Amy Rounds
Gilbert,AZ
Summary
Service-oriented Claims Adjuster skilled at applying creative approaches to solving complex problems. Adept at developing profitable and quality-focused processes. Analytical thinker skilled ar developing solutions to complex problems.
Overview
14
14
years of professional experience
Work History
Claim Specialist-HCCSS
State Farm
07.2023 - Current
- Reviewed and maintained accurate claim files, ensuring all necessary documentation was in place for future reference.
- Maintained compliance with industry regulations by staying up-to-date on changes in policies and procedures, ensuring proper handling of sensitive information.
- Conducted thorough investigations into insurance claims to determine coverage eligibility and appropriate compensation amounts.
- Enhanced customer satisfaction with prompt and accurate claim resolutions, resulting in positive feedback and increased client retention.
- Provided exceptional customer service during difficult situations, displaying empathy while explaining complex claim issues clearly to clients.
- Collaborated closely with adjusters to ensure accurate, fair, and timely claims settlements for all involved parties.
- Managed high-volume caseloads effectively, prioritizing urgent cases while maintaining attention to detail for all claims.
- Improved policyholder satisfaction by ensuring transparent communication and setting realistic expectations throughout claim process.
- Receive inbound calls as well as making outbound calls to policyholders and claimants
- Review and monitor work queues which may include task items, calendars, mail, messages and new claims.
Concierge Resolution Specialist
Cenlar FSB
12.2019 - 07.2023
- Selected by upper Management to develop Concierge team to assist with High Networth Clients Morgan Stanley and CitiBank.
- Researched incomplete tasks initiated by the clients to develop resolutions.
- Performed outbound calls to customers to resolve
escalated issues. - Drove dispute resolutions using effective problem-solving and by guiding mutual understanding of opposing viewpoints.
- Formulated focused and individualized resolutions aimed to peacefully settle disputes.
- Quickly learned new skills and applied them to daily tasks, improving efficiency and productivity.
- Demonstrated respect, friendliness and willingness to help wherever.
- Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
- Displayed strong telephone etiquette, effectively handling difficult calls.
- Demonstrated leadership by making improvements to work processes and helping to train others.
Operations Processor 2
Wells Fargo
04.2019 - 08.2019
- Delivered various types of mail on routes according to strict timelines.
- Received, sorted, and reviewed incoming work.
- Took accountability from receipt of work, to resolution.
- Data entry and records maintenance using multiple online systems.
- Resolved issues and escalated unresolved or unusual issues as needed to senior staff members or
management for guidance and resolution.
Substitute Teacher
Penmac Staffing
06.2017 - 10.2018
- Enforced classroom routines to keep students on schedule and operating at consistent level.
- Implemented lesson plans assigned by classroom teacher to educate students about key concepts.
- Provided notes and reports on school day activities to primary teacher.
- Educated students in various subjects to provide seamless transition during absence of head teacher.
- Maintained student attendance and assignment records to prevent lapses during teacher absences.
- Differentiated classroom and small group instruction to meet needs of students with various learning styles and abilities.
- Provided classroom instruction outlined in teacher's lesson plans.
- Created classroom environment conducive to learning and appropriate to student maturity and interests.
Security Mortgage Analyst
Preferred Resources (U.S. Bank)
05.2016 - 03.2017
- Modified existing software to correct errors, allow it to adapt to new hardware, or to improve its- performance.
- Confered with systems analysts, engineers, programmers and others to design system and to obtain- information on project limitations and capabilities, performance requirements and interfaces.
- Analyzed user needs and software requirements to determine feasibility of design within time and cost- constraints.
- Stored, retrieved, and manipulated data for analysis of system capabilities and requirements.
- Trained users to use new or modified equipment.
- Analyzed information to determine, recommend, and plan computer specifications, layouts, and- peripheral equipment modifications.
- Administered security access to multiple applications that are used by Mortgage US Bank Employees.
General Clerk 2
Dextera Corporation
10.2013 - 05.2016
- Received 50-70 inbound calls per day to discuss Health Insurance.
- Associate mailroom and digitally imaged support documents to appropriate consumer records.
- Ability to handle confidential and sensitive information at all times.
- Accurately prepared spreadsheets and pivot tables using Excel to manage all consumer's inconsistencies.
- Verified income, residency, exemptions, and other documentation to meet requirements and clear- inconsistencies from the applications.
- Delivered high-quality customer service through deep commitment to knowledge and performance.
HR Administrator
Manpower
10.2012 - 06.2013
- Regularly updated HR databases to reflect employee information, changes in benefits and other details.
- Managed all human resource documentation, including new hire letters, employee contracts and corporate policies and procedures.
- Supervised onboarding process for newly hired employees, including distribution of all paperwork.
- Handled employee conflicts efficiently while following all company procedures.
- Completed reports and employment forms.
- Supported top talent identification processes by interviewing candidates and executing onboarding, orientation and benefits processes.
- Developed and maintained resources and materials to support hiring managers throughout onboarding life cycle.
- Answered employee questions regarding health benefits and 401k options.
- Scheduled or conducted new employee orientations.
- Informed job applicants of duties and responsibilities, compensation and benefits.
Administrative Assistant
Jefferson College Area Technical School
02.2011 - 05.2012
- Prepared course materials such as syllabi, homework assignments, and
handouts. - Evaluated and graded students' class work, assignments, and papers.
- Supervised undergraduate or graduate teaching, internship, and research work.
- Inventoried and ordered supplies for office.
- Developed administrative processes to achieve organizational objectives and improve office efficiency.
- Prepared and prioritized calendars and correspondence.
- Coordinated appointments, meetings and conferences.
- Maintained accurate department and customer records.
- Utilized editing programs to proofread content for typo-free emails, memos and documentation.
- Managed office duties, ordered materials, organized workspaces, answered emails and made phone calls.
Education
Associate of Applied Science - Business Admin/Medical
Jefferson College
05.2012
Skills
- Records management systems
- Proposal writing
- Back office operations
- Executive presentation development
- Problem-solving abilities
- Technologically savvy
- Call Center Operations
- Inbound and Outbound Calling
- High-energy attitude
- Dispute management
- Analytical
- Microsoft Office
- Critical thinking
- Policy Interpretation
- Claims Investigation
- Claims analysis
Pickleball, Hiking
I've been playing Pickleball for almost 2 years now, and you will find me either practicing in my garage against the wall, or on the courts at least 5 days per week. I've developed quite the passion for this game and am always training to be my best.
If I'm not the Pickleball courts, and when temperatures are on the cooler side, you will find me hiking. My favorite hike so far was Humphrey's Peak Trail in Flagstaff with over 12,600 ft of elevation gain. The hike is a strenuous 5 miles, challenging and not for beginners. I felt like I could accomplish anything after making it to the top and loved all the wildlife while walking the trail.
Timeline
Claim Specialist-HCCSS
State Farm
07.2023 - Current
Concierge Resolution Specialist
Cenlar FSB
12.2019 - 07.2023
Operations Processor 2
Wells Fargo
04.2019 - 08.2019
Substitute Teacher
Penmac Staffing
06.2017 - 10.2018
Security Mortgage Analyst
Preferred Resources (U.S. Bank)
05.2016 - 03.2017
General Clerk 2
Dextera Corporation
10.2013 - 05.2016
HR Administrator
Manpower
10.2012 - 06.2013
Administrative Assistant
Jefferson College Area Technical School
02.2011 - 05.2012
Associate of Applied Science - Business Admin/Medical
Jefferson College