Nicole Clinton

Experience

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  Maryland Automobile Insurance Fund

  Jan 2001 - Jul 2013

  Purpose and Scope: Analyzed overall operations and developed new policies, processes and provided hands-on leadership that successfully elevated division into today’s high performing business until. Duties include managing financial functions to process all claims in a timely and accurate manner, and concurrently manage and oversee fraud investigations. Serve in an executive coaching and support role in areas of business planning, strategy development, cost containment, best practice standardization, and enterprise-level decision making. As records custodian, maintain in-depth knowledge of HIPPA and FOIA mandates. Organizational Impact | Contributions: Serve as Liaison with the National Insurance Crime Bureau supporting fraud investigations. Provide organizational-wide OFAC oversight and expertise for all investigations. Maintain OFAC regulatory compliance, and spearhead policy and procedural development requirements.  Direct all aspects of financial reporting, planning, and collection of $60M in receivables on an annual basis.  Leadership and vision reaped immediate results upon joining the division. Achieved a 12% increase in recoveries (the first increase that had been achieved in the past 4 years) despite a 19% reduction in incoming recovery files.  Wrote and implemented a best practices guide that includes detailed procedural requirements of each member of the management team to comply with business continuity requirements, and perform regular risk assessments and quality assurance reviews to identify gaps and ensure full best practices conformance. Efforts were lauded at the highest levels and are now being adopted by the corporate compliance officer and internal auditing across other divisions of MAIF.  Recently authored a comprehensive article entitled “Exploring the Impact of Fraud on the Automobile Industry” currently being reviewed for publication by SIU Today. Show less Purpose and Scope: Promoted to proactively manage daily operations of division investigating, evaluating, negotiating and settling / litigating bodily injury claims effectively and efficiently. Forged a cohesive team of 4 supervisors and 26 adjusters and administrative support personnel. Collaborated closely with SIU division monitoring and investigating potential fraud cases in cooperation with NICB Maryland Insurance Administration Insurance Fraud Division, up to and including providing testimony that delivered positive outcomes and reduced / eliminated exposure and expenses. Organizational Impact | Contributions: Achieved a 3-point reduction of combined operating ratio by launching a comprehensive training program across the entire claims organization in claims evaluation and negotiating skills.  Frequently provided expertise reviewing pending legislation. Providing written analysis and presented findings and opinions to the MAIF Board of Trustees. Show less Purpose and Scope: Excelled in role and quickly promoted to a direct leadership role. Supervised, empowered, and oversaw the work of 4 Supervisors and 24 PIP adjustors and administrative and medical support professionals. Organizational Impact | Contributions: Guided and personally assisted employees in reviewing, investigating, negotiating, litigating and settling medical claims. As necessary, worked in concert with SIU investigating and prosecuting insurance fraud cases.  Oversaw the planning and execution of medical clinic inspections to ensure billing accuracy and appropriateness was in conformance with legal and ethical guidelines, and that facilities were fully licensed and presented a safe environment for treating insured clients.  Consistently exceeded self, company, client, and partner agency expectations. Key accomplishments also include the creation and implementation of streamlined operational processes that facilitated accurate and timely handling of PIP and UD claims. Show less

  • Subrogation, Claims Support Unit Manager and SIU Administrator

    May 2011 - Jul 2013

  • Casualty Claims Manager

    Jan 2006 - May 2011

  • PIP/UM/Medical Management Manager

    Jan 2001 - Jan 2006
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  Nationwide

  Sept 2013 - Sept 2018

  Purpose and Scope: Came on board and took over a position as an Arbitration Subrogation Specialist. Quickly adapted to the new claims systems and within 2 weeks was on full draw handling a built pending of files with a goal of recovery of due funds through filing of successful arbitrations as well as creating savings for Nationwide through successful defense of arbitrations filed against Nationwide.Organizational Impact | Contributions: Guided and personally managed arbitration compiling, filing, arguments and decision processing.  Worked in assistant capacity for claims manager by assisting in his absence with customer service inquiries and work flow management within the unit. Consistently exceeded self, company, client, and partner agency expectations. Show less

  • Bodily Injury Claims Manager - Regional Medicare Compliance Manager

    Sept 2014 - Sept 2018

  • Claims Specialist

    Sept 2013 - Sept 2014
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  Anne Arundel County Government

  Sept 2018 - now

  • Deputy Central Services Officer

    Jun 2023 - now

  • Safety and Insurance Manager, Risk Management Division

    Sept 2018 - Jun 2023