Erven Flores
Goodyear,AZ
Summary
Accomplished Claim Specialist with a proven track record at State Farm, enhancing customer satisfaction and reducing claim processing times through meticulous claims analysis and critical thinking. Skilled in policy interpretation and fostering teamwork, consistently met performance metrics, and excelled in customer service. Achieved promotions through dedication and excellence in claims management.
Overview
10
10
years of professional experience
Work History
Reserve Claim Specialist
State Farm
07.2024 - Current
- 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.
Claim Specialist
State Farm
05.2019 - 05.2024
- 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.
- Managed high-volume caseloads effectively, prioritizing urgent cases while maintaining attention to detail for all claims.
- Identified fraudulent activity through meticulous analysis of claim data, protecting company resources from potential losses.
- Participated in ongoing professional development courses to stay updated on best practices within the industry.
- Reduced claim processing time by implementing efficient workflow procedures and organization systems.
- Mentored junior team members by providing guidance on navigating complex claim scenarios efficiently.
- Obtained promotion from a P4 to a P5
Claim Associate - Auto ILR
State Farm
04.2017 - 05.2019
- Consistently met or exceeded performance metrics in key areas such as accuracy, timeliness, and customer satisfaction ratings.
- Maintain incoming calls to assist customers in filing their initial loss report
- Began the investigation for non complex losses
- Handled high inbound call volume
- Obtained promotion from a PA2 to a PA3
Customer Service Assistant Supervisor
XPO Logistics
06.2014 - 04.2017
- Enhanced customer satisfaction by addressing and resolving complex issues in a timely manner.
- Developed comprehensive training materials to ensure consistent performance among team members.
- Conducted regular performance evaluations to identify areas of improvement for team members, promoting professional growth within the team.
- Utilized a customer-centric approach to problem-solving, enhancing the overall perception of the company''s commitment to service excellence.
- Organized team meetings to discuss best practices and share insights on improving customer interactions.
- Mentored new, resulting in increased productivity and reduced turnover rates.
- Boosted overall efficiency by identifying areas of improvement within the department and implementing necessary changes.
- Proactively addressed potential customer concerns by anticipating their needs through active listening techniques and attentive service delivery methods.
Education
High School Diploma -
La Joya Community High School
Avondale, AZ05.2009
Skills
- Policy Interpretation
- Claims Investigation
- Claims analysis
- Critical Thinking
- Decision-Making
- Customer Service
- Attention to Detail
- Documentation abilities
- Teamwork and Collaboration
- Coverage Determination
- Adaptability
Languages
English
Native or Bilingual
Spanish
Native or Bilingual
Timeline
Reserve Claim Specialist
State Farm
07.2024 - Current
Claim Specialist
State Farm
05.2019 - 05.2024
Claim Associate - Auto ILR
State Farm
04.2017 - 05.2019
Customer Service Assistant Supervisor
XPO Logistics
06.2014 - 04.2017
High School Diploma -
La Joya Community High School
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