KARLENE EDWARDS
Duluth,GA
Summary
Driven operations and support professional, with organizational, research and analytical skills. I desire to apply my customer service, claims processing, support and reporting skills in a thriving culture that promotes growth and advancement from within.
Overview
13
13
years of professional experience
Work History
ILR Claims Associate
State Farm
09.2024 - Current
Post-Sales Warranty
Acuity Brands Lighting, Inc.
05.2016 - 09.2024
- Using claims workbench, review and process new claims and maintain claim load of continuing warranty claims from agencies and end users.
- Utilizing resources such as staff electricians, product support, and engineers, obtain photos and other information to determine best resolution.
- Negotiate and approve contactor and equipment payments for labor to repair and or replace defective items.
- Identify and track issues for product support and manufacturing plant reports
- Correspond with all parties through phone, email and business letter
Claims Resolutions & Escalations Adjuster
Safeguard Products International
02.2014 - 05.2016
- Managed claims investigations to ensure compliance with company policies and industry regulations.
- Review and resolve escalated claim issues from Agents, Dealers, Sales Reps and OEM management
- Document data for root cause counter measure, recall and other solution based processes.
- Senior adjuster duties including mentoring and coaching of new hires, providing floor support and handling escalated calls in the absence of supervisory staff
- Collaborated with clients and stakeholders to resolve disputes and facilitate timely claim resolutions.
- Mentored new adjusters on effective negotiation techniques and claims assessment strategies.
- Led cross-functional meetings to address complex claims issues, fostering teamwork and collaboration across departments.
- Maintained strong relationships with policyholders, agents, and colleagues by consistently demonstrating professionalism, empathy, and effective communication skills.
- Correspond with all parties through phone, email and business letter
Claims Adjuster
Safeguard Products International
02.2014 - 02.2015
- Receiving, processing and rendering decision for vehicle service warranty claims
- Providing claim and payment status for approved claims.
- Senior adjuster duties including mentoring and coaching of new hires, providing floor support and handling escalated calls in the absence of supervisory staff
STD Claims Analyst
Lincoln Financial Group
03.2013 - 02.2014
- Receiving, processing and rendering decision for Short Term Disability claims
- Obtaining and reviewing medical documentation for continuation of benefits
- Preparation and presentation of medical findings in weekly medical consultations with staff physicians and specialists for direction when needed
- Ensuring accurate calculations for benefit payments and timely updates entered in system to continue benefit payments
- Correspondence by phone, email and business letter with claimants, healthcare providers and employers
- Presenting claims for transition to Long Term Disability
Education
High School Diploma - undefined
Boyd H. Anderson High School
Lauderdale Lakes, FLPsychology
Broward College
Coconut Creek, FLSkills
- Proficient in MS Office programs including Excel and Power Point
- Correspondence via email, and business letters
- Collaboration with various teams including engineering, production and product development for ongoing root cause and quality improvement projects
- Participation on teams responsible for reviewing standard work and other processes to identify challenges, gaps and make recommendations for improvements for department-wide implementation
Timeline
ILR Claims Associate
State Farm
09.2024 - Current
Post-Sales Warranty
Acuity Brands Lighting, Inc.
05.2016 - 09.2024
Claims Resolutions & Escalations Adjuster
Safeguard Products International
02.2014 - 05.2016
Claims Adjuster
Safeguard Products International
02.2014 - 02.2015
STD Claims Analyst
Lincoln Financial Group
03.2013 - 02.2014
High School Diploma - undefined
Boyd H. Anderson High School
Psychology
Broward College