DALONZA EVANS
CHESAPEAKE,VIRGINIA
Summary
Over 23 years of experience in the Business industry along with an extensive background in administrative excellence, customer service, submission of reports, quality control and supervision.
Overview
25
25
years of professional experience
Work History
Insurance Claims Adjuster
USAA
08.2012 - 08.2022
- Investigate, negotiate and adjust complex claims
- Determine legal liability and equitably settle/defend in compliance with state regulatory requirements
- Work closely with direct vendors and internal business partners to facilitate claims resolution
- Maintain a property and casualty license in DE, FL, TX, NC and VA.
- Documented all investigation activity and presented reports to management.
- Examined claims forms and other records to determine insurance coverage.
- Verified insurance claims and determined fair amount for settlement.
- Substantiated legitimate claims and denied unjustified claims.
- Trained other claims staff members on proper handling and evaluation of injury claims.
- Established relationships with clients and insurance companies to foster timely claims resolution.
- Conducted comprehensive interviews of witnesses and claimants to gather facts and information.
- Answered customer questions regarding deductibles.
- Researched and analyzed policy contracts to verify proper payment of claims.
- Mitigated risks and increased profitability with well-developed strategies for reducing future claims and costs.
- Prepared summaries of damage, payments, and policy coverage.
- Analyzed information gathered by investigation and report findings and recommendations.
- Resolved complex, severe exposure claims using high service oriented file handling.
- Conducted day-to-day administrative tasks to maintain information files and process paperwork.
- Handled [Type] calls from customers and other stakeholders about [Type] processes.
- Delivered exceptional customer service to policyholders by communicating important information and patiently listening to issues.
- Synthesized data into comprehensive quarterly written reports for management.
- Handled customer inquiries and suggestions courteously and professionally.
- Actively listened to customers, handled concerns quickly and escalated major issues to supervisor.
- Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
- Processed customer service orders promptly to increase customer satisfaction.
- Participated in team meetings and training sessions to stay informed about product updates and changes.
- Interacted with internal customers to understand business needs and translate into requirements and project scope.
- Performed gap analysis to identify areas of improvement.
- Analyzed key aspects of business to evaluate factors driving results and summarized into presentations.
- Drafted reports on company financial metrics to assess successes and account for deficiencies.
- Developed and implemented project plans and budgets to ensure successful execution.
- Reported regularly to managers on project budget, progress and technical problems.
- Maintained open communication by presenting regular updates on project status to customers.
- Provided technical support to project stakeholders to help meet project objectives.
Insurance Claims Representative
GEICO
02.1998 - 08.2012
- Investigate, evaluate and settle claims, applying technical knowledge and human relations skills to effect fair and prompt disposal of cases and to contribute to a reduced loss ratio
- Resolve complex, severe exposure claims, using high service oriented file handling
- Pay and process claims within designated authority level
- Contact and interview claimants, doctors, medical specialist or employers to get additional information
- Conduct detailed bill reviews to implement sound litigation management and expense control
- Mentor new adjuster on quality standards and goals.
- Developed and implemented strategies to improve claim processes.
- Analyzed and addressed escalated claims to resolve issues quickly.
- Updated claims system to track claim status and provide relevant information to other department.
- Collaborated with internal departments and external vendors to achieve fast resolution of claims.
- Developed in-depth understanding of insurance policies and procedures to give accurate recommendations to suit clients' needs.
- Maintained accurate and up-to-date records of claim information for future reference.
- Prepared and presented detailed reports to management on claims issues to aid in decision making.
- Verified client information by analyzing existing evidence on file.
- Carried out administrative tasks by communicating with clients, distributing mail, and scanning documents.
- Reviewed outstanding requests and redirected workloads to complete projects on time.
Customer Service Supervisor
GEICO
01.2002 - 01.2007
- Provide performance coaching to associates while building a positive and motivating work environment
- Monitor for quality assurance providing constructive feedback
- Administrative duties to include monthly evaluations, maintaining team statistics and associates desk files
- Develop on the job training modules for service associates and peers
- Supervise the Quality control department conducting reviews of selected files processed by associates for quality assurance
- Resolving policy related concerns with a high emphasize on customer satisfaction.
- Coached employees through day-to-day work and complex problems.
- Responded to customer inquiries and resolved complaints to establish trust and increase satisfaction.
- Developed and maintained strong relationships with customers to maintain loyalty and satisfaction.
- Conducted training and mentored team members to promote productivity, accuracy, and commitment to friendly service.
- Coached team members to deliver hospitable, professional service while adhering to set service models.
- Actively supported service associates by quickly responding to questions via phone and email and finding appropriate solutions to customer issues.
- Set priorities and problem-solved workflow issues to maintain rapport with customers and managers.
- Created, prepared, and delivered reports to various departments.
- Monitored metrics and developed actionable insights to improve efficiency and performance.
- Led regular customer service meetings to review progress identify challenges and provide feedback.
- Resolved issues through active listening and open-ended questioning, escalating major problems to manager.
- Improved customer satisfaction scores through application of superior conflict resolution and problem-solving skills.
- Implemented project management techniques to overcome obstacles and increase team productivity.
- Developed internal requirements and standards to minimize regulatory risks and liability across programs.
- Improved office operations by automating client correspondence, record tracking and data communications.
- Organized meetings for executives and coordinated availability of conference rooms for participants.
Program Analyst
GEICO
01.1998 - 01.2002
- Establish coverage for new members, explaining all available coverage options based their needs
- Provide comprehensive knowledge of personal auto coverage to enhance insurance policies
- Provide technical support to on-line users assisting with the navigation of our self- service options
- Develop best practices in an effort to improve the performance and efficiency of my peers
- Mentor New associates on quality standards and goals.
- Reviewed program implementation plans to assess risk and feasibility.
- Helped solve diverse program problems with in-depth analysis.
- Validated results and performed quality assurance to assess accuracy of data.
- Handled customer inquiries and suggestions courteously and professionally.
- Updated account information to maintain customer records.
- Participated in team meetings and training sessions to stay informed about product updates and changes.
- Utilized customer service software to manage interactions and track customer satisfaction.
- Tracked customer service cases and updated service software with customer information.
- Responded to customer requests, offering excellent support and tailored recommendations to address needs.
- Maintained up-to-date knowledge of product and service changes.
- Sought ways to improve processes and services provided.
- Assisted in procurements to secure adequate resources to facilitate operations.
- Executed record filing system to improve document organization and management.
- Created and maintained databases to track and record customer data.
- Developed and updated spreadsheets and databases to track, analyze, and report on performance and sales data.
- Scheduled office meetings and client appointments for staff teams.
- Coordinated and scheduled meetings and conference calls to optimize scheduling of senior staff.
- Developed strategies to streamline and improve office procedures.
- Assisted development and implementation of new administrative procedures.
- Handled administrative duties, filing, and errands.
- Performed work according to project schedules and established quality standards.
- Created and updated records and files to maintain document compliance.
Education
Certificate - Paralegal Studies
Old Dominion University
Norfolk, VAHigh School Diploma -
Booker T. Washington High School
Norfolk, VA06.1991
Skills
- Computer Skills:
- Microsoft Word, PowerPoint, Excel, Microsoft Outlook, Type 50 wpm
- Process Optimization
- Critical Thinking
- Customer Relationship Management
- Report Preparation
- Order Processing
- Project Management Abilities
- Database Entry
- Project Monitoring
- Organize Files
Timeline
Insurance Claims Adjuster
USAA
08.2012 - 08.2022
Customer Service Supervisor
GEICO
01.2002 - 01.2007
Insurance Claims Representative
GEICO
02.1998 - 08.2012
Program Analyst
GEICO
01.1998 - 01.2002
Certificate - Paralegal Studies
Old Dominion University
High School Diploma -
Booker T. Washington High School