KiWi LoveMe
@kiwiloveme
Strategic claims manager and compliance specialist transitioning into healthcare operations and policy.
United StatesWhat I'm looking for
I am a strategic, detail-oriented claims manager and compliance specialist with 13+ years of experience handling disability claims, customer service, and quality assurance while pursuing a Bachelor of Science in Healthcare Administration.
I currently manage 90+ active long-term disability claims, maintain audit-ready documentation, exceed service metrics, coordinate IMEs and return-to-work planning, and identify fraud and elder-abuse concerns. I have led internal audits, coached teams to 98%+ audit scores, negotiated settlements, performed financial and escrow calculations, and located 10+ debtors daily through skip tracing.
I bring analytical precision, empathetic communication, and cross-functional collaboration to operations and policy roles in healthcare, and I am eager to apply my compliance, case-management, and quality-assurance expertise to drive process improvements and regulatory adherence.
Experience
Work history, roles, and key accomplishments
PRManage 90+ active long-term disability claims, analyze medical records to determine eligibility, coordinate IMEs and return-to-work planning, and identify fraud or elder abuse while maintaining audit-ready documentation and exceeding service metrics.
WFNegotiated settlements and resolved delinquent auto and mortgage accounts, locating 10+ debtors daily and supporting repossession and collateral recovery. Led internal audits, coached new hires, and maintained 98%+ audit scores while delivering ADA education and facilitating accommodations.
Education
Degrees, certifications, and relevant coursework
UPUniversity of Phoenix
Bachelor of Science, Healthcare Administration
Activities and societies: Relevant Coursework: Accounting I & II; Organizational Behavior; Conflict Resolution; Business Communications; Economics & Finance; Computer Applications. Projects: Excel Budget Management & Finance Tracker; Cost-Utility Analysis comparing economic systems.
Pursuing a Bachelor of Science in Healthcare Administration with expected completion in July 2026.
UPUniversity of Phoenix
Associate of Arts, Business Fundamentals
Activities and societies: Relevant Coursework: Accounting I & II; Organizational Behavior; Conflict Resolution; Business Communications; Economics & Finance; Computer Applications.
Completed an Associate of Arts in Business Fundamentals in February 2024.
Tech stack
Software and tools used professionally
Availability
Location
United StatesAuthorized to work in
Job categories
Skills
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