- Spending time with my partner and my soon to be 12 year old daughter
- Enjoying the art of cooking, experimenting with new recipes and food trends
- I enjoy helping others and giving back to the community
- Exploring famous landmarks, historical sites, and cultural attractions in a new destination
- Sharing travel tips, recommendations, and insights with fellow enthusiasts
- Participating in local clean-up initiatives
- Offering time and support to shelters for the homeless, women, and animals
- Reading
- Acting and Theater
- Concerts
- Music
Ashly Stark
North Liberty
Summary
Pursuing full-time role that presents professional challenges and leverages interpersonal skills, effective time management, and problem-solving expertise.
Demonstrates strong analytical, communication, and teamwork skills, with proven ability to quickly adapt to new environments. Eager to contribute to team success and further develop professional skills. Brings positive attitude and commitment to continuous learning and growth.
Overview
20
20
years of professional experience
Work History
Medical Payment Adjuster II
Farmers Insurance Exchange
09.2019 - Current
- Evaluated and processed insurance claims to ensure compliance with company policies and regulations.
- Conducted thorough investigations to determine claim validity.
- Collaborated with policyholders, agents, and legal teams to resolve complex claims disputes efficiently.
- Collaborated with adjusters on best practices for handling diverse claim scenarios and customer interactions.
- Implemented process improvements that enhanced claim turnaround time and customer satisfaction ratings.
- Assisted staff on new software tools for claims management, increasing operational efficiency across the team.
- Maintained strong relationships with policyholders, agents, legal representatives and colleagues by consistently demonstrating professionalism, empathy, and effective communication skills.
- Ensured compliance with state regulations and company policies through diligent review of all claim-related materials.
- Assisted clients in understanding their insurance coverage by explaining complex terms and conditions clearly and concisely.
- Improved claim processing efficiency by conducting thorough investigations and promptly addressing discrepancies.
- Reviewed police reports, medical treatment records, and physical property damage to determine accident relatedness.
- Contributed to team success by participating in regular training sessions, sharing best practices, and mentoring new adjusters.
- Increased overall productivity by managing a large caseload while maintaining strict attention to detail and accuracy in documentation.
- Reduced backlogs of pending claims using effective time-management strategies such as prioritizing tasks based on urgency or complexity levels.
- Conducted comprehensive interviews of witnesses and claimants to gather facts and information.
- Analyzed information gathered by investigation and reported findings and recommendations.
- Reviewed questionable claims by conducting agent and claimant interviews to correct omissions and errors.
- Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
- Maintained contact with claimants and attorneys to determine treatment status.
- Read over insurance policies to ascertain levels of coverage and determine whether claims would receive approvals or denials.
- Identified suspicious losses and contacted manager for investigative assistance.
- Followed up on potentially fraudulent claims initiated by claims representatives.
Customer Service Representative
MetLife Auto and Home
Freeport, IL
10.2017 - 09.2019
- Receive incoming calls regarding payments, rental, liability status, deductibles.
- Receive incoming calls to set up home and auto claims, gathering valuable detail to assist file handlers.
- Examine documents and file notes to confirm correctness of payments that are needed.
- Place outgoing calls to customers/shops regarding claims.
- Place stop payments & reissue payments after verifying correct amount.
- Request all needed documents from customers to assist in moving file to close.
- Set up rental vehicles for insureds.
- Work with staff appraisers, Dispatch, MDRT, and shops regarding estimates.
- Assist the Rental team to clear alerts & authorize rental extensions if warranted.
- Assist with Subrogation unit to place claims with adverse carriers.
- Track claim information & payment information in BOX & Excel forms to assist with helping to lower incoming calls to CST team.
- Trouble shooting claims to assist the file handlers to help file move to close.
- Advanced understanding of both auto and home policies and coverages.
- Med-Pay assist: accept attorney forms, update Charlie with valuable information regarding medical bills, attorney Letter or Rep/attorney release/UM or UIM forms, evaluate files and find correct addresses to resend mail to correct locations, completed alerts from IST adjusters with assisting in sending letters to adverse carriers, medical providers, insureds.
- Place calls to attorneys & medical providers to obtain useful information for files to assist with moving files to a close.
Auto Adjuster
MetLife Auto & Home
Freeport, IL
08.2006 - 07.2014
- Scheduled appointments for customers of all areas
- Took incoming calls and placed out bound calls
- Achieved personal goals, as well as unit goals
- Completed quarterly and yearly courses and tests to obtain licensing for multiple states
- Troubleshooting for customers/employees over the phone
- Handle highly confidential account information for customers
- Assist many other departments, including endorsements and customer care department to help meet their daily goals
- Fraud detection
- Provided excellent service to our customers by accepting timely calls to answer any questions while also setting up claims
- Assisted managers by calculating rental days to decrease cost of rental pay out
- Attend different training classes to take on new tasks to further aide our customers
- Assisted in training employees for various positions and applications
- Assisted employees with their day-to-day duties
Education
High School Diploma -
Dubuque Senior High School
Dubuque, IA01-2003
Business Management
University of Wisconsin – Platteville
Platteville, WI01-2003
Skills
- Ability to adapt and work in a team structured environment, as well as individually
- Strength in Microsoft Word, BOX, Excel, spreadsheets, and power point
- Analytical
- Self-motivating
- Phone etiquette
- Value company integrity
- Attention to detail
- Claims investigation
- Policy interpretation
- Critical thinking and trouble-shooting
- Decision-making
- Best practices implementation
- Caseload and workflow management and prioritization
- Claims file management processes
- Claims file documentation
- Claims investigations and client interviewing
- Payment processing
- Coverage determination
- Report and records review
- Coverage assessments
- Multiple claims adjuster license
- Regulatory compliance
- Risk management
- Team collaboration
- Multitasking and organization
Accomplishments
- Maintained a straight through processing rating of 46.12%, exceeding the 41-42% department goal.
- Absorbed a sizeable undertaking of claims by assuming a coworkers pending after leaving the company, starting with 191 exposures and 275 overdue activities and single handedly reduced this pending to 85 exposures and no overdue activities in 1 month.
- Registered an average of 2.8 claims per day, exceeding company targets of 2 claims a day.
- Able to assist with multiple SIU claims by completing extensive investigations to help SIU adjuster determine next courses of actions, along with aiding in their discoveries
Interests
Timeline
Medical Payment Adjuster II
Farmers Insurance Exchange
09.2019 - Current
Customer Service Representative
MetLife Auto and Home
10.2017 - 09.2019
Auto Adjuster
MetLife Auto & Home
08.2006 - 07.2014
Business Management
University of Wisconsin – Platteville
High School Diploma -
Dubuque Senior High School