Jennifer Smith
Santee,CA
Summary
Senior level investigator with 19+ years in insurance industry, dedicated to supporting the organizational mission of auto insurance claims. Highly adept in client relations, policies and protocols, and documentation. Strong work ethic, adaptability and exceptional interpersonal skills.
Overview
20
20
years of professional experience
Work History
Senior Internal Investigator
GEICO
01.2016 - Current
- Investigate potentially fraudulent claims with focus on thoroughness, quality, cost control and completion within established timeframes
- Skilled interviewer with claimants in determining validity of information; including analysis of phrasing, tonal nuances, and forward level question tactics to seek out accurate details
- Collected, analyzed and interpreted information, documentation, and physical evidence associated with investigations.
- Maintain organized records of information and material as it relates to investigation
- Hire and facilitate 3rd party vendor inspections on vehicles and interpret vendor reports
- Prepare detailed investigative reports summarizing findings, conclusions, and recommendations
- Maintain clear communication and collaboration with claims department regarding assigned cases
- Participate in educational seminars to maintain knowledge on current industry trends
- Exceeded monthly goals of cases worked, timely, and quality investigations
- Coached and trained staff on fraud prevention techniques to increase awareness and reduce risk.
Claims Security Investigator
GEICO
08.2013 - 01.2016
- Newly created position responsible for developing and implementing, and subsequently built to 6 positions
- Led to creation of country-wide positions within organization
- Trained new associates on position
- Reviewed claim file and medical documents in detail and extracted pertinent information to assist in investigation
- Completed necessary database runs and analyzed information within database
- Utilized pertinent information to conduct social media review, in effort to gather evidence to mitigate claim
- Memorialized evidence gathered into fact-finding, comprehensive and detailed report for claims examiner
- Exceeded monthly goals of cases worked, timely, and quality investigations
- Participated in educational seminars to maintain knowledge on current industry trends.
- Co-facilitated day long trainings with specific case examples to onboard department on skill of social media investigations
Liability Claims Coach
GEICO
07.2010 - 08.2013
- Promoted to coach after demonstrating skilled expertise as liability claims examiner
- Provided guidance to new associates to help them develop their skills and achieve desired goals in their professional development
- Supervise 4-6 employees in real-life scenarios, handling claims, with side-by-side mentoring and coaching to increase skills competency
- Analyzed performance data to identify areas of improvement for individuals or teams
- Analyzed data from post-training evaluations and suggested improvements for future classes
- Facilitated group discussions and activities to promote knowledge sharing among trainees
- Developed and delivered training programs to support claims process
- Obtained and organized manuals, guides and visual materials for development and training purposes.
Liability Claims Examiner
GEICO
11.2006 - 07.2010
- Promoted from damage recovery and entry-level call center with extensive hands-on training to handle more complex claims
- Managed pending of over 200 claims at one time
- Completed comprehensive review of claim and determined information needed to move claim to closure
- Completed telephonic recorded statements to gather evidence to determine liability in vehicle collisions
- Negotiated liability negligence with adverse carriers
- Communicated liability decisions, favorable or not, to involved parties
- Completed coverage investigations which included conducting telephonic recorded statements of insureds and claimants and gathered evidence to support findings
- Selected as associate that incoming new hires would sit with to listen to calls and learn position
- Recognized for high amount of compliment calls, file and call quality.
Payment Recovery Examiner
GEICO
06.2005 - 11.2006
- Responsible for recovering funds paid out to repair vehicle, or for medical bills related to auto collision
- Gathered and compiled evidence to support facts of loss in effort to recover monies paid out for damages
- Responded to filings from other carriers and defended company's position of liability to avoid payout for damages not owed
- Referred files to collection agencies to pursue subjects directly
- Maintain efficient diary system for updates and status on recovery payments.
- Negotiated payment arrangements with uninsured claimants to recover claims payments made
Claims Service Representative
GEICO
02.2004 - 06.2005
- Entry level claims position in call center environment
- Worked productively in fast-moving work environment to process large volumes of claims.
- Responsible for taking first notice of loss, advising of liability and scheduling repairs
- Documented new losses and used knowledge and experience to determine if claim needed to be assigned to another level based on coverage, injury and liability concerns
- Developed in-depth understanding of insurance policies and procedures
- Followed up with customers on unresolved issues.
Skills
- Leadership
- Employee Training
- Investigative Research
- File and Record Management
- Trend Evaluations
- Microsoft Office Suite
- Deadline and Results-Oriented
- Time Management
- Customer Service
- Communication
- Critical Thinking
- Integrity
Designations
American Educational Institute, Fraud Claim Law Specialist Designation, 04/2020
Timeline
Senior Internal Investigator
GEICO
01.2016 - Current
Claims Security Investigator
GEICO
08.2013 - 01.2016
Liability Claims Coach
GEICO
07.2010 - 08.2013
Liability Claims Examiner
GEICO
11.2006 - 07.2010
Payment Recovery Examiner
GEICO
06.2005 - 11.2006
Claims Service Representative
GEICO
02.2004 - 06.2005
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