Jamoy Calvin

• Company Overview: GEICO is well-known for its auto insurance, offering coverage for private passenger vehicles, property insurance and commercial insurance
• Review medical records to ensure claims align with policy limits, enhancing accuracy.
• Negotiate settlements and educate policyholders, improving understanding and satisfaction.
• Collaborate with attorneys to resolve claims, reducing litigation risks.
• Identify high-risk claims, manage payments, ensuring timely processing.
• Maintain documentation of assessments, ensuring accurate case resolution.
• Streamlined claims processing workflow by prioritizing high-risk cases and implementing proactive settlement strategies to prevent litigation.
• Provided clear guidance to policyholders regarding coverage details, claim decisions, and settlement outcomes while maintaining professional communication standards

Accomplishments

• Top performer for 2025 quarter 1 out of 20 individuals contributing significantly to the team’s overall success and growth. Recently appointed point of contact for new adjusters, improving their claim handling efficiency. Negotiated and secured settlements that were, on average, 10% higher than the team’s average

• Respond to inquiries from policyholders and claimants about their claims.
• Gather information to determine the validity of a claim, including but not limited to interviewing customers, working with other departments, and reviewing policy information.
• Expound on applicable coverages, and claim status to policyholders and claimants, ensuring they understand their rights and responsibilities.
• Provide exceptional customer service by resolving any questions or concerns the customer may have, furnishing a pleasant experience.
• Check the development of pending claims and provide policyholders and claimants with updates on their status.
• Contacting claimants for additional information, and documentation, or to follow up on any outstanding claims.
• Connect with claimants for additional information, and documentation, or to follow up on outstanding claims.

Accomplishments

• Maintained an 80% first-call resolution rate, consistently resolving claims efficiently and effectively on the first call. Consistently achieved customer satisfaction scores of 4.5/5 or higher. Recognized for exceptional teamwork by proactively assisting peers with complex claims issues, sharing best practices, and contributing to a collaborative environment that led to a 15% increase in overall team efficiency

• Company Overview: Conduent, a provider of business services, offers a range of solutions, including Human Capital Solutions that help employees make better decisions about their health, wealth, and careers, as well as Health Benefits Solutions that clients can use to access their health and wealth benefits digitally
• Successfully enforced organizational policies and procedures to ensure compliance.
• Management responsibilities include hiring & terminating decisions, training and development of employees.
• Manage timekeeping/payroll activities for direct reports under my organization.
• Performed annual evaluations and reviews for direct reports
• Successfully managed multiple high-volume teams simultaneously.
• Partnered with Workforce Management for forecast and analytics for client service agreements which led to successfully meeting metrics.
• Manage annual enrollment processes.
• Interfaced with the client and administration for exceptional customer experience

Accomplishments

• Spearheaded a cross-functional team initiative that resulted in a 15% increase in team productivity, positioning me as a leader and top performer among 5 individuals through strategic planning and execution. Implemented employee recognition programs and offered skill development opportunities, contributing to a 20% reduction in turnover rates within the customer service department

• Complete coaching mentorship which included mentoring employees and quality call evaluations
• Communicated daily SLA, FCR, and Call back reports to the team
• Provide on-the-job, client specific training to new team members
• Ensure all associates are knowledgeable of changes and updates made to plan rules and provisions by scheduling huddles.
• Manage escalations
• Assist representatives with active call questions.
• Request system access for new hires to perform their daily task
• Assist with the development of Senior Representatives through mentoring

Accomplishments

• Recognized as Employee of the Month for 5 consecutive months, standing out from 30 individuals for delivering exceptional customer service and leading team projects to successful completion ahead of deadlines.

• Assisted participants with benefit enrollment
• Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
• Maintained high-quality scores each month
• De-escalated calls
• Processed Life events and answered questions regarding benefit changes

Accomplishments

• Consistently ranked among the top 5 performers out of 60 team members, surpassing key performance indicators by an average of 20%, demonstrating exceptional efficiency and commitment to excellence.