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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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

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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