Jawana Montgomery
Douglasville,Georgia
Summary
Energetic and enthusiastic insurance professional motivated to succeed in fast-paced and deadline-driven professional environment. Comprehensive knowledge of claims adjustments with special knowledge of auto appraisals and CCC pathways estimations.
Overview
19
19
years of professional experience
Work History
Claim Specialist Injury
State Farm
Atlanta, GA
07.2022 - Current
- Investigating, evaluating, negotiating, and settling claims
- Applying knowledge of policies, procedures, laws, statutes, and insurance regulations when determining coverage, liability, & damages
- Contacting customers by telephone, written correspondence and/or various electronic media
- Effectively managing work through task driven queues while multi-tasking in a fast-paced call center environment
- Supporting our customers through personalized, caring, and simple interactions.
- Identified potential fraud indicators and escalated to appropriate personnel for further investigation.
- Responded to inquiries from claimants, attorneys, medical providers. regarding the status of their claim.
- Analyzed medical reports, bills, legal documents, or other information related to claims.
- Participated in special projects as assigned by management team.
- Provided excellent customer service throughout the entire claims process.
- Ensured that all documentation was accurately entered into the system.
- Resolved difficult issues promptly while maintaining a high level of professionalism.
- Reviewed policies and procedures regularly to ensure they are up-to-date with industry standards.
- Attended continuing education courses related to insurance regulations and best practices.
- Assessed damages sustained by insureds due to property loss or personal injury.
- Processed payments accurately according to established timelines.
- Maintained knowledge of policies and procedures and insurance coverage benefit levels, eligibility systems and verification processes.
- Conducted interviews with involved claims parties and witnesses to gather detailed information and arrange investigations.
- Processed claims for payment or forwarded to appropriate personnel for further investigation
- Collaborated with fellow team members to manage large volume of claims.
Scholarship Administration Specialist
Georgia Department of Early Care and Learning (DECAL)
Atlanta, GA
08.2020 - 07.2022
- Process and redetermination CAPS scholarships
- Determine program eligibility
- Process assigned electronic and hard copy renewal applications to determine ongoing eligibility
- Verify eligibility through appropriate documents
- Process referrals through the Department of Family and Children Services or agencies for CAPS
- Data Entry from forms, records, and reports.
- Developed and implemented specialized procedures for customer service operations.
- Coordinated with other departments to ensure efficient workflow processes.
- Exercised versatility in fast-paced, agile work environments.
- Displayed strong telephone etiquette, effectively handling difficult calls.
- Identified needs of customers promptly and efficiently.
- Utilized document management system to organize company files, keeping up-to-date and easily accessible data.
Substitute Teacher
Atlanta Public School System
Atlanta, GA
04.2016 - 07.2020
- Provided instruction and guidance to students in the absence of a regular teacher.
- Organized lesson plans and activities for students.
- Assisted with classroom management issues when needed.
- Implemented school policies and procedures in the classroom.
- Collaborated with other teachers to ensure student success.
- Maintained accurate records of student performance, attendance, and behavior.
- Monitored student progress throughout the day.
- Encouraged positive behavior among students through effective communication techniques.
- Developed creative learning strategies to engage all types of learners.
- Ensured that each student had access to appropriate materials and resources.
- Adapted teaching methods to accommodate diverse learning styles.
- Provided classroom instruction outlined in teacher's lesson plans.
- Provided notes and reports on school day activities to primary teacher.
- Requested as substitute teacher based on excellent referrals and trusted performance.
- Tutored students individually and in small groups to help with difficult subjects.
- Prepared, administered and graded tests and assignments to evaluate student progress.
- Attended training and workshops to improve teaching skills.
Case Manager
Family First
Atlanta, GA
04.2013 - 04.2016
- Conducted comprehensive intake admissions for new referrals through interview, assessment, collection of previous service records, and collaboration with other service providers
- Developed and monitored the individualized plan
- Provided crisis intervention, guidance, and supportive counseling
- Complete documentation and reports on a weekly and quarterly basis to ensure eligibility, funding, and compliance
- Ensured all enrollment activities adhered to established procedures.
- Attended court hearings as a representative of the organization when needed.
- Counseled clients on available resources within the community that could help meet their needs.
- Monitored client progress through regular follow-up contacts.
- Maintained logs and electronic client records following department and agency policies for effective monitoring.
- Adhered to ethical principles and standards to protect clients' confidential information.
- Participated in regular team meetings and in-house training sessions to boost group effectiveness.
- Communicated with legal services providers, social services agencies and local judicial systems regarding cases.
- Handled administrative procedures to meet objectives set by boards of directors or senior management.
Customer Service Agent
Working Solutions
Plano, Texas
07.2011 - 03.2013
- Assisted customers with inquiries regarding products and services through phone, email, and chat.
- Provided product information to customers in a timely manner.
- Resolved customer complaints quickly and efficiently.
- Maintained a high level of customer satisfaction by providing accurate and helpful responses.
- Tracked orders from placement to delivery using internal systems.
- Performed administrative duties related to customer service such as filing documents or completing paperwork.
- Answered incoming calls promptly and professionally within company standards.
- Provided technical support over the phone when needed.
- Managed high-volume of inbound and outbound customer calls.
- Utilized active listening and communication skills to address customer inquiries and escalate issues to supervisor.
- Reviewed files, records and other obtained documents to respond to customer requests.
- Met or exceeded call speed, accuracy and volume benchmarks on consistent basis.
- Maintained strong call control and quickly worked through scripts to address problems.
- De-escalated problematic customer concerns, maintaining calm, friendly demeanor.
T.E. Mail Carrier
United States Postal Service
Atlanta, Georgia
10.2007 - 06.2011
- Sorted mail to be delivered according to route and customer address.
- Scanned packages for delivery tracking.
- Delivered packages and letters to residential customers.
- Collected signatures from recipients of registered mail items.
- Provided friendly customer service at all times while delivering mail.
- Verified accuracy of addresses before delivering packages.
- Updated daily delivery logs to record number of deliveries made.
- Organized parcels into appropriate size containers for transport.
- Delivered mail along prescribed route and retrieved additional mail from relay boxes.
- Delivered various types of mail on routes according to strict timelines.
- Delivered mail to residents and business within assigned area.
- Bundled mail in preparation for delivery or transportation to relay boxes.
Private Investigator's Clerk
Borders Corporation
Atlanta, Georgia
02.2005 - 08.2007
- Responsible for receiving and screening a high volume of internal and external communications, including emailing and written documents
- Managed the daily calendar for the senior director
- Also assisted with monthly reports showing gains and profit loss for the month.
- Collected intelligence from public records and sources in the field.
- Analyzed data to identify patterns and trends related to investigations.
- Utilized specialized computer software programs to track leads and analyze data collected during investigations.
- Interacted with law enforcement personnel to coordinate efforts on ongoing cases.
- Prepared legal documents such as subpoenas, search warrants and affidavits.
- Researched public records.
- Gathered proof of activities through video recordings, photographs and statements.
- Produced timely and accurate reports about findings.
- Prepared case summaries highlighting investigated findings.
- Conducted research for insurance claims to expose stolen funds and fraudulent claims.
Education
B.S. Education -
Clayton State University
12.2018
A.S. -
Shorter University
12.2012
Skills
- Settlement Negotiation
- Conflict Resolution
- Litigation Resolution
- Liability And Coverage
- Customer Communication
- Customer Service
- Insurance Claims Review
- Claims File Management Processes
- Claims Management
- Information Verification
- Document Management
- Excellent Time Management Skills
- Policy Regulations Knowledge
- Policy Coverage Determinations
- Billing Management
- Account Management
- Understanding Of Insurance Policies
- Insurance Claim Regulations
- Legal Billing
- Data Review
- Reviewing Risk Exposure
- Accident Review
- Report Writing
- Claims Adjuster License
References
Reference are available upon request
References
References available upon request.
Timeline
Claim Specialist Injury
State Farm
07.2022 - Current
Scholarship Administration Specialist
Georgia Department of Early Care and Learning (DECAL)
08.2020 - 07.2022
Substitute Teacher
Atlanta Public School System
04.2016 - 07.2020
Case Manager
Family First
04.2013 - 04.2016
Customer Service Agent
Working Solutions
07.2011 - 03.2013
T.E. Mail Carrier
United States Postal Service
10.2007 - 06.2011
Private Investigator's Clerk
Borders Corporation
02.2005 - 08.2007
B.S. Education -
Clayton State University
A.S. -
Shorter University