicians and specialists as targets for possible contracting efforts.* Assist Contract Management in selling partnership services to physicians as needed to meet network requirements.* Conduct orientations for new providers and office staff.* Provide ongoing education of providers and office staff.* Identify, analyze and resolve issues in a timely manner. (including root cause analysis)* Facilitate seminars, educating the provider community on any updates to Medicaid/Medicar e guidelines.* Develop a strong rapport with physicians in network in order to promote a mutually beneficial relationship.Nov ember 2006 - September 2009 Touchstone Health, HMO (TH), Binghamton, NY Provide ...
81 hits
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J Levy Location: Rego Park, NY 11374 ... nd no-fault casesDrafted pleadings and bills of particulars YURIY PRAKHIN LAW OFFICES Brooklyn, NY Paralegal Aug 2007 to Feb 2008Drafted pleadings and bills of particulars Drafted motions and oppositions to motionsFAIRMONT FUNDING Brooklyn, NY Loan Officer/Consulta nt Jul 2006 to Apr 2007Established contacts with mortgage brokers in New York, New Jersey, Pennsylvania, and Virginia. Evaluated and processed loan applications for purchases and refinancing of homes. Worked with different companies, in ...
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