Alla Gelfand
Benton,AR
Summary
Seasoned Senior Complex Claims Examiner at Progressive Insurance, specializing in coverage analysis and active listening to drive successful outcomes. A meticulous attention to detail and unwavering commitment to regulatory compliance define a professional approach that consistently delivers results. Collaborative efforts with a dedicated team effectively manage pre-litigated claims, engaging with public adjusters and attorneys to negotiate and settle intricate cases. Strong communication skills foster long-term client relationships and ensure fair claim resolutions, underscoring a dedication to integrity and client satisfaction.
Overview
25
25
years of professional experience
Work History
Sr. Complex Claims Examiner (RCU Unit)
Progressive Insurance
10.2022 - Current
- As a Sr. Complex Claims Examiner at Progressive Insurance, I managed a diverse range of represented claims, prepared property damage evaluations, negotiated settlements, and issued timely payments within check authority limits. My attention to detail and strong communication skills led to successful claim resolutions and high customer satisfaction levels.
- Handled mediations, appraisals, DOI complaints and assisted with pre-suit mediations
- Negotiated settlements within the represented claims unit and issued timely payments
- Ensured successful claim resolutions and high customer satisfaction
Complex Claims Examiner
Security First Insurance
12.2019 - 10.2022
- Approve, reject or refer a claim for subrogation.
- Determine whether payouts are reasonable.
- Determines need for SIU, field adjusters and cause and origin experts.
- Ensure compliance with regulatory standards, company policy and guidelines.
- [11/01/2021] Transferred to the complex unit to handle pre-litigated claims.
- Handle claims involving Public Adjusters and Attorneys.
- Manage, investigate and evaluates coverage, and damages, in order to negotiate and settle complex claims within prescribed authority.
- Confidently negotiate claims to fairly resolve pending inventory.
Ophthalmic Technician
Mount Sinai Health System
10.2017 - 08.2018
- Performs preliminary screening examinations for physician review including, but not limited to, central and peripheral visual field tests; ocular motility tests; color vision tests; refractions; tonometry, to determine intraocular pressure and pupil testing for size, equality and reaction prior to dilation.
- Obtain medical data from patients
- Perform technical work ups and special testing such as corneal topography, retinal nerve fiber layer retinal and corneal thickness.
- Surgical assisting with in office procedures, sterilization of instruments and sending medications to pharmacy as per doctors orders. Worked with corneal, retinal, glaucoma and oculoplastics specialists.
- Actively participated on the job training.
Ophthalmic Technician
Laser and Microsurgery Institute
06.2012 - 04.2014
- Take medical histories from patients, perform routine preliminary work up tasks such as visual acuity, and perform general office duties and other functions as required or assigned.
- Assist the physicians with patient care and clinical flow
- Accurately performs the following: Visual acuity measurements near and far, with and without glasses, obtaining eye glass information via automated lensometry, auto refractions, OCT, Visual Fields and Pentacam.
Licensed Real Estate Salesperson
Silva Group Llc
06.2007 - 09.2012
- Generated lists of properties that are compatible with renters needs and financial resources.
- Generated new clients through marketing, advertising and establishing relationships with clients by obtaining referrals through networking.
- Build strategic relationships with building managers and leasing staff.
- Maintain referral contacts by way of educational efforts.
- Created marketing material and maintained website.
- Collect data on new developments.
- Update and revise listings.
- Participated in training programs and staff meetings.
- Submit documents on behalf of clients to owners or building management.
- Closed an average of 25-30 transactions per year.
Assistant Manager
Trends Menswear
07.2001 - 03.2007
- Began in Sales, subsequently advanced to Assistant Manager.
- Trained and supervised new employees on store operations and customer service.
- Accurately handled a large volume of daily transactions.
- Ensured staff competence, so as to optimize and sustain sales performance, profitability and customer satisfaction.
- Ensured that work produced by team members is in accordance with company standards.
- Provided performance related feedback on team members to the regional manager.
- Provided training and coaching to team members on assigned shifts.
- Assisted regional manager in merchandising, to drive sales through effective merchandise presentations.
Education
Bachelor of Applied Science (B.A.Sc.) - Food Science and Human Nutrition
City University of New York-Brooklyn College
Skills
- Active listening skills
- Creative Problem Solving
- Analytical Skills
- Negotiation Skills
- Proficiency in Microsoft word
Languages
Russian (Native or Bilingual)
English (Native or Bilingual)
Timeline
Sr. Complex Claims Examiner (RCU Unit)
Progressive Insurance
10.2022 - Current
Complex Claims Examiner
Security First Insurance
12.2019 - 10.2022
Ophthalmic Technician
Mount Sinai Health System
10.2017 - 08.2018
Ophthalmic Technician
Laser and Microsurgery Institute
06.2012 - 04.2014
Licensed Real Estate Salesperson
Silva Group Llc
06.2007 - 09.2012
Assistant Manager
Trends Menswear
07.2001 - 03.2007
Bachelor of Applied Science (B.A.Sc.) - Food Science and Human Nutrition
City University of New York-Brooklyn College