Naomi Brown

Experience

• 

  Aetna

  Jun 2006 - Jul 2013

  Life Claims Analyst

  Achieve superior life claim service. Secure, analyze, and approve claim information to make recommendations for approval or denial of life claims. Lead Analyst for claim account management• Manage/adjudicate a wide range of assigned life and AD&D claims, (including adverse claims and complex AD&D) independently, seeking guidance and direction for more complex claims in accordance with the terms of the contracts.• Responsibility for constituent satisfaction according to policies and practices• Perform detailed analysis and documentation of claim data to direct effective outcome• Coordinates investigation with consultants, interprets insurance contracts to determine liability• Determines claimant’s eligibility and qualification for benefit and extent of dismemberment• Ensures compliance with contract provisions and state/federal regulations• Effectively uses outside vendors to obtain information according to guidelines• Independently prepares all claim denials with review from Consultant or Manager• Makes accurate claim decisions in accordance with the terms of the contracts• Responds to claim and account inquiries from claimants, policyholders, and other interested parties and creatively resolves issues through effective verbal and written communication and by involving appropriate people within or outside company• Contributes new ideas and concepts in a consistently changing environment• Perform any additional/miscellaneous duties (not inclusive of job description) as requested by management team within the scope of the knowledge/ability Show less

• 

  MetLife

  Aug 2013 - now

  Provides exemplary leadership and customer service by ensuring the processing of group disability income insurance claims in a timely and accurate manner• Coaches, coordinates and develops claims specialists.• Acts as resource for claim-related and technical issues.• Monitors case managers' work queues to ensure claims team is meeting expectations and applicable performance guarantees.• Conducts weekly quality audits; assists with training; resolves escalated phone calls.• Provides feedback to unit managers on individuals' performance.• Performs other related duties as assigned or required.• Provide guidance to junior staff members.• Facilitates daily meetings. Show less • Manages assigned caseload of long-term disability (LTD) claims • Determines whether to return, pend, deny or pay claims. • Inputs data and evaluates claimant eligibility via information received from claimant, attending physician, and employer. • Decides payment period, follows up and monitors payment accuracy and timeliness. • Follows plans to closure. • Follows established claim policies and practices to resolve claims and issues. • Performs other related duties as assigned or required. Show less

  • Senior STD Unit Manager

    Dec 2022 - now

  • Unit Manager

    Aug 2021 - Dec 2022

  • Claim Support Specialist

    Jan 2016 - Aug 2021

  • LTD Claim Specialist

    Aug 2013 - Jan 2016