Amy Wind
Surprise,AZ
Summary
Results-driven professional with a strong background in claims management, seeking a role to leverage current experience and further develop within a company's core values. With over 5 years in claims, brings the ability to consistently execute best practices and a strong commitment to thoroughly investigate claims in alignment with company and regulatory guidelines.
Overview
9
9
years of professional experience
1
1
Certification
Work History
Claim Specialist
State Farm Insurance
09.2023 - Current
- Conducted thorough investigations into insurance claims to determine coverage eligibility and appropriate compensation amounts.
- Negotiated and settled claims within authorized limits, considering policy provisions, industry standards , and company standards.
- Used several claims management software and other relevant tools.
- Reviewed both residential and building construction estimates and wrote estimates.
- Maintained compliance with industry regulations by staying up-to-date on changes in policies and procedures, ensuring proper handling of sensitive information.
- Enhanced customer satisfaction with prompt and accurate claim resolutions, resulting in positive feedback and increased client retention.
- Gathered reports and documents for review to support the claims handling process.
- Review for fraud indicators
- Prepare file for subrogation
- Interact with internal departments and agents
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
Property Adjuster
USAA Insurance
03.2020 - 09.2023
- Enhanced customer satisfaction with prompt communication and consistent follow-up on claim status updates.
- Prepared reports of findings of investigations.
- Achieved timely resolution of property claims by investigating, evaluating, and settling a variety of cases.
- Exercised proper judgment and decision making to analyze property claims within scope of the damages presented.
- Write and review estimates using XACTAMATE software.
- Set initial reserve, update reserve, document rationale and claim summary notes.
- Summarize documents and enter into claim system notes, documenting a clam file with notes, coverage decision making process.
- Explain policy coverages to customers.
- Prepare letters State Mandated Letters.
- Prepare file for subrogation.
- Review file for fraud indicators.
- Assisted clients in navigating the recovery process after catastrophic events such as hurricanes or floods, guiding them through available resources and understanding their policy coverage''s limitations.
- Provided exceptional customer service and empathy during all situations , even in high stress situations.
Part-Time Billing Specialist
Advanced Audio and Video
03.2019 - 09.2023
- Responded to customer requests for products, services, and company information.
- Prepared billing invoices
- Accounting
- Scheduling appointments
- Ordering products for job installs
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
Casualty Claims Adjuster
American Family Insurance
04.2016 - 07.2019
- Coordinated closely with underwriting teams to address coverage discrepancies, resulting in fewer claim disputes and improved client satisfaction.
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
- Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.
- Developed strong product knowledge to provide informed recommendations based on individual customer needs.
- Trained new adjusters on company policies and procedures, contributing to a well-prepared team of professionals.
- Negotiated settlements with claimants and claimants' attorneys.
- Identified potential areas of fraud through meticulous attention to detail and diligent investigative work.
- Facilitated clear communication between all parties involved in the claim process, preventing misunderstandings and delays.
- Negotiated terms and handled settlements and adjustments with attorneys, claimants and co-defenders.
- Interviewed policyholders, witnesses and third parties to gather information and details regarding injury event to determine liability.
- Interviewed relevant parties to determine claim denial or settlement.
- Participated in ongoing training programs to stay up-to-date on industry trends, regulatory changes, and best practices for bodily injury claims handling.
- Assisted policyholders in understanding coverage options, helping them make informed decisions about their insurance needs.
- Negotiated fair settlements with claimants, ensuring both parties reached a satisfactory agreement.
- Reduced claim processing time through efficient investigation and documentation of claim details.
- Set up rentals, towing , and preferred provider shops for repairs as needed.
- Determine liability for auto claims.
- Review medical reports, police reports , photos and any documents related to claim.
Education
Master of Business Administration -
University of Phoenix
Phoenix, AZParalegal Certificate - undefined
Premier Career College
Phoenix, AZBachelor of Science - Business Administration
University of Phoenix
Phoenix, AZSkills
- Licensed in property and casualty insurance
- Certified paralegal
- Proficient in diverse claims handling
- Bodily injury assessments
- Claims assessment and regulatory adherence
- Damage analysis and policy interpretation
- Formal letter writing
- Analysis of state statutes
- Analytical problem-solving abilities
- Effective time management
- Effective troubleshooting
- Subrogation and fraud assessment
- Clear interpersonal communication
- Analyzing and interpreting documents
- Assist in legal hearings and arbitrations
- Engagement with claim-related parties
- Experienced with Guidewire and claims management platforms
- Knowledge of relocation policies for domestic and international assignments
- Facilitating temporary housing assistance
- Effective investigative abilities
- Ethical and trustworthy
- Knowledge of court procedures, statutes, researching court documents, rules of the court and preparing legal documents
- Direct experience in internships in preparation of memorandums of law, typing correspondence, complaints, answers, disclosure statements, and case briefings
- Initiative-taker
- Results-oriented professional
- Claims analysis
Certification
- Property and Casualty license
- Certified Paralegal
Languages
English
Full Professional
Interests
Hiking
Traveling
Kareoke
Animals
Software
MICROSOFT OFFICE
GUIDEWIRE
XACTAMATE
Work Preference
Work Type
Full TimeLocation Preference
RemoteQuote
It’s easier to ask forgiveness than it is to get permission.
Grace Hopper
Timeline
Claim Specialist
State Farm Insurance
09.2023 - Current
Property Adjuster
USAA Insurance
03.2020 - 09.2023
Part-Time Billing Specialist
Advanced Audio and Video
03.2019 - 09.2023
Casualty Claims Adjuster
American Family Insurance
04.2016 - 07.2019
Paralegal Certificate - undefined
Premier Career College
Bachelor of Science - Business Administration
University of Phoenix
Master of Business Administration -
University of Phoenix
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