Ramone Woods
Matteson,IL
Summary
Experienced with claims assessment, negotiation, and resolution. Utilizes strategic problem-solving to manage high-volume claims efficiently. Track record of enhancing team performance and ensuring compliance with regulatory standards.
Overview
5
5
years of professional experience
Work History
Personal Injury Claims Manager
SBSB Law
02.2025 - Current
- Handled claims consistent with client and corporate policies, procedures, best practices and regulations.
- Documented and communicated timely claims information while supporting accurate outcomes.
- Conducted thorough investigations of complex claims, gathering evidence to support decision-making processes.
- Negotiated settlements with claimants, achieving fair outcomes while controlling costs.
- Collaborated with other departments to improve overall organizational effectiveness in addressing client needs.
Claims Examiner
Sedgwick Claims Management
11.2023 - 02.2025
- Utilized analytical skills to evaluate medical bills for accuracy and appropriateness of charges before approving payments as part of the claims process.
- Reduced claim processing time by implementing efficient workflow strategies and prioritizing tasks effectively.
- Enhanced customer satisfaction by promptly addressing inquiries and providing accurate information on claim status.
- Maintained detailed records of all claims activities, ensuring compliance with regulatory requirements and company policies.
- Researched claims and incident information to deliver solutions and resolve problems.
Claims Analyst
Sagility Health
04.2022 - 11.2023
- Managed high-volume caseloads, prioritizing tasks to ensure timely completion of all claims.
- Maintained compliance with industry regulations and company policies while managing sensitive client information and claims records.
- Demonstrated a high level of accuracy and attention to detail in reviewing claim documentation for approval or denial decisions.
- Enhanced customer satisfaction by resolving complex claims issues in a timely manner.
- Conducted thorough investigations into each claim, gathering relevant data and documentation to support decision-making processes.
Claims Representative
Teleperformance USA
05.2020 - 04.2022
- Worked productively in fast-moving work environment to process large volumes of claims.
- Followed up with customers on unresolved issues.
- Improved customer satisfaction by providing timely and accurate information on claim status and resolution.
- Maintained compliance with industry regulations by adhering to established procedures and guidelines in claims handling.
- Negotiated favorable settlements with claimants, resulting in cost savings for the company.
Education
Associate of Arts - Communications
South Suburban College of Cook County
South Holland, IL01-2026
High School Diploma -
Holy Cross HighSchool
05-2019
Skills
- Claims analysis
- Claims investigation and research
- Policy interpretation
- Investigation techniques
- Procedure implementation
- Planning and organization
- Claims processing
- Legal compliance
Timeline
Personal Injury Claims Manager
SBSB Law
02.2025 - Current
Claims Examiner
Sedgwick Claims Management
11.2023 - 02.2025
Claims Analyst
Sagility Health
04.2022 - 11.2023
Claims Representative
Teleperformance USA
05.2020 - 04.2022
Associate of Arts - Communications
South Suburban College of Cook County
High School Diploma -
Holy Cross HighSchool
Similar Profiles
Ramone WoodsRamone Woods
Bookkeeper at SBSB Eastham Law FirmBookkeeper at SBSB Eastham Law Firm
Yuvashree RYuvashree R
Article assistant at SBSB and AssociatesArticle assistant at SBSB and Associates
Ellyn StierEllyn Stier
Attorney/Owner at Lake Oswego Elder Law and Ellyn R. Stier, Attorney at LawAttorney/Owner at Lake Oswego Elder Law and Ellyn R. Stier, Attorney at Law
Jermaine BivinsJermaine Bivins
General Sales Manager / Finance Director at South Suburban MitsubishiGeneral Sales Manager / Finance Director at South Suburban Mitsubishi
Karyn DanielKaryn Daniel
Fulfillment Associate / Learning Ambassador at AmazonFulfillment Associate / Learning Ambassador at Amazon