Summary
Overview
Work History
Education
Skills
Certification
Company Engagement
Timeline
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Charysse Joseph

Claim Specialist
Buford,GA

Summary

Experienced Claims Insurance Specialist successful at managing high caseloads in fast-paced environments. Organized, driven and adaptable with excellent planning and problem-solving abilities. Offering 25 years of experience and willingness to take on any challenge.

Overview

27
27
years of professional experience
5
5
years of post-secondary education
2
2
Certifications

Work History

Claim Specialist

State Farm Insurance Company
2000.12 - Current
  • Reviewed new files to determine current status of injury claim and to develop plan of action.
  • Leveraged appropriate job aids, expertise and tools to accurately and consistently handle complex claims.
  • Independently review, evaluate and settle large volumes of complex/non-routine property, casualty and subrogation claims as well as claims requiring special investigation.
  • Collaborated with attorneys in defense of first party and/or third-party lawsuits which require management involvement and may include attending trials, arbitrations, mediations, and/or depositions.
  • Coordinated and lead special projects as assigned resulting in increased productivity and customer satisfaction.
  • Mentored junior team members by providing guidance on navigating complex claim scenarios efficiently.
  • Reviewed and maintain accurate claim files, ensuring all necessary documentation was in place for future reference.
  • Managed high-volume caseloads effectively, prioritizing urgent cases while maintaining attention to detail for all claims.
  • Provided exceptional customer service during difficult situations, displaying empathy while explaining complex claim issues clearly to clients.
  • Conducted thorough investigations into insurance claims to determine coverage eligibility and appropriate compensation amounts.
  • Collaborated closely with adjusters to ensure accurate, fair, and timely claims settlements for all involved parties.
  • Developed and maintain courteous and effective working relationships.
  • Developed strong communication and organizational skills through working on group projects.
  • Participated in team projects, demonstrating ability to work collaboratively and effectively.

Claims Representative-Grievances

United Healthcare Insurance
White Plains , NY
1997.09 - 2000.07
  • Demonstrated expertise in interpreting policy language accurately, leading to better-informed decisions on coverage application during claims evaluation.
  • Followed up with customers on unresolved issues.
  • Interviewed policyholders to verify information and obtain additional details.
  • Collaborated with cross-functional teams to expedite complex claims investigations and resolutions.
  • Researched and analyzed complex claims to determine next steps and possible outcomes.
  • Prepared and presented detailed reports to management on claims issues to aid in decision making.
  • Examined reports, accounts, and evidence to determine integrity and accuracy of information.
  • Participated in team projects, demonstrating ability to work collaboratively and effectively.
  • Demonstrated respect, friendliness and willingness to help wherever needed.
  • Completed paperwork, recognizing discrepancies and promptly addressing for resolution.

Education

MBA - Business Administration

University of Arizona
Tucson, AZ
2022.09 - Current

Bachelor of Arts - Mass Media Arts/Public Relations

Clark Atlanta University
Atlanta, GA
1993.08 - 1997.05

Skills

Teamwork and Collaboration

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Certification

State of Florida Insurance Adjuster License

Company Engagement

  • Chosen for team lead on two committees to increase employee engagement and service delivery consistency
  • Appropriately influence teams to work cohesively to achieve company goals by creating an incentive and rewards program

Timeline

MBA - Business Administration

University of Arizona
2022.09 - Current

Claim Specialist

State Farm Insurance Company
2000.12 - Current

Claims Representative-Grievances

United Healthcare Insurance
1997.09 - 2000.07

Bachelor of Arts - Mass Media Arts/Public Relations

Clark Atlanta University
1993.08 - 1997.05
State of Florida Insurance Adjuster License
South Carolina Property, Surety and Marine Adjuster License
Charysse JosephClaim Specialist