Experienced Claims Specialist with 5+ years in insurance claims processing. Proven track record of reducing claims resolution time by 50% while maintaining 100% accuracy. Skilled in customer service, best practices and claim adjudication.
Overview
24
24
years of professional experience
1
1
Certification
Work History
Customer Service Associate, Remote Contact Center
Lincoln Financial Group
Charlotte, NC
10.2021 - 07.2022
Handled incoming customer, agent and broker inquiries regarding life insurance and financial products
Resolved escalations, identified solutions and took appropriate actions to meet company guidelines and compliance standards
Processed account changes, premium payments and reinstatements on applicable life products
Maintained a 95% metric quality and service level agreement
Senior Associate-Customer Service, Inforce Contact Center
AXA Equitable Life Insurance
Charlotte, NC
08.2013 - 02.2020
Resolved advisors, broker and policyholder complex complaints to minimize escalations on multiple life insurance products raised to upper management via outgoing and incoming calls in addition to chat and email
Trained and created new employees mentoring programs
Participated in training sessions covering existing and new life insurance products
Successfully managed heavy call volumes while maintaining a high degree of professionalism in addition to achieving corporate metrics and SLA goals
Total Loss Claims Adjuster
Travelers Property Casualty Insurance Co.
Charlotte, NC
05.2005 - 08.2009
Negotiated, mitigated, and adjudicated automobile claims with attorneys, claimants and policyowners in a timely manner
Managed and processed legal time sensitive paperwork within department specific guidelines to maintain financial accuracy
Established immediate contact with attorneys, policyholders, and claimants to mitigate claim resolution set within Best Practices determining the appropriate financial reserves and time guidelines
Strong organizational skills to manage multiple queries based on priority and sensitivity level for diaries and claim caseloads
Consistently maintains licensure with meeting yearly continuing education classes to ensure compliance guidelines with various state laws
Customer Service Representative, Call Center
The Equitable
Charlotte, NC
01.1999 - 05.2005
Answered 60 to 70 calls daily from agents, brokers and policyowners resolving detailed life insurance policy questions with one call resolution
Processed death claim calls while answering transferred interdepartmental calls
Succeeded daily exceeding the call center corporate metrics required
Education
Associates of Arts Degree - Accounting
Florida State College
Jacksonville, FL
Skills
Insurance knowledge
Claim adjudication
Determined coverage status
Managed claims inbox
Risk management
Interpreted insurance brochures and products
Insurance license
Time management
Certification
Adjuster License, North Carolina Department of Insurance
Timeline
Customer Service Associate, Remote Contact Center
Lincoln Financial Group
10.2021 - 07.2022
Senior Associate-Customer Service, Inforce Contact Center