Summary
Overview
Work History
Education
Skills
Accomplishments
Certification
References
Timeline
Generic
Evelyn De Leon

Evelyn De Leon

Las Cruces,NM

Summary

Friendly and upbeat team player with organized and disciplined approach. Experienced Claims Insurance Specialist successful at managing high caseloads in fast-paced environments. Organized, driven and adaptable with excellent planning and problem-solving abilities. Hardworking bringing 9 years of experience meeting customer needs via telecommuting roles. Skilled at listening to customers, meeting productivity targets and maintaining current knowledge of company offerings. Offering empathy, reliability and enthusiasm for satisfying customers.

Overview

11
11
years of professional experience
1
1
Certification

Work History

Claims Representative

Accuserve Solutions
03.2024 - Current
  • Examined reports, accounts, and evidence to determine integrity and accuracy of information.
  • Followed up with customers on unresolved issues.
  • Interviewed policyholders to verify information and obtain additional details.
  • Worked productively in fast-moving work environment to process large volumes of claims.

Technical Reviewer

Accuserve Solutions
07.2023 - 03.2024

Technical Reviewer for all carriers in water mitigation property losses. Oversee water mitigation projects after drying has been complete on the estimate being received. IICRC certified in water mitigation for all carriers.

  • Answered constant flow of customer calls with minimal wait times.
  • Revise and update Xactimate projects to send over comparative scopes.
  • Maintained strict confidentiality with sensitive client information, adhering to industry standards and company policies.
  • Maintained strong attention to detail while reviewing numerous documents daily, ensuring consistent quality and accuracy.
  • Provided input on refining internal review processes based on client feedback, ensuring positive experience for all stakeholders.
  • Ensured consistency across multiple review projects by maintaining strict adherence to established protocols and procedures.
  • Built, established and maintained relationships with sources.
  • Identified control gaps in processes, procedures and systems through in-depth research and assessment and suggested methods for improvement.
  • Excellent communication skills, both verbal and written
  • Paid attention to detail while completing assignments.

Claims Service Specialist II

Allstate Insurance Company
11.2015 - 05.2023
  • Inquiry calls such as payment settlement, rental, subrogation status, update any participant information necessary.
  • Completed outbound work to ensure compliance with relevant claims express regulations.
  • Examined reports, accounts, and evidence to determine integrity and accuracy of information.
  • Interviewed policyholders to verify information and obtain additional details
  • Followed up with customers on unresolved issues.
  • Worked productively in fast-moving work environment to process large volumes of claims.
  • Checked documentation for accuracy and validity on updated systems
  • Examined reports, accounts, and evidence to determine integrity and accuracy of information.
  • Worked productively in fast-moving work environment to process large volumes of claims.
  • Negotiated claim settlements with claimants and attorneys to resolve claims efficiently and fairly.

Customer Service Representative

Foundever Sitel
10.2012 - 11.2015
  • Answered customer telephone calls promptly to avoid on-hold wait times.
  • Offered advice and assistance to customers, paying attention to special needs or wants.
  • Answered constant flow of customer calls with minimal wait times.
  • Provided primary customer support to internal and external customers.
  • Identified and responded to customer requests and concerns through email, online chat, and phone for both English and Spanish-speaking customers.
  • Processed various transactions with accuracy and according to bank standards and legal requirements.
  • Educated customers about available services, products and bank resources.

Education

Associates - Science

Laredo Community College
Laredo, TX
2011

Skills

  • Policy understanding
  • Customer service
  • Problem solving
  • Xactanalysis
  • Negotiating
  • Written Communication
  • Settlement determinations
  • Documentation abilities
  • Sales Force
  • Xactimate projects
  • Systematics

Accomplishments

  • Documented and resolved root cause problem solutions which led to concise and clear guidelines for specialist to perform their critical role in the claims express office.
  • Used Microsoft Excel to develop inventory tracking spreadsheets.
  • Documented and resolved clear liability which led to claim closure and satisfied customer experience.
  • Collaborated with team of 15 through Microsoft teams as I work from home. Boost moral, get praised/ recognition for Spanish help support.
  • Claims Compass Champion from the graduating class of November 2015.
  • Achieved custom pricing by introducing Xactimate for negotiation tasks.

Certification

  • Certified Claims Service Specialist, Allstate Insurance Company - 8 Years
  • Bilingual Specialist- Training - 8 years
  • Customer Service Representative, Citizens Bank Sitel Cooperation - 3 years
  • Certified WTR IICRC, Accuserve Solutions - 12/2023-12/2027

References

T'KEYAH ALFORD, TEAM LEADER EXPRESS 700

Cell phone number: (205)335-7175

WANITA PATKO, SUPERVISOR TECHNICAL REVIEWER WITH ACCUSERVE

Cell phone number: (715)220-2209

JARROD DORRIAN, CAT EXPRESS ADJUSTER

Cell phone number: (205)317-3322

Timeline

Claims Representative

Accuserve Solutions
03.2024 - Current

Technical Reviewer

Accuserve Solutions
07.2023 - 03.2024

Claims Service Specialist II

Allstate Insurance Company
11.2015 - 05.2023

Customer Service Representative

Foundever Sitel
10.2012 - 11.2015

Associates - Science

Laredo Community College
Evelyn De Leon