Hard working Individual with desire to take on new challenges. Strong work ethic, adaptability and interpersonal skills. Experienced insurance professional with 12 year career determining liabilities and negotiating settlements. Efficiently handle high case volumes with accuracy and care.
Overview
20
20
years of professional experience
Work History
Telephone Claims Adjuster 2
GEICO, Government Employees Insurance
Macon, GA
04.2017 - 06.2021
Conducted interviews and secured recorded statements with insureds, claimants, and witnesses to facilitate fair claims investigations
Reviewed police reports, medical treatment records and physical property damage to determine extent of and analyzed suspicious and potentially fraudulent insurance claims
Responded to inquiries and followed up with insured(s), claimant(s), and attorneys regarding treatment status and to share findings and offer solutions
Paid and processed claims within designated authority level that were legitimate and denied unjustified claims
Used strong customer service skills to negotiate UBI claims with insured
Adhered strictly to departmental guidelines; ensured that all activities were compliant with applicable state laws.
Trained and mentored team members on proper workflows and processes to enhance productivity
Conducted regular meetings with team members to discuss progress, challenges, and solutions.
Telephone Claims Representative 1
GEICO, Government Employees Insurance
Macon, GA
12.2013 - 04.2017
Resolved customer inquiries, complaints, and disputes in a timely manner.
Investigated insurance claims, reviewed coverage and liability, prepared reports and recommended payment or denial of claims.
Corresponded with claimants and the insured via telephone calls or letters regarding the status of their claim.
Monitored pending liability claims on a daily basis and followed up with customers as needed.
Researched relevant case law to support coverage decisions.
Established reserves for each claim based on analysis of the facts and applicable law.
Evaluated subrogation opportunities in order to recover payments made on behalf of an insured party.
Claims Service Representative
GEICO, Government Employees Insurance
Macon, GA
10.2009 - 12.2013
Took First Notice of Loss and determined liability on non complex claim
Initiated contact with customers to gather additional information or documentation needed to process claims.
Advised customers on proper procedures for filing a claim or resolving an issue with their policy.
Responded to client inquiries via telephone, email, or other communication methods in a timely manner.
Maintained accurate records of customer interactions for further reference.
Assisted customer with scheduling their vehicle repairs and car rentals
Lienholder Specialist
GEICO, Government Employees Insurance
Macon, GA
10.2008 - 09.2009
Followed all company policies and procedures to deliver quality work
Listened and responded to customer requests and forwarded necessary information to superiors
Verified Coverage
Forwarded policy binders, ID cards to insured(s), Car dealerships, rental companies...etc
Answered an average of 60+ calls daily while keeping my average handling time low.
Emergency Roadside Dispatcher
GEICO, Government Employees Insurance
Macon, GA
10.2008 - 09.2009
Facilitated communications between customers and field personnel to answer questions or resolve concerns
Responded to over 100 daily caller requests with information about assistance and timeframes
Worked flexible hours; night, weekend, and holiday shifts
Maintained energy and enthusiasm in fast-paced environment
Developed and maintained courteous and effective working relationships
Assistant Store Manager
SHOE SHOW
Macon, GA
06.2007 - 10.2008
Maintained positive customer relationships by responding quickly to customer service inquiries
Managed opening and closing procedures and recommended changes to enhance efficiency of daily activities
Responded to customer concerns, working with manager to significantly raise customer satisfaction ratings
Interviewed, hired and trained staff associates and equipped to comply with company policies and procedures
Rotated merchandise and displays to feature new products and promotions
Processed payments for credit and debit cards and returned proper change for cash transactions
Reconciled daily sales transactions to balance and log day-to-day revenue
Walked through store areas every hour to identify and proactively resolve issues negatively impacting operations.
Secretary's Assistant
Dixon Realty
Macon, GA
08.2001 - 06.2003
Conducted weekly staff meetings to motivate staff members, address concerns and questions.
Education
BBA -
Central Georgia Technical College
Macon, GA
Skills
Caseload Management
Quality Control
Highly motivated
Multitasking
Customer Service
Sections
CONTACT
SKILLS, Settlement Negotiation
Time management
Multitasking
Organization and Attention to Detail
Recordkeeping Requirements
Process Monitoring and Improvement
Understanding of Applicable Laws
CAREER OBJECTIVE, Telephone Claims Adjuster GEICO, Government Employees Insurance, Macon, GA My claims career began in October 2009 as an entry level adjuster in a call center setting. Over the course of 11 years I was promoted several times and also accepted lateral positions in order to explore other aspects of the claims handling process.
EXPERIENCE, October 2009 - June 2021 Conducted interviews and secured recorded statements with insureds, claimants, and witnesses to facilitate fair claims investigations.
Responded to inquiries and followed up with insured(s), claimant(s), and attorneys regarding treatment status and to share findings and offer solutions.
Reviewed police reports, medical treatment records and physical property damage to determine extent of and analyzed suspicious and potentially fraudulent insurance claims.
Paid and processed claims within designated authority level that were legitimate and denied unjustified claims.
Reviewed medical records and policy documents to determine coverage eligibility for insureds benefits. Assessed accuracy of payments by comparing submitted bills to benefits allowance guidelines
Investigated, evaluated, and negotiated bodily injury settlements with claimants, attorneys and other parties. Used strong customer service skills to negotiate UBI claims with insured.
Maintained claims data in Atlas, Claims IQ, ECF, MITCHELL, and OPIQ by inputting concise yet sufficient file documentation.
Maintained detailed records of claim activity including contact information, correspondence, actions taken and settlement amounts.
Managed a high volume of files within established time frames without compromising quality.
Prepared letters informing insureds of their rights under the policy terms.
Trained and mentored team members on proper workflows and processes to enhance productivity.
Conducted regular meetings with team members to discuss progress, challenges, and solutions. October 2008 - September 2009 Lienholder Specialist GEICO, Government Employees Insurance, Macon, GA Emergency Roadside Dispatcher GEICO, Government Employees Insurance, Macon, GA Assistant Store Manager SHOE SHOW, Macon, GA Followed all company policies and procedures to deliver quality work.
Listened and responded to customer requests and forwarded necessary information to superiors.
Verified Coverage
Forwarded policy binders, ID cards to insured(s), Car dealerships, rental companies...etc.
Answered an average of 60+ calls daily while keeping my average handling time low. June 2007 - October 2008 Facilitated communications between customers and field personnel to answer questions or resolve concerns.
Responded to over 100 daily caller requests with information about assistance and timeframes.
Served as mediator when appropriate to settle conflicts and discrepancies between field personnel and management.
Quickly learned new skills and applied them to daily tasks, improving efficiency and productivity.
Worked flexible hours; night, weekend, and holiday shifts.
Maintained energy and enthusiasm in fast-paced environment.
Offered friendly and efficient service to customers, handled challenging situations with ease.
Developed and maintained courteous and effective working relationships.
Maintained excellent attendance record, consistently arriving to work on time. September 2003 - March 2007 Maintained positive customer relationships by responding quickly to customer service inquiries.
Managed opening and closing procedures and recommended changes to enhance efficiency of daily activities.
Responded to customer concerns, working with manager to significantly raise customer satisfaction ratings.
Interviewed, hired and trained staff associates and equipped to comply with company policies and procedures.
Rotated merchandise and displays to feature new products and promotions.
Processed payments for credit and debit cards and returned proper change for cash transactions.
Reconciled daily sales transactions to balance and log day-to-day revenue.
Walked through store areas every hour to identify and proactively resolve issues negatively impacting operations.
Secretary's Assistant Dixon Realty, Macon, GA Conducted weekly staff meetings to motivate staff members, address concerns and questions. August 2001 - June 2003 Answered multi-line phone system and greeted callers enthusiastically.
Scheduled appointments and conducted follow-up calls to clients.
Maintained office supplies inventory by checking stock and ordering new supplies.
Provided clerical support to company employees by copying, faxing and filing documents.
Drafted agendas, recorded minutes and created documents for meetings.
Responded to emails and other correspondence to facilitate communication and enhance business processes