Grace Sheerin
Ngaio,WGN
Summary
Results-driven Claims & Underwriting Manager with expertise in Health Insurance, specializing in risk assessment and claims processing. Led teams in implementing technology solutions that improved operational efficiency and delivered customized insurance solutions, ensuring client satisfaction and adherence to industry standards.
Overview
14
14
years of professional experience
Work History
Claims & Underwriting Manager
UniMed
05.2024 - Current
- Led underwriting team in assessing risk for health insurance applications and mentored junior underwriters on industry standards, enhancing team expertise.
- Managed team of underwriters to ensure accurate, timely processing of applications, contributing to improved customer satisfaction.
- Developed comprehensive guidelines for evaluating applicant eligibility and coverage options, improving consistency in decision-making.
- Reviewed complex cases to provide tailored solutions for unique client needs.
- Led claims processing operations for diverse insurance products.
- Implemented technology solutions to streamline claims management workflows.
Claims & Underwriting Manager
Accuro Health Insurance
10.2021 - 05.2024
- Led underwriting team to assess risk for health insurance applications & mentored junior underwriters on industry standards and best practices.
- Oversaw underwriting team to ensure accurate, timely processing of applications, improving overall service delivery.
- Created guidelines for evaluating applicant eligibility and coverage options to enhance consistency in underwriting decisions.
- Reviewed complex cases to provide tailored solutions for unique client needs.
- Led claims processing operations for diverse insurance products.
- Implemented technology solutions that streamlined claims management workflows, reducing processing time and improving accuracy.
Claims & Underwriting Team Lead
Accuro Health Insurance
10.2019 - 10.2021
- Led claims processing teams to ensure timely resolution of customer inquiries.
- Resolved escalated claims issues, delivering effective solutions that strengthened customer trust.
- Led team in implementing customer service strategies, resulting in higher client satisfaction rates.
- Coordinated training programs to enhance staff skills and knowledge, improving overall service quality in health insurance.
Claims & Underwriting Specialist
Accuro Health Insurance
05.2015 - 10.2019
- Underwrite new business and exclusion reviews in a timely and professional manner within agreed underwriting parameters and service standards including by assessing background information on clients and calculating the risk.
- Reviewing claim submissions and determining eligibility and level of coverage.
- Responded promptly and accurately to member claim enquiries via email and phone, including assessment of health information and processing of pre-approvals and claims.
- Filed claims and entered data while updating databases accurately and timely.
- Delivered courteous and knowledgeable service to Accuro’s members, staff, and agents via phone and email.
- Resolved product and service complaints by clarifying issues, determining causes, and selecting solutions.
Customer Service Consultant
IRD
01.2015 - 04.2015
- Delivered strong customer service to enhance customer satisfaction
- Managed inbound and outbound calls to assist customers
- Handled an average of 60 calls daily to support customer needs
- Advised customers on new legislation impacts on individual situations
- Coached staff members needing additional support
- Participated in team meetings to discuss project updates
- Focus on child support
Store Manager
The Just Group
07.2013 - 12.2014
- Managed daily store operations, driving efficient workflow and maximizing team productivity.
- Trained and developed staff in customer service and sales techniques, improving overall service quality.
- Oversaw inventory management, optimizing stock levels and product placement.
- Implemented visual merchandising standards, elevating store presentation and customer engagement.
- Conducted staff performance evaluations, providing constructive feedback and support.
Visual Merchandiser
Coast Super Flagship
London
05.2012 - 06.2013
- Created visually appealing displays that increased product visibility and attracted customer attention.
- Executed seasonal theme changes across store layouts and displays to align with customer preferences and enhance shopping experience.
- Analyzed customer traffic patterns to optimize product placement.
- Conducted regular assessments of display effectiveness and adjusted strategies to maximize customer engagement.
- Trained staff on visual merchandising standards and techniques.
Education
Queen Margaret College
Wellington, New Zealand01-2008
Skills
- Claims processing
- Underwriting guidelines
- Risk assessment and management
- Health insurance expertise
- Technology solutions
- Customer relationship management
References
- Jason Withell, Operations Team Leader & Senior Underwriter, Accuro, Available on request
- Mark Robinson, Team Leader, IRD, Available on request
Timeline
Claims & Underwriting Manager
UniMed
05.2024 - Current
Claims & Underwriting Manager
Accuro Health Insurance
10.2021 - 05.2024
Claims & Underwriting Team Lead
Accuro Health Insurance
10.2019 - 10.2021
Claims & Underwriting Specialist
Accuro Health Insurance
05.2015 - 10.2019
Customer Service Consultant
IRD
01.2015 - 04.2015
Store Manager
The Just Group
07.2013 - 12.2014
Visual Merchandiser
Coast Super Flagship
05.2012 - 06.2013
Queen Margaret College