April Jones
Atlanta
Summary
Skilled professional with over 10 years of experience in insurance claims processing, customer service, and team leadership. Currently pursuing an MBA in Healthcare Administration at Western Governors University, expected December 2026. A strategic leader with expertise in managing operations, improving service standards, and training staff to deliver accurate and timely results. Seeking to leverage comprehensive experience in TPA operations and claims management as the TPA Services Manager.
Overview
13
13
years of professional experience
Work History
Total Loss Claims Specialist
State Farm
Dunwoody, Georgia
07.2024 - Current
- Manage complex total loss auto claims from initiation to settlement, ensuring compliance with regulatory standards.
- Analyzed claims to determine coverage and eligibility based on policy provisions.
- Collaborated with customers to gather necessary documentation for streamlined claim processing.
- Conduct thorough reviews of documentation and maintain comprehensive records to support audits and compliance checks.
- Collaborate with salvage vendors and adjusters to streamline the claims process, driving efficiency and accuracy in claims resolution.
- Provide exceptional customer service and support to policyholders, ensuring a positive claims experience.
Personal Banker II
VyStar Credit Union
Marietta, Georgia
05.2024 - 07.2024
- Delivered personalized financial solutions and processed complex transactions, ensuring high accuracy and compliance with bank regulations.
- Built strong member relationships through effective communication and problem-solving, resulting in high satisfaction scores and referral growth.
- Managed customer relationships by providing personalized financial solutions and guidance.
- Assisted clients with account openings, transactions, and inquiries to ensure service excellence.
- Educated members on products and services to enhance financial literacy and engagement.
- Assisted customers with setting up or closing accounts, completing loan applications, and signing up for new services.
Claims Representative
GEICO
Macon, Georgia
05.2016 - 05.2024
- Handled incoming auto and personal claims, conducting investigations to assess damages and coordinating with internal teams to facilitate timely resolutions.
- Led onboarding training for new employees, creating training materials and mentoring staff to promote knowledge and performance.
- Managed call center operations, addressing member inquiries and complaints, and enhancing overall call quality and member satisfaction.
- Utilized internal systems to track, review, and record claims information, ensuring compliance with regulations and internal policies.
- Processed claims efficiently, ensuring compliance with company policies and state regulations.
- Reviewed claim documentation for accuracy, reducing processing errors through meticulous attention to detail.
Branch Manager
Complete Cash
Cordele, Georgia
09.2015 - 05.2016
- Directed daily operations and managed staff to ensure compliance with legal requirements and company policies.
- Trained and developed team members to meet sales metrics and improve service quality, resulting in increased customer satisfaction.
- Led branch operations, ensuring compliance with company policies and regulatory requirements.
- Developed and implemented strategic plans to enhance customer service and operational efficiency.
- Managed team performance through coaching, training, and mentoring to improve productivity.
- Analyzed financial reports to identify trends and drive decision-making for branch growth.
Assistant Store Manager
Rue21
Cordele, Georgia
07.2013 - 05.2016
- Showcased efficient leadership skills by managing workforce metrics such as staff scheduling, interviewing, on-boarding, training processes, human resource duties, and developing in-store marketing strategies. Working closely with associates to ensure that all workplace milestones are met and sales floor protocol is being followed to increase customer shopping experiences and satisfaction. Strategically participated in store operational duties, leading opening and closing procedures in accordance with company compliance and safety standards while handling deposits and other company monies to ensure account balancing at the end of each business day.
- Exemplified servant leadership while engaging on the sales floor with customers, assisting with various requests on products and services. Using workplace knowledge to update customers on applicable discounts, promotional, and other company incentives to increase retention and satisfaction. Regularly inspecting the sales floor to ensure that all inventory is fully stocked and in their designated areas while inspecting areas for hazards and debris to eliminate and minimize any possible risks or liabilities.
- Assisted in managing daily store operations, ensuring compliance with company policies.
- Developed and implemented merchandising strategies to enhance product visibility and sales performance.
Branch Manager
Security Finance
Cordele, Georgia
03.2013 - 09.2015
- Directed a team of proactive in-office leaders by developing workplace strategies to increase employee success. Made attentive decisions to staff office with high-quality team members and associates through recruiting and sourcing duties while managing the hiring process, and on-boarding and training processes. Ensuring associate success by regularly giving critical feedback on performance that adds value to associate’s career development.
- Practiced high ethical standards to protect company and customer confidential information and utilized in-office security measures to store and manage all customers files and documents under lock and key, while ensuring that all computing systems were password protected and accessible to the appropriate associates and team members. Strategically conceptualized and carried out community marketing events to build business brand reputation throughout the local community. Actively participated in chamber of commerce business events and other community events to attract clients and customers to generate lead and pipeline management.
- Established strong relationships with clients to foster loyalty and increase retention rates.
- Oversaw inventory management processes, optimizing stock levels to meet customer demands efficiently.
Education
MBA - Health Administration
Western Governors University
12-2026
B.S. Business Administration - Healthcare Management
Colorado Technical University
06-2025
A.S. Business Administration - undefined
Colorado Technical University
11-2023
High School Diploma - undefined
Crisp County High School
05-2002
Skills
- Claims Processing: Extensive experience managing claims workflows, ensuring compliance with industry regulations, and conducting quality audits
- Call Center Operations: Proven ability to oversee call center activities, monitor performance metrics, and enhance member services through effective coaching
- Staff Training and Development: Strong background in onboarding and training new team members, fostering a collaborative and supportive work environment
- Regulatory Knowledge: Familiar with ERISA, HIPAA, and federal/state insurance regulations, ensuring compliance in all operations
- Analytical Skills: Capable of identifying trends, resolving issues, and implementing process improvements to enhance efficiency
- Microsoft Office & Claims Management Systems: Proficient in Microsoft Office Suite and relevant claims management or benefits administration software
Timeline
Total Loss Claims Specialist
State Farm
07.2024 - Current
Personal Banker II
VyStar Credit Union
05.2024 - 07.2024
Claims Representative
GEICO
05.2016 - 05.2024
Branch Manager
Complete Cash
09.2015 - 05.2016
Assistant Store Manager
Rue21
07.2013 - 05.2016
Branch Manager
Security Finance
03.2013 - 09.2015
B.S. Business Administration - Healthcare Management
Colorado Technical University
A.S. Business Administration - undefined
Colorado Technical University
High School Diploma - undefined
Crisp County High School
MBA - Health Administration
Western Governors University