Олександр
Operations, Claims Specialist
- Employment type:
- full-time
- Age:
- 27 years
- City of residence:
- Vinnytsia
- Ready to work:
- Remote, Vinnytsia
Contact information
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You can get this candidate's contact information from https://www.work.ua/resumes/12119155/
Work experience
Pipeline Manager
from 01.2025 to now
(1 year 11 months)
Roofing company in Jax, FL, Remote (Construction, architecture, interior design)
- Pipeline Oversight: Manage the end-to-end construction repair and replacement pipeline from lead generation to final carrier payment, optimizing key metrics such as conversion and approval rates.
- Claim & Supplemental Management: Streamline communication with insurance companies regarding property claims and post-work supplementals, ensuring strict adherence to legal timelines.
- Cross-Functional Leadership: Supervise an assistant, coordinate project managers, crew scheduling, and sales teams using Monday.com and modern CRM software.
- Stakeholder Relations: Facilitate partnerships with property attorneys, public adjusters, and appraisers; collaborate with the C-suite on company growth and sales strategy.
Primary biller (medical insurance)
from 02.2024 to 12.2024
(11 months)
Pharmbills, Remote (Consulting, accounting and auditing)
- Revenue Cycle Management: Maintained and reduced outstanding balances (billing/aging) by submitting monthly resident health insurance claims.
- Denial Management: Investigated root causes for claim denials or reduced payments, determining corrective actions to recover old and current balances.
- Performance & Collaboration: Consistently met target collection metrics to qualify for maximum performance bonuses; collaborated with SNF facility management and insurance upper management using NCS (National Care Systems).
Associate Vendor Coordinator
from 04.2023 to 02.2024
(11 months)
Zelh, Vinnytsia (Transportation and logistics)
- Carrier Onboarding & Training: Trained drivers and carriers on load specifications, required equipment, and safety compliance.
- Compliance Screening: Verified carrier eligibility, insurance coverage, and safety records via the FMCSA website.
- Recognition: Leveraged bilingual proficiency (English/Russian/Ukrainian) to assist team members and resolve communication barriers, earning an expedited pay raise.
Insurance & claims specialist
from 01.2020 to 04.2023
(3 years 4 months)
Logistics company (NDA restricted), Mykolaiv (Transportation and logistics)
- Insurance Compliance: Managed comprehensive insurance coverage for drivers, cargo, and equipment; acted as a mediator between owner-drivers and insurance providers.
- Incident & Claims Management: Served as the primary point of contact for accidents, coordinating emergency response, police assistance, and repair shops, while seeking property damage compensation from liable parties.
- Risk Assessment: Screened driver hiring records and documentation from an insurance perspective to provide risk mitigation recommendations.
Education
Petro Mohyla black sea national university
Finance, insurance & banking with extended english learning, Mykolaiv
Higher, from 2017 to 2020 (3 years)
Additional education and certificates
British Council English certificate C1.
Has achieved CEFR C1 in the EnglishScore Core Skills test
Knowledge and skills
- Insurance Claims Management & Compliance
- Medical Billing & Aging / Revenue Cycle Management
- FMCSA Regulations & Trucking Logistics
- Management of CRM
- Data Analysis (Google Sheets) & Process Optimization
- Cross-functional Team Leadership & Negotiation
Language proficiencies
- English — advanced
- Ukrainian — advanced
Additional information
Detail-oriented and results-driven professional with over 5 years of experience spanning insurance claims management, medical billing, trucking logistics, and construction pipeline management. Fluent in English (C1) with a proven track record of optimizing workflows, reducing outstanding balances, and managing cross-functional operations
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