Constance Briggs
Atlanta
Summary
Detail-oriented Senior Claims Associate with proven skills in claims processing, compliance assessment, and data analysis. Recognized for effective team collaboration and conflict resolution, driving process improvements and enhancing customer satisfaction. Dynamic professional with extensive experience in claims management and team leadership. Skilled in analyzing claims data and training staff, fostering a collaborative environment that resolves complex issues efficiently and enhances operational effectiveness. Highly competent Senior Claims Associate with broad experience managing insurance claims and investigating fraudulent activities. Strengths include strong analytical skills, comprehensive knowledge of insurance policies, and ability to manage high-volume caseloads. Demonstrated effectiveness in streamlining processes for increased efficiency within previous roles. Skilled in interviewing, records searching and documentation. Excellent critical thinking and organizational abilities. Proficient in insurance policy coverage levels, industry practices and compliance requirements.
Overview
1
1
Certification
25
25
years of professional experience
Work History
Senior Claims Associate
Genpact
Atlanta
12.2020 - 06.2026
- Managed claims processing for diverse client accounts at Genpact.
- Reviewed documentation to ensure compliance with company policies and regulations.
- Collaborated with cross-functional teams to resolve complex claims issues effectively.
- Analyzed trends in claims data to identify potential areas for process improvement.
- Drafted correspondence regarding the status of pending claims for both customers and other stakeholders.
- Reviewed documentation and accounts to gain full picture.
- Communicated effectively with policyholders, providing updates and explaining the claims process clearly.
- Utilized claims management software to track claims progress and maintain organized documentation.
- Evaluated and processed insurance claims according to company policies and industry standards.
Settlement Representative/PIP Claims
Change Healthcare
Atlanta
03.2018 - 04.2020
- Reviewed and analyzed settlement agreements for compliance and accuracy.
- Collaborated with cross-functional teams to streamline settlement procedures.
- Trained new staff on settlement protocols and best practices.
- Utilized proprietary software for tracking and documenting settlements.
- Communicated with clients to clarify settlement details and requirements.
- Monitored industry regulations affecting settlement processes and policies.
- Prepared final closing disclosure forms and ensured that they were delivered to borrowers in accordance with applicable regulations.
Claim Adjuster
Renfroe
Birmingham
06.2015 - 03.2018
- Evaluated insurance claims for accuracy and compliance with policy guidelines.
- Investigated claims by interviewing involved parties and reviewing relevant information.
- Negotiated settlements with claimants while adhering to company policies and procedures.
- Utilized claims management software to track and update claim statuses efficiently.
- Negotiated settlements with claimants or their representatives in order to resolve disputes quickly and economically.
- Maintained accurate documentation of all claim activity within designated system.
- Gathered information from various third parties to determine claim acceptability.
- Ensured timely follow-up on all open matters; kept stakeholders informed regarding status updates.
- Developed relationships with attorneys, experts and vendors in order to ensure prompt service when necessary.
- Interpreted insurance policy language to apply appropriate coverage.
- Analyzed and determined fault in auto accidents based on evidence and applicable laws.
- Checked into questionable claims, interviewing agents and claimants to resolve errors and omissions.
Team Leader/Quality Assurance Analyst
Assurant
Duluth
05.2001 - 04.2015
- Led team in daily operations and ensured workflow efficiency.
- Facilitated training sessions for new employees and ongoing staff development.
- Coordinated cross-departmental communication to enhance project collaboration.
- Implemented process improvements to streamline operational procedures.
- Monitored team performance and provided constructive feedback regularly.
- Developed schedules and assigned tasks to optimize resource allocation.
- Resolved conflicts and promoted a positive team environment consistently.
- Conducted performance reviews and outlined development plans for team members.
- Maintained a positive work environment that promoted collaboration between team members.
- Offered training and support to keep team members motivated and working toward objectives.
- Delegated daily tasks to team members to optimize group productivity.
- Motivated and empowered team members to build customer satisfaction and loyalty to support retention and growth.
- Developed strategies for problem solving and conflict resolution among team members.
- Reviewed completed work to verify consistency, quality, and conformance.
- Completed daily quality assurance duties to provide feedback for improvements.
- Conducted regular performance reviews to assess individual team member progress.
Education
Bachelor of Science - Business Administration
University of Arkansas Pine Bluff
Pine Bluff, AR06-1987
Skills
- Claims processing
- Compliance assessment
- Data analysis
- Claims management software
- Documentation review
- Regulatory monitoring
- Conflict resolution
- Training and development
- Team collaboration
Certification
- Claim Adjuster Licenses
Timeline
Senior Claims Associate
Genpact
12.2020 - 06.2026
Settlement Representative/PIP Claims
Change Healthcare
03.2018 - 04.2020
Claim Adjuster
Renfroe
06.2015 - 03.2018
Team Leader/Quality Assurance Analyst
Assurant
05.2001 - 04.2015
Bachelor of Science - Business Administration
University of Arkansas Pine Bluff