ALECIA SCRUGGS-HILL
Atlanta,GA
Summary
Multifaceted professional with over a decade of experience in social services, case management, and complex claims investigation. Demonstrated expertise in crisis intervention, protective services, legal coordination, and supervising high-performing teams. Currently serving as a Complex Claims Specialist with State Farm, applying analytical, evaluative, and policy interpretation skills to resolve high-exposure auto and property insurance claims. Proven ability to manage sensitive and high-impact cases from start to finish, while delivering exceptional customer service, maintaining regulatory compliance, and collaborating with internal and external stakeholders to achieve resolution. Strong background in documentation, negotiation, and decision-making in both government and corporate environments.
Overview
13
13
years of professional experience
Work History
Complex Claims Specialist
State Farm
02.2024 - Current
- - Investigate, evaluate, and resolve complex auto and property insurance claims with high financial exposure.
- - Review claim files, assess coverage, determine liability, and document damages based on company policy.
- - Negotiate settlements with claimants, attorneys, and involved parties in compliance with legal and company guidelines.
- - Maintain detailed and accurate claim documentation and reports throughout the resolution process.
- - Provide exceptional customer service by responding to inquiries, offering timely updates, and ensuring satisfaction.
- - Collaborate with agents, legal teams, and fellow claims professionals to resolve claims efficiently.
- - Apply in-depth knowledge of insurance policy terms, procedures, and legal considerations.
Social Service Specialist Supervisor
State of Georgia
01.2023 - 12.2023
- - Supervised and guided assigned staff, planning and evaluating workloads.
- - Conducted investigations, gathered evidence, and ensured compliance with legal standards.
- - Developed and monitored individualized case plans and services.
- - Conducted home visits and assessed safety and well-being of clients.
- - Coordinated placements and services for children in foster care or protective custody.
- - Approved casework decisions and collaborated with legal teams on guardianship or adoption.
- - Maintained detailed documentation and ensured policy compliance.
Human Service Specialist IV
Atlantic County Government
01.2021 - 01.2023
- - Supervised assigned staff and managed service delivery resources.
- - Conducted client interviews and assessments; supported benefit applications.
- - Maintained strict client confidentiality and compliance with policy.
- - Created tailored service plans based on individual family needs and assessments.
- - Maintained comprehensive case files and recorded qualitative/quantitative data.
- - Identified barriers to success and implemented swift interventions.
Human Service Specialist III
Atlantic County Government
05.2012 - 01.2021
- - Evaluated and processed service applications for completeness and eligibility.
- - Ensured compliance with internal quality control procedures.
- - Prepared case summaries and acted as court liaison.
- - Conducted investigations and verified application information.
- - Drafted written reports, case briefings, and advocacy materials.
- - Provided direct case management and support to clients and families.
Education
Bachelor of Arts - Liberal Studies
Thomas Edison State University
Trenton, NJ09.2021
Master of Arts - Social Work
Walden University
Minneapolis, MNSkills
- - Claim Investigation & Documentation
- - Written & Verbal Communication
- - Data Analysis & Utilization
- - Critical Thinking & Reasoning
- - Policy Interpretation
- - Customer Service
- - Negotiation & Settlement
- - Team Collaboration
- - Case Management
- - Multitasking & Prioritization
- Claims investigation
- Liability assessment
- Negotiation techniques
- Claims documentation
- Insurance policy analysis
- Customer service
- Case management
- Legal compliance
- Conflict resolution
- Team collaboration
- Risk assessment
- Attention to detail
- Effective communication
- Problem solving
- Claims
- Policy interpretation
- Estimate preparation
- Settlement management
- Allocating claims
- Claims analysis
- Settlement determinations
- Liability denials
- Coverage assessments
- Settlement coordination
- Negotiation leadership
- Inspection report review
- Claims processing
- Microsoft office
- Verbal communication
- Documentation review
- Complex claims consulting
- Forms validation
- Accident investigations
- Multitasking Abilities
- Forms preparation
- Great mathematical skills
- Negotiation tactics
- Problem-solving
- Reliability
- Investigation support
- Detail orientation
- Patient contact
- Database management
- Active listening
- Documentation processing
- Medical terminology
- Problem-solving abilities
- Application review
- Insurance coverage verification
- Claims preparation
- Data integrity
- Adaptability and flexibility
- Policy requirements and eligibility
- Form preparation
- Regulatory compliance adherence
- Team building
- Excellent communication
- Task prioritization
- Account management expertise
- Small claims payouts
- Data management
- Adaptability
- Personal data evaluation
- Background in insurance
- Relationship building
- Critical thinking
Timeline
Complex Claims Specialist
State Farm
02.2024 - Current
Social Service Specialist Supervisor
State of Georgia
01.2023 - 12.2023
Human Service Specialist IV
Atlantic County Government
01.2021 - 01.2023
Human Service Specialist III
Atlantic County Government
05.2012 - 01.2021
Bachelor of Arts - Liberal Studies
Thomas Edison State University
Master of Arts - Social Work
Walden University
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