Kay Barnes
Ozone Park,NY
Summary
Seasoned insurance specialist with excellent planning and problem solving abilities. Offering several years of experience and a willingness to take on any challenge. Organized, driven and adaptable professional with successful history managing high caseloads in fast-paced environments.
Overview
18
18
years of professional experience
1
1
Certification
Work History
CL Claims Specialist
Progressive
New Hyde Park, NY
05.2023 - Current
- Researched medical records to evaluate claim validity and verify the existence of pre-existing conditions.
- Interpreted legal documents related to claims processing such as contracts and policy language.
- Received incoming calls from insureds or claimants seeking assistance with their auto claims.
- Prepared reports summarizing findings from investigations into auto insurance fraud cases.
- Provided customer service to policyholders regarding their auto claims inquiries or concerns.
- Negotiated settlements with claimants, attorneys and other parties involved in the claim process.
- Maintained detailed records of all claims activities and documentation for auditing purposes.
- Investigated auto insurance claims to ensure accuracy and completeness of information.
- Advised customers on the progress of their claim status throughout the duration of the claim process.
- Analyzed accident reports to determine liability and damages in accordance with applicable laws.
Attorney Represented Claims Resolution Specialist
LIBERTY MUTUAL INSURANCE COMPANY
Uniondale, NY
09.2021 - 05.2023
- Negotiated with other involved parties to arrange settlements for maximum results.
- Investigated issues to determine appropriate coverage and liability for Bodily Injury claims.
- Reviewed insurance and claims documents to verify required information and secure any missing data for settlements.
- Provided advice to customers regarding claims, rights and insurance processes to prevent disputes.
- Conducted full claim investigations and reported updates and legal actions.
- Reviewed new files to determine current status of injury claim and to develop plan of action.
- Drafted and reviewed legal documents utilizing knowledge of relevant clauses to minimize incurred liability.
- Conducted risk evaluations on claims settlement proposals to encourage sound decision-making regarding settlement offers.
- Escalated files with significant indemnity exposure to supervisor for further investigation.
- Responded to inquiries by answering questions, providing information and directing customers to appropriate resources.
- Explained policy coverage, liability and denials to policyholders, lawyers and other involved parties.
- Collaborated with legal counsel to make organizational claims decisions aligning with governing laws.
Bodily Injury Claims Adjuster
Geico
Woodbury , NY
07.2017 - 09.2021
- Examined policy contracts to determine insurance coverage.
- Prepared reports of findings in investigations.
- Reviewed medical treatment reports, police reports and medical bills to come to fair settlement with Bodily Injury Attorneys.
- Interviewed relevant parties to determine claim denial or settlement through recorded statements.
- Managed over 50 customer calls per day.
- Reviewed and analyzed suspicious and potentially fraudulent insurance claims.
- Substantiated legitimate claims and denied unjustified claims.
- Evaluated all evidence with ultimate goal of protecting our insureds policy.
- Collaborated with other claims department and industry anti-fraud organizations to resolve claims.
- Investigated claims involving potential and suspected fraudulent activities.
- Reviewed field inspections and analyzed vehicle damage photos.
- Answered questions posed by insured and attorneys.
- Maintained contact with attorneys to determine treatment status.
- Answered customer questions regarding deductibles and policy coverages.
Property Damage Liability Investigator
Geico
Woodbury , NY
07.2012 - 07.2017
- Responded to customer requests via telephone and email.
- Researched and investigated auto accidents to determine liability.
- Collected, analyzed and interpreted information, documentation and evidence to complete a liability investigation.
- Conducted interviews with insureds, claimants and witnesses.
- Answered phone calls from customers and assisted with resolving their issues.
- Resolved customer issues in timely manner while complying with company standards.
- Managed complex transactional and emotional customer situations promptly and professionally while meeting service commitments.
- Delivered exceptional customer service through acknowledgement, communication and commitment to quality.
Customer Service Agent
Geico
Woodbury, NY
01.2008 - 07.2012
- Investigated and resolved customer inquiries and complaints in timely and empathetic manner.
- Serviced customers in timely fashion, while quickly determining their needs.
- Gathered sensitive information to update customer insurance policies.
- Described product to customers and accurately explained their coverages.
- Determined customer needs by asking relevant questions and listening actively to responses.
- Asked open-ended questions to assess customer needs.
- Identified issues and took appropriate action to ensure speedy resolution.
Management Trainee
Enterprise Rent-A-Car
Queens, NY
09.2006 - 01.2008
- Explained services and products to customers in friendly and engaging way.
- Responded to customer concerns in swift and knowledgeable manner to maintain satisfaction.
- Resolved escalated concerns using professionalism and understanding of all facets of issue.
- Ensured that each renter's experience was positive, memorable and consistent.
- Worked directly with auto insurance companies, body shops and dealerships to provide their customers with rental vehicles.
Education
Bachelor of Science - Business Management in Finance
Brooklyn College of The City University of New York
06.2009
Skills
- Negotiate Settlements
- Complex Problem-Solving
- Claims Investigation
- Customer Service
- Data Entry
- Active Listening
- Documentation abilities
- Analytical Thinking
Additional Information
- Completed Lean Six Sigma Training
- Completed Human Resource Diversity Training
Certification
- Connecticut Claims Adjuster License - 09/2021 to 05/2023
- Florida Claims Adjuster License - 05/2023 to present
Timeline
CL Claims Specialist
Progressive
05.2023 - Current
Attorney Represented Claims Resolution Specialist
LIBERTY MUTUAL INSURANCE COMPANY
09.2021 - 05.2023
Bodily Injury Claims Adjuster
Geico
07.2017 - 09.2021
Property Damage Liability Investigator
Geico
07.2012 - 07.2017
Customer Service Agent
Geico
01.2008 - 07.2012
Management Trainee
Enterprise Rent-A-Car
09.2006 - 01.2008
Bachelor of Science - Business Management in Finance
Brooklyn College of The City University of New York
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