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Wendi Duarte

@wendiduarte

Experienced administration and claims professional driving efficiency, customer service, and process improvement.

United States
Message

What I'm looking for

I seek a role where I can apply claims and administrative expertise to improve processes, mentor staff, and drive measurable operational and customer-service outcomes.

I am an experienced administrative and claims professional with a consistent track record of improving efficiency, increasing productivity, and delivering superior customer service in fast-paced environments.

In my current role as an LTD Senior Claims Examiner at Lincoln Financial, I met and exceeded metrics, created and implemented action plans for timely claim decisions, and served as primary contact for claims from setup through determination. I have hands-on knowledge of vocational services, settlements, SIU resources, and ASO team processes for multiple customers.

Previously, I led patient service operations at Wentworth-Douglass Hospital as a Lead Patient Service Representative and CMAA Certified Medical Administrative Assistant, acting as a preceptor, super user for NextGen and Epic, and liaison for service recovery while participating in Operation Excellence and patient experience initiatives.

My background also includes education and long-term office management and sales leadership roles where I recruited and developed staff, managed finances and audits, and implemented systems that improved workflow and revenue. I am goal-oriented, process-focused, and committed to contributing measurable improvements to organizational performance.

Experience

Work history, roles, and key accomplishments

LF
Current

LTD Senior Claims Examiner

Lincoln Financial

Feb 2022 - Present (3 years 8 months)

Manage LTD claims from intake to determination, implemented action plans to meet metrics and improve decision timeliness, and recommended process improvements; recipient of REACH award for exceptional customer service.

WH

Patient Service Representative Lead

Wentworth Douglass Hospital

Jun 2019 - Feb 2022 (2 years 8 months)

Promoted to Lead after certification; precepted and trained new staff, served as liaison for service recovery, and acted as super user for NextGen and Epic while managing insurance verifications and end-of-day reconciliations.

DA

Audit Director of Sales & Marketing

Days Inns of America

Oct 1987 - Apr 1992 (4 years 6 months)

Managed 27 staff across front office, banquet and reservations for a 200-room hotel, oversaw night audit and reconciliations, recruited and trained staff, and exceeded revenue goals over five years.

Education

Degrees, certifications, and relevant coursework

University of Massachusetts Amherst logoUA

University of Massachusetts Amherst

Bachelor of Arts, Business Management

Activities and societies: Additional coursework at Granite State College and California College of Science.

Completed a Bachelor of Arts in Business Management with coursework in finance, accounting, marketing, and management.

Tech stack

Software and tools used professionally

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Wendi Duarte - LTD Senior Claims Examiner - Lincoln Financial | Himalayas