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熊猫简历Claims Risk Manager简历模板，简约、设计感、经典、上下结构风格简历模板，支持自定义板块、自定义颜色、AI润色、技能条、荣誉墙、一键更换模板，专业AI辅助一键优化Claims Risk Manager简历内容，仅需5分钟即可拥有一份精美的Claims Risk Manager简历模板，助力你获得「高薪职位」。
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Coco Panda
Claims Risk Manager
PROFESSIONAL SUMMARY
Claims Risk Manager with 9 years of experience improving claim quality, reserve accuracy, litigation controls, and regulatory compliance across property, casualty, and workers' compensation portfolios. Proven record leading audit programs, risk analytics, and cross-functional mitigation strategies that reduce leakage, legal spend, and operational exposure.
PROFESSIONAL SKILLS
Claims Risk Management
Claims Quality AuditsReserve Adequacy ReviewLitigation ManagementLoss Trend AnalysisCoverage Evaluation
Analytics, Compliance & Controls
Risk ScoringRegulatory ComplianceFraud IndicatorsTableauAdvanced Excel
Leadership & Operations
Team CoachingVendor ManagementExecutive ReportingProcess ImprovementCross-Functional Collaboration
PROFESSIONAL EXPERIENCE
Northeast Mutual Insurance
Property & CasualtyRegional Carrier
Hartford, CT
Claims Risk Manager
Claims GovernanceRisk Controls
Sep 2020 - Present
- Managed a 14-person claims risk team overseeing casualty and property claim audits, reducing reserve leakage by 18% within four quarters.
- Built severity-based risk scoring models with analytics partners, improving high-risk claim identification by 24% and accelerating escalation decisions.
- Standardized litigation management review protocols across six regional offices, lowering average legal spend per litigated claim by 11% year over year.
- Presented quarterly loss trend, fraud, and reserve adequacy findings to senior leadership, supporting $6.2M in annual risk mitigation actions.
- Coached adjusters and supervisors on coverage evaluation, diary discipline, and compliance controls, increasing audit pass rates from 86% to 95%.
Atlantic Shield Insurance Group
Commercial InsuranceClaims Operations
Boston, MA
Senior Claims Risk Analyst
Claims AnalyticsCompliance Review
Jun 2016 - Aug 2020
- Analyzed workers' compensation and general liability claim portfolios exceeding $420M in reserves, identifying exposure patterns and adverse development drivers.
- Developed monthly risk dashboards in Tableau and Excel, reducing manual reporting time by 35% while improving executive visibility.
- Partnered with SIU, underwriting, and actuarial teams to flag suspicious claims, contributing to $1.4M in avoided losses annually.
- Reviewed 300+ complex claim files annually for compliance, reserving accuracy, subrogation opportunity, and adherence to state regulatory requirements.
CERTIFICATIONS
Associate in Claims - The Institutes
May 2023
Associate in Risk Management - The Institutes
Oct 2021
EDUCATION
University of Connecticut
Risk ManagementInsurance
Storrs, CT
Bachelor of Science in Business Administration
Sep 2011 - May 2015
Concentration in risk management and insurance.
Coco Panda
Claims Risk Manager
PROFESSIONAL SUMMARY
Claims Risk Manager with 9 years of experience improving claim quality, reserve accuracy, litigation controls, and regulatory compliance across property, casualty, and workers' compensation portfolios. Proven record leading audit programs, risk analytics, and cross-functional mitigation strategies that reduce leakage, legal spend, and operational exposure.
PROFESSIONAL SKILLS
Claims Risk Management
Claims Quality AuditsReserve Adequacy ReviewLitigation ManagementLoss Trend AnalysisCoverage Evaluation
Analytics, Compliance & Controls
Risk ScoringRegulatory ComplianceFraud IndicatorsTableauAdvanced Excel
Leadership & Operations
Team CoachingVendor ManagementExecutive ReportingProcess ImprovementCross-Functional Collaboration
PROFESSIONAL EXPERIENCE
Northeast Mutual Insurance
Property & CasualtyRegional Carrier
Hartford, CT
Claims Risk Manager
Claims GovernanceRisk Controls
Sep 2020 - Present
- Managed a 14-person claims risk team overseeing casualty and property claim audits, reducing reserve leakage by 18% within four quarters.
- Built severity-based risk scoring models with analytics partners, improving high-risk claim identification by 24% and accelerating escalation decisions.
- Standardized litigation management review protocols across six regional offices, lowering average legal spend per litigated claim by 11% year over year.
- Presented quarterly loss trend, fraud, and reserve adequacy findings to senior leadership, supporting $6.2M in annual risk mitigation actions.
- Coached adjusters and supervisors on coverage evaluation, diary discipline, and compliance controls, increasing audit pass rates from 86% to 95%.
Atlantic Shield Insurance Group
Commercial InsuranceClaims Operations
Boston, MA
Senior Claims Risk Analyst
Claims AnalyticsCompliance Review
Jun 2016 - Aug 2020
- Analyzed workers' compensation and general liability claim portfolios exceeding $420M in reserves, identifying exposure patterns and adverse development drivers.
- Developed monthly risk dashboards in Tableau and Excel, reducing manual reporting time by 35% while improving executive visibility.
- Partnered with SIU, underwriting, and actuarial teams to flag suspicious claims, contributing to $1.4M in avoided losses annually.
- Reviewed 300+ complex claim files annually for compliance, reserving accuracy, subrogation opportunity, and adherence to state regulatory requirements.
CERTIFICATIONS
Associate in Claims - The Institutes
May 2023
Associate in Risk Management - The Institutes
Oct 2021
EDUCATION
University of Connecticut
Risk ManagementInsurance
Storrs, CT
Bachelor of Science in Business Administration
Sep 2011 - May 2015
Concentration in risk management and insurance.
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