1. ROGER LANCASTER
3115 Lincoln View Blvd., #802, H: 510-904-2277; C: 415-704-2377
San Francisco, CA 94107 rlancaster98@gmail.com
SUMMARY OF QUALIFICATIONS
Accomplished Senior Claims Analyst Offering 10 Years’ Experience in Insurance Claims
Strong history of leadership and training, resulting in multiple promotions at a nationwide leading
insurance provider.
Experienced in multiple aspects of insurance and claims processes, including claims management,
claims eligibility, and provider relations.
Proven track record of developing talent in teams to achieve superior unit quality ratings, both
individually and on a unit-wide basis.
Fluent in Spanish with the ability to interpret regarding insurance claims.
Skilled in claims management and claims processing software systems, and client databases with
proficiency in Microsoft Word, PowerPoint, and Outlook. Adept in learning new technology.
RELEVANT EXPERIENCE
OPTIMUM CARE INSURANCE, San Francisco, CA
Senior Claims Analyst October 20xx-Present
Promoted to lead and manage unit of 6 Claims Analyst II’s. Interviewed candidates and trained, mentored, and
evaluated members of the unit. Responsible for maintaining an excellent overall team rating in compliance and
productivity goals. Reviewed and gave feedback on claims denials, and analyzed claims for suspected fraud. Member
of the Senior Leadership Team.
Raised team’s quality rating to 98% in 6 months through initiating a Quality-First approach and improving
training curriculum for new employees.
Addressed training deficits of 2 struggling team members, increasing individual quality ratings to 95%.
Claims Analyst II July 20xx-October 20xx
Advanced after 2 years due to strong performance. Reviewed initial claims for an average caseload of 140 cases
across 10 states; determined claims eligibility under 9 policy types and individual state-specifications. Completed
initial expense reimbursements for eligible claims. Inspected initial claims to detect fraud and documented
extensively to support cases of claim denial and/or suspected fraud. Aided Audit Department with Random File
Reviews after being approached for assistance.
Took initiative to train and mentor new team members, resulting in being given additional responsibility as
designated unit trainer/mentor.
Chosen to manage 10 Claims Analyst II’s for 4 months in absence of supervisor.
2. Claims Analyst I October 20xx-July 20xx
Mastered 13 various policy types of long-term care insurance to process reimbursements and claims eligibility.
Investigated claims for indicators of fraud and meticulously documented findings for further analysis.
Selected as designated trainer/mentor for unit after 1 year as a result of proactively training new hires and
advising colleagues concerning policy interpretation and complicated claims issues.
Surpassed company on-time reporting and quality goals with a consistent rating of 100% while handling an
average caseload of 175 cases.
Saw increase in regional scope from 10 states to 15 states after 9 months due to high competency with
complex policies and state requirements.
ADDITIONAL EXPERIENCE
UNITED STATES ARMY, Fort Irwin, CA
Sergeant (E-5) December 20xx-December 20xx
Promoted in rank to Sergeant (E-5) in January 20xx after demonstrating effective leadership in deployment.
Supervised and trained a unit of 10 soldiers, earning recognition as a highly skilled trainer.
Received the following military awards: Meritorious Unit Commendation (20xx), Bronze Star (20xx).
EDUCATION
SAN FRANCISCO STATE UNIVERSITY, San Francisco, CA
B.S., Business Administration—Management Focus; Minor in Information Systems
Took advanced Spanish language courses, including: Advanced Grammar and Composition, Accelerated
Grammar, and Conversation and Reading.