John Sargent
Missouri City,TX
Summary
Results-driven professional with over 20 years of experience in the insurance industry. Skilled in evaluating claims for accuracy and compliance, detecting fraud, and analyzing policies. Committed to enhancing customer understanding of coverage options and streamlining claims processes.
Overview
28
28
years of professional experience
Work History
Claims Specialist Total Loss Auto Property
State Farm Insurance
Atlanta , GA
07.2016 - 05.2025
- Evaluated insurance claims for accuracy and compliance with company policies.
- Evaluated claim details and determined appropriate resolutions based on policy guidelines.
- Assisted clients in understanding their coverage options and claim processes.
- Maintained detailed records of all claim activities including notes about conversations with claimants or representatives.
- Reviewed and analyzed insurance claims to determine validity, completeness, accuracy, and eligibility for payment.
- Coordinated with repair shops to obtain estimates for vehicle damages.
- Communicated effectively with clients via telephone, email, or written correspondence.
- Monitored industry trends related to total loss processes and best practices.
- Analyzed vehicle history reports to determine if a total loss was warranted.
- Adhered to established procedures for handling sensitive information securely.
- Assessed salvage values for totaled vehicles in order to calculate settlement amounts.
- Evaluated claims for possible fraud, contacting appropriate department for assistance and further investigation.
- Documented vehicle damage and condition by taking meticulous notes and photographs.
- Managed heavy workload of ongoing cases thanks to strong organizational, time management, and collaboration skills.
Claims Representative Total Loss Call Center
State Farm Insurance
Baton Rouge, Louisiana
08.2004 - 06.2016
- Processed insurance claims efficiently following company policies and procedures.
- Reviewed claim documentation to ensure accuracy and completeness.
- Coordinated with internal departments to resolve claim issues promptly.
- Assisted customers in understanding their policy coverage and claim processes.
- Provided quality customer service to assigned, insured and claimants throughout claims process to deliver timely service to customers.
- Maintained detailed records of all communication with customers, claimants, providers, and internal departments.
- Adhered to strict guidelines pertaining to confidentiality while handling sensitive personal information.
- Investigated facts, confirmed coverage and liability, negotiated settlements, and determined payments for claims.
Claims Representative Injury/Property Consultant
State Farm Insurance
New Orleans , LA
03.1997 - 07.2004
- Provided quality customer service to assigned, insured and claimants throughout claims process to deliver timely service to customers.
- Processed insurance claims using company-specific software and guidelines.
- Educated clients on policy coverage, claim processes, and timelines effectively.
- Maintained detailed records of all communication with customers, claimants, providers, and internal departments.
- Provided clear explanations of benefits, eligibility requirements, and applicable laws when communicating with customers.
- Conducted research into medical terminology related to healthcare claims processing activities.
- Identified potential fraud indicators during the review process and reported suspicious activity accordingly.
- Implemented cost-saving measures without compromising on the quality of service or claim outcomes.
- Attended legal proceedings related to claims, including arbitrations and mediations, as required.
Education
Bachelor of Science - Computer Information Systems
Grambling State University
Grambling, LA05-1995
Skills
- Claims evaluation
- Fraud detection
- Policy analysis
- Coverage assessment
- Settlement negotiation
- Customer service
Timeline
Claims Specialist Total Loss Auto Property
State Farm Insurance
07.2016 - 05.2025
Claims Representative Total Loss Call Center
State Farm Insurance
08.2004 - 06.2016
Claims Representative Injury/Property Consultant
State Farm Insurance
03.1997 - 07.2004
Bachelor of Science - Computer Information Systems
Grambling State University