What I Do.

LinkedIn

 

Prudential Financial 

Claims Examiner 

May 2018 – Present

 

 

I specialize in handling a high volume of claims, ranging in face value between $50,000 to $2,000,000, clearing 25 cases per day on average. My high caseload includes complex matters that require me to work closely with third parties, including external risk management firms, brokers, human resources professionals, cooperate council, and law enforcement, to gather all relevant information to ensure fair and efficient claims handling.

As a customer-obsessed professional, I provide empathetic and compassionate support to beneficiaries during difficult times. I understand that time matters for families when a family member passes. I ensure that cases get resolved within five days or less on average.

Collaborative and team-focused, I work with a cross-functional team of professionals in over ten time zones. I ensure that defects, extra processing, waiting, and motion decrease so all group members can work effectively and efficiently.

Skilled in processing claims though-out the whole Group Life Claims Process from initial first pay adjudication on claims with no additional information needed. Also, handling claims with high defects due to incomplete details from third parties. Work collaboratively with clients and family members of policyholders to analyze the root cause of variations in external stakeholders' responses to outreaches for information to ensure the completion of claims within acceptable time frames.

Adept at reading complex policy and contractual documents, applying their correct intent to ensure the proper payment of policies, and performing complex mathematical calculations based on policy information to ensure valid face-value policy payments.
 

 

Skills: Microsoft PowerPoint · Customer Relationship Management (CRM) · Microsoft Word · Microsoft Excel · Insurance Claims · Claims Management · Fraud Prevention · Salesforce · Risk Management · Regulatory Compliance · Corporate Communications · Technical Writing · Business Process Improvement · Data Analysis · Information Technology · Microsoft Office · Time Management · Customer Service · Multitasking · Data Privacy · Computer Security

 

 

Pichette Consulting LLC

Human Resources/IT Consulting

May 2018 – June 2022 

 

I engaged with our leadership team around talent management. From job intake meetings to screening, recruiting, interviewing, hiring, and onboarding new employees, I worked with a cross-functional team to ensure positions were filled with quality talent. Utilizing Google Workspace and Zoho Recruit, I implemented several different applicant tracking systems for clients to ensure applicant satisfaction and decrease applicant attrition. The streamlining and simplification of recruiting allowed my clients to devote less time to recruiting tasks and focus on their businesses day-to-day operations.

Implemented a strategy to direct-hire employees for a client's estate, including instituting a minimum base pay of $16.00 per hour to ensure employee retention; for a client, this included a total reorganization of their third-party-staffing provider. Absenteeism decreased to nil versus the third-party provider's low to moderate absenteeism performance metrics. Additionally, I devised and implemented performance improvement plans for employees who were not meeting expectations and off-boarded employees who failed to meet the goals outlined in their performance improvement plan.

Advised clients on customer relationship management by identifying key areas that require process improvement to help ensure customer satisfaction and increase client retention, meeting the privacy requirements of the client and applicable law. Implement solutions such as Simple Practice, which allows clients to communicate securely with mental health care providers. Simple Practice solutions consistently increased the bottom line of my client's practices by automating payment processing and securely storing PHI.

Collaborated with clients to devise, implement, and set up IT hardware/software solutions. Including the full spectrum of the IT life cycle and the implementation of platforms such as QuickBooks Payroll, Google Workspace, and Microsoft 365. 

 

Skills: Microsoft PowerPoint · Management · Customer Relationship Management (CRM) · Microsoft Word · Microsoft Excel · Job Description Creation · Risk Management · Regulatory Compliance · Technical Writing · Business Process Improvement · Recruiting · Human Resources (HR) · Information Technology · Time Management · IT Consulting · Data Privacy · Computer Security

 

Pichette Group LLC

Partner

Sept 2015- June 2022 

 

I managed the investment strategy of a private estate, liaising with partners to identify, develop, and implement a plan for long-term investment fund growth, performing ongoing research on investment strategies to ensure that proposed investment vehicles were evaluated for properness and collaborated with attorneys, CPAs, and other subject matter experts on tax compliance and portfolio management matters. Ensured all business-related filings with external third parties were completed promptly and accurately.

 

Skills: Microsoft PowerPoint · Management · Customer Relationship Management (CRM) · Microsoft Word · Microsoft Excel · Risk Management · Regulatory Compliance · Technical Writing · Business Process Improvement · Recruiting · Human Resources (HR) · Information Technology · Time Management · Data Privacy · Computer Security

 

Ripon College

Intern Human Resources Department

May 2014 – May 2015

 

While in college, I earned the trust of the full-time HR team and leaders and was allowed to take on more complex/advanced work. I performed a jobs analysis by developing a new position description questionnaire that complied with the Americans with Disabilities Act, EEOC Guidance, the Federal Fair Labor Standards Act, and the Wisconsin Fair Labor Standards Act. I disseminated position description questioners to 200 non-union employees, edited returned questionnaires, engaged in data analysis/data entry, and placed finished questionnaires in a tracking database. I utilized employee relations skills to develop rapport with survey respondents. I created a cost-saving of approximately $600,000-$1,000,000, streamlining head count. 

Used analytical skills to compare similar college's risk management strategies; devised a standardized fleet vehicle policy for the college's approved driver program to reduce civil liability. Functions included: clarifying the definition and scope of official college business; crafting liability waivers, driver safety guidelines, authorized driver screening questionnaires, emergency procedures, and uniform accident incident reports; and researching current best practices. I eliminated the potential for $75,000 in excess liability per incident.

Evaluated the college's employee benefits administration compliance with the Affordable Care Act's Applicable Large Employer requirements, creating a tracking system to ensure that non-full-time staff and facility stayed within 1000 person-hours per year. Ensuring the college would not need to pay the IRS a $600,000 plus liability.

I assisted in onboarding and offboarding employees to the college by properly placing all employee documentation when generated, ensuring that all documentation was retained and filed within personnel files. Ensuring that all personnel files were correctly classified, destroying files that met destruction criteria.

 

Skills: Microsoft PowerPoint · Microsoft Word · Microsoft Excel · Fraud Prevention · Job Description Creation · Risk Management · Regulatory Compliance · Technical Writing · Human Resources (HR) · Information Technology · Time Management · Data Privacy · Computer Security

 

 

Ripon College-Politics and Government, Bachelor's Degree  

Aug 2012 - May 2015