Chelsea Mckinstry
Birmingham,AL
Summary
At Wells Fargo, a seasoned Senior Fraud and Claim Specialist adept in policy interpretation and customer service, I enhanced claim processing efficiency and customer satisfaction. My expertise in claims investigation and empathetic client interactions led to significant improvements in client retention and fraud detection, showcasing a blend of critical thinking and financial acumen.
Overview
11
11
years of professional experience
Work History
Senior Fraud and Claim Specialist
Wells Fargo
10.2013 - 07.2024
- Reviewed and maintained accurate claim files, ensuring all necessary documentation was in place for future reference.
- Maintained compliance with industry regulations by staying up-to-date on changes in policies and procedures, ensuring proper handling of sensitive information.
- Conducted thorough investigations into insurance claims to determine coverage eligibility and appropriate compensation amounts.
- Enhanced customer satisfaction with prompt and accurate claim resolutions, resulting in positive feedback and increased client retention.
- Provided exceptional customer service during difficult situations, displaying empathy while explaining complex claim issues clearly to clients.
- Participated in ongoing professional development courses to stay updated on best practices within the industry.
- Managed high-volume caseloads effectively, prioritizing urgent cases while maintaining attention to detail for all claims.
- Reduced claim processing time by implementing efficient workflow procedures and organization systems.
- Identified fraudulent activity through meticulous analysis of claim data, protecting company resources from potential losses.
- Accelerated resolution of disputed claims by mediating between involved parties and finding mutually acceptable solutions.
- Enhanced customer satisfaction with timely and empathetic communication throughout claim process.
- Innovated claim tracking methods, enabling more accurate forecasting and resource allocation.
- Followed up with customers on unresolved issues.
- Worked with claims adjusters and examiners to expedite processing in alignment with procedures.
- Posted payments to accounts and maintained records.
Education
High School Diploma - General Studies
Thornton Township High School
Harvey, IL05.1987
Skills
- Policy Interpretation
- Legal Compliance
- Financial Acumen
- Claims Investigation
- Customer Service
- Decision-Making
- Critical Thinking
- Claims analysis
- Attention to Detail
- Organizing and Prioritizing Work
- Active Listening
- Patient contact
- Claims Processing
- Microsoft Office
- Data Entry
- Claims adjustment
Timeline
Senior Fraud and Claim Specialist
Wells Fargo
10.2013 - 07.2024
High School Diploma - General Studies
Thornton Township High School
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