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Matthew Balantac

@matthewbalantac

Detail-oriented claims examiner with expertise in complex insurance resolutions.

Germany
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What I'm looking for

I am looking for a role that fosters professional growth and values strategic problem-solving.

I am a detail-oriented and analytical professional with extensive experience in managing and resolving complex insurance claims. My career has been marked by a commitment to delivering efficient, fair, and timely resolutions that align with organizational goals. I excel at conducting thorough investigations, assessing claims for accuracy and compliance, and negotiating settlements to achieve optimal outcomes for both clients and the company.

Throughout my career, I have successfully improved claims management processes, reducing resolution times and enhancing client satisfaction through clear communication and strategic problem-solving. I have a strong ability to navigate regulatory requirements while managing a diverse portfolio of claims. My leadership skills have allowed me to guide teams in developing innovative solutions that meet the needs of all parties involved, ensuring a collaborative and effective claims resolution process.

Experience

Work history, roles, and key accomplishments

TM

Claims Examiner

Tristar Risk Management

Examined and processed claims, ensuring accuracy and compliance with established procedures. Collaborated with various parties to facilitate claim settlements.

SC

Sr. Claims Examiner

Sedgwick CMS/SRS

Jan 2011 - Dec 2015 (4 years 11 months)

Managed complex claims and spearheaded issue resolution to minimize client risk and exposure. Conducted thorough investigations to ascertain workers' compensation benefits eligibility, ensuring adherence to legal and policy requirements.

SF

Claims Examiner Senior

Spherion/Fireman’s Fund

Managed and processed claims, ensuring accuracy and compliance with established guidelines. Collaborated with various stakeholders to facilitate timely claim resolutions.

KS

Claims Supervisor

Kemper Employers Claim Services

Supervised claims operations, ensuring adherence to company policies and regulatory requirements. Provided guidance and support to claims staff.

AS

Director of Marketing

Alpine Information Systems

Led marketing initiatives to promote information systems and solutions. Developed and executed marketing campaigns to reach target audiences.

NA

Sr. Claims Examiner

Next Level Administrators

Jan 2020 - Dec 2022 (2 years 11 months)

Managed a portfolio of 150 lost time and litigated workers' compensation claims, focusing on resolving complex cases efficiently. Developed and implemented strategic solutions while ensuring thorough investigation and accurate determination of benefits.

AC

Sr. Claim Examiner

Alternative Service Concepts

Jan 2017 - Dec 2020 (3 years 11 months)

Managed workers' compensation claims, ensuring investigation and accurate determination of benefits. Implemented strategic solutions, effectively serving as a liaison between the company and major clients to facilitate understanding and resolution of claims.

IG

Claims Examiner Senior- Supervisor

Insurance Relief Risk/Frank Gates

Managed and supervised claims processes, ensuring efficient resolution and adherence to company policies. Provided guidance and oversight to a team of claims examiners.

Education

Degrees, certifications, and relevant coursework

California State University, Sacramento logoCS

California State University, Sacramento

Bachelor of Science, Business Administration with a concentration in Marketing

Completed a Bachelor of Science degree with a major in Business Administration, focusing on Marketing. Gained comprehensive knowledge in business principles and marketing strategies.

Tech stack

Software and tools used professionally

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Matthew Balantac - Claims Examiner - Tristar Risk Management | Himalayas