Angelia Moore
Memphis,US
Summary
Detail-oriented Examiner with 30 years of experience. Strong command of conflict resolution and negotiation combined with excellent reporting and research skills. Thorough understanding of claims process and excellent negotiation techniques..
Overview
29
29
years of professional experience
Work History
Senior Claims Examiner
Advanced Business Services
08.2019 - 08.2023
- Review claims for proper diagnosis and determine appropriate coverage as needed Claims handling, including gathering of labor time and cost, parts costs, enter information into system, set-up claim in system with notes, reasons for approval/denial; monitor claims through completion Knowledgeable of automotive parts, repairs, car rentals and towing to ensure proper administration and handling Review all technical issues for accuracy of diagnosis, repairs, and proper repair procedures Perform investigation of unusual claims as requested by management by talking to customers, home service providers or any other involved parties
- Ensured accurate documentation of claim files by diligently updating notes reflecting ongoing developments, communications, and resolutions.
- Negotiated fair settlements for clients by thoroughly analyzing claim details and assessing appropriate payout amounts.
- Ensure complete and sound claim approvals, legal reviews, and investigations when necessary Manage employees' attendance, timesheets, and metrics
- Managing the workflow of employees Manage current and outstanding open claims Appraise and help develop procedures to improve accountability and ease workflow issues
- Issued payouts to claimants.
- Documented all findings in concise reports.
- Examined photographs and surveillance and any other documents relating to claims.
- Negotiated with claimants to settle claims.
- Kept current on insurance regulations, laws, policies and procedures.
- Reviewed police reports, photographs and other documentation to gain complete understanding of accident.
- Coordinated with local body shops to assign repair jobs and obtained rental vehicles for customers for duration of restoration process.
- Enhanced customer satisfaction by delivering honest advice to policyholders in regards to repair work and body shop processes.
- Carried and managed consistently heavy project workload through exemplary organizational, time management and collaboration talents.
- Identified suspicious claims, escalating issues to supervisor for further investigation and analysis.
- Successfully negotiated settlements with claimants and insurers.
- Assessed complex claims and accurately determined value of damages.
- Analyzed complex data and prepared accurate and comprehensive reports for clients.
- Created detailed assessments of damages to property and vehicles.
- Skilled at working independently and collaboratively in a team environment.
- Self-motivated, with a strong sense of personal responsibility.
- Proven ability to learn quickly and adapt to new situations.
- Worked well in a team setting, providing support and guidance.
- Worked effectively in fast-paced environments.
- Managed time efficiently in order to complete all tasks within deadlines.
- Demonstrated respect, friendliness and willingness to help wherever needed.
- Excellent communication skills, both verbal and written.
- Passionate about learning and committed to continual improvement.
- Proved successful working within tight deadlines and a fast-paced environment.
- Strengthened communication skills through regular interactions with others.
- Organized and detail-oriented with a strong work ethic.
- Adaptable and proficient in learning new concepts quickly and efficiently.
- Used critical thinking to break down problems, evaluate solutions and make decisions.
- Paid attention to detail while completing assignments.
- Worked flexible hours across night, weekend and holiday shifts.
- Developed and maintained courteous and effective working relationships.
- Identified issues, analyzed information and provided solutions to problems.
- Participated in team projects, demonstrating an ability to work collaboratively and effectively.
- Evaluated and investigated over 519 auto claims in 2017 and decided whether insurer should pay claim
- Kept detailed records of all property inspections, damages, estimates, and related claim information for future reference.
- Collaborated with various departments to ensure accurate documentation and seamless claim processing.
- Developed strong relationships with local contractors, facilitating efficient repair scheduling and cost-effective solutions for policyholders.
- Negotiated fair settlements with policyholders and contractors, maintaining a professional demeanor throughout discussions.
- Utilized advanced technology tools to effectively document damages and expedite the processing of property field claims.
Auto Claims Adjuster Liability
Dr EP Cooper
04.1994 - 02.2018
- Developed comprehensive reports to track claims outcomes, identifying patterns and areas for improvement.
- Utilized strong negotiation skills to settle disputed liability cases in a fair and reasonable manner, ultimately minimizing company exposure to financial risk.
- Managed portfolio of claims from initiation to closure, ensuring all customer interactions were handled professionally.
- Established an effective system for tracking and monitoring claims from initial report to final resolution, ensuring timely updates were provided to all relevant parties.
- Resolved complex claims efficiently, leveraging extensive knowledge of auto insurance policies and coverage.
- Negotiated settlements with claimants and repair facilities to control costs while maintaining high levels of customer satisfaction.
- Negotiated fair settlements with both customers and third-party claimants, balancing empathy with fiscal responsibility to protect company assets.
- Increased accuracy in claims assessment by regularly attending advanced training in vehicle repair and valuation.
- Ensured regulatory compliance in all aspects of the auto claims process by staying up-to-date on industry laws and regulations.
- Reduced disputes and appeals by establishing clear, transparent criteria for claims evaluation.
- Strengthened relationships with repair vendors, ensuring quality repairs at competitive prices.
- Maintained strong relationships with key stakeholders such as adjusters, agents, repair facilities, medical providers, and legal representatives for seamless collaboration throughout the claims process.
- Assisted clients with navigating complex insurance policies, ensuring they understood the extent of their coverage and benefits available to them during the claims process.
- Demonstrated expert knowledge of auto insurance policies and coverages, allowing for accurate assessment of damages and appropriate claim payouts.
- Expedited claim settlements by maintaining open lines of communication with all parties involved, fostering trust, and ensuring a smooth process.
- Negotiated with claimants to settle claims.
- Acted as a reliable point of contact for customers throughout the claims process, addressing their concerns with empathy and professionalism.
- Documented all findings in concise reports.
- Increased overall efficiency in claims handling by utilizing advanced technology tools for documentation, record-keeping, and data analysis.
- Kept current on insurance regulations, laws, policies and procedures.
- Reviewed police reports, photographs and other documentation to gain complete understanding of accident.
Education
Associate of Science - Finance
University of Arkansas, Fayetteville
Fayetteville, AR12.2020
Skills
- Marketing
- Project Management
- Budget Planning
- Social Media
- Planning
- Communication
- Received 12 Employee Awards for customer service excellence
- Leadership
- Local Suicide Chapter Vice president for the midsouth area
- Policy Interpretation
- Multi-Line Phone Systems
- Corporate Policies and Procedures
- Insurance Policy Coverage Knowledge
- Settlement Determinations
- Claims Investigations
- Damage Mitigation
- Financial Accounting
- Damage Assessment
- Fraud Detection Knowledge
- Claim Handling
- Claims Assessments
- Liability Determinations
- Medical Records Management
- Risk Assessment
- Court Proceedings
- Personal Interviews
- Medical Terminology
- Monitoring Accounts
- Internal Fraud
- Auto Mechanics
- Credit Card Transaction Processing
- Claims Process Explanation
- Deductible Collection
- Body Shop Knowledge
- Salvage Value Determination
- Billing
- Bookkeeping
- Litigation Management
- Investigation techniques
- Claim Resolution
Timeline
Senior Claims Examiner
Advanced Business Services
08.2019 - 08.2023
Auto Claims Adjuster Liability
Dr EP Cooper
04.1994 - 02.2018
Associate of Science - Finance
University of Arkansas, Fayetteville