Kelly Tulchin
Granbury,TX
Summary
Experienced Claim Specialist successful at managing high caseloads in fast-paced environments. Organized, driven and adaptable with excellent planning and problem-solving abilities. Offering 33 years of experience and willingness to take on any challenge.
Overview
33
33
years of professional experience
4
4
Certification
Work History
WCCS Deployed Catastrophe Claim Specialist
State Farm Insurance
06.2018 - 11.2023
- Reviewed insurance and claims documents to verify required information and secure any missing data for settlements.
- Followed up with customers on unresolved issues.
- Understood requirements for disputes, gathered evidence to support claims and prepared customer cases to handle appeals.
- Monitored compliance with regulations and industry best practices to promote fair and proper treatment for insured customers.
- Responded to inquiries by answering questions, providing information and directing customers to appropriate resources.
- Performed administrative duties by verifying documentation, researching facts and contacting other parties involved to determine fault percentages and minimize potential losses.
- Conducted full claim investigations and reported updates and legal actions.
- Provided advice to customers regarding claims, rights and insurance processes to prevent disputes.
- Escalated files with significant indemnity exposure to supervisor for further investigation.
- Negotiated with other involved parties to arrange settlements for maximum results.
- Conducted risk evaluations on claims settlement proposals to encourage sound decision-making regarding settlement offers.
- Drafted and reviewed legal documents utilizing knowledge of relevant clauses to minimize incurred liability.
- Collaborated with legal counsel to make organizational claims decisions aligning with governing laws.
- Utilized appropriate cost containment techniques to reduce overall claim costs.
- Generated, posted and attached information to claim files.
- Checked documentation for accuracy and validity on updated systems.
- Carried out administrative tasks by communicating with clients, distributing mail, and scanning documents.
- Verified client information by analyzing existing evidence on file.
- Prepared insurance claim forms or related documents and reviewed for completeness.
- Posted payments to accounts and maintained records.
- Processed and recorded new policies and claims.
- Determined appropriateness of payers to protect organization and minimize risk.
- Extensive travel throughout the United States.
Bodily Injury Trainer
State Farm Insurance
- Mentored new hires, resulting in stronger staff development and increased productivity.
- Monitored and reported trainee progress, introducing new learning tools to address individual needs.
- Analyzed team performance and identified opportunities for additional training.
- Monitored participant workflow and behaviors throughout training process.
- Delivered instructional presentations on equipment use, focusing on efficiency and safety.
- Developed effective training plans based on department needs and objectives.
- Developed individualized training plans to achieve staff readiness.
- Educated clients on proper use of products and systems.
- Tracked attendance and evaluated progress for assigned trainees.
- Implemented diverse instructional methods, optimizing trainee engagement.
- Supported productivity increase and business growth through new hire training and mentoring.
- Prepared and presented supplementary learning material to support structured lessons.
- Introduced standardized training for cohesive learning environments.
- Performed continuous evaluations of content and plans to enhance delivery and improve effectiveness.
- Scheduled and taught in class and online courses to increase learning opportunities.
- Implemented new training courses after assessing corporate data and identifying employee weaknesses.
- Provided coaching and mentoring to employees.
- Analyzed and evaluated training effectiveness and program outcomes.
- Conducted needs assessments to identify gaps in performance and develop targeted learning solutions.
- Facilitated virtual, in-person and blended learning sessions.
- Utilized variety of instructional design methodologies to create effective learning experiences.
- Developed and implemented successful onboarding program.
- Designed and delivered web-based, self-directed learning materials.
Express Team Lead
State Farm Insurance
- Coached team members in techniques necessary to complete job tasks.
- Worked different stations to provide optimal coverage and meet production goals.
- Trained new team members by relaying information on company procedures and safety requirements.
- Evaluated employee skills and knowledge regularly, training, and mentoring individuals with lagging skills.
- Minimized resource and time losses by addressing employee or production issue directly and implementing timely solutions.
- Monitored team performance and provided constructive feedback to increase productivity and maintain quality standards.
- Supervised team members to confirm compliance with set procedures and quality requirements.
- Built strong relationships with customers through positive attitude and attentive response.
- Worked with team to identify areas of improvement and devised solutions based on findings.
- Established open and professional relationships with team members to achieve quick resolutions for various issues.
- Conducted training and mentored team members to promote productivity, accuracy, and commitment to friendly service.
- Promoted high standerds through personal example to help each member understand expected behavious and standards.
- Mentored and guided employees to foster proper completion of assigned duties.
- Conducted training and mentored team members to promote productivity and commitment to friendly service.
- Held weekly team meetings to inform team members on company news and updates.
- Optimized customer experience by delivering superior services and effectively troubleshooting issues.
- Educated staff on organizational mission and goals to help employees achieve success.
- Evaluated staff performance and provided coaching to address inefficiencies.
Auto Claim Central - Claims Specialist
State Farm Insurance
- Reviewed insurance and claims documents to verify required information and secure any missing data for settlements.
- Followed up with customers on unresolved issues.
- Understood requirements for disputes, gathered evidence to support claims and prepared customer cases to handle appeals.
- Monitored compliance with regulations and industry best practices to promote fair and proper treatment for insured customers.
- Responded to inquiries by answering questions, providing information and directing customers to appropriate resources.
- Performed administrative duties by verifying documentation, researching facts and contacting other parties involved to determine fault percentages and minimize potential losses.
- Conducted full claim investigations and reported updates and legal actions.
- Provided advice to customers regarding claims, rights and insurance processes to prevent disputes.
- Escalated files with significant indemnity exposure to supervisor for further investigation.
- Negotiated with other involved parties to arrange settlements for maximum results.
- Generated, posted and attached information to claim files.
- Checked documentation for accuracy and validity on updated systems.
- Carried out administrative tasks by communicating with clients, distributing mail, and scanning documents.
Bodily Injury Claims Specialist
State Farm Insurance
- Reviewed insurance and claims documents to verify required information and secure any missing data for settlements.
- Followed up with customers on unresolved issues.
- Understood requirements for disputes, gathered evidence to support claims and prepared customer cases to handle appeals.
- Monitored compliance with regulations and industry best practices to promote fair and proper treatment for insured customers.
- Responded to inquiries by answering questions, providing information and directing customers to appropriate resources.
- Performed administrative duties by verifying documentation, researching facts and contacting other parties involved to determine fault percentages and minimize potential losses.
- Conducted full claim investigations and reported updates and legal actions.
- Provided advice to customers regarding claims, rights and insurance processes to prevent disputes.
- Escalated files with significant indemnity exposure to supervisor for further investigation.
- Negotiated with other involved parties to arrange settlements for maximum results.
- Reviewed new files to determine current status of injury claim and to develop plan of action.
- Conducted risk evaluations on claims settlement proposals to encourage sound decision-making regarding settlement offers.
- Collaborated with legal counsel to make organizational claims decisions aligning with governing laws.
- Generated, posted and attached information to claim files.
- Checked documentation for accuracy and validity on updated systems.
- Carried out administrative tasks by communicating with clients, distributing mail, and scanning documents.
- Maintained confidentiality of patient finances, records, and health statuses.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Verified client information by analyzing existing evidence on file.
- Posted payments to accounts and maintained records.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
Education
High School Diploma -
Normandy Senior High School
Parma, OhioNo Degree - Arts/Business
Ohio University
Athens, OHSkills
- Proficient in ECS and Claims X
- Accident Investigations
- Settlement Determinations
- Coverage Assessments
- Compliance Management
- Claims
- Estimate Preparation
- Documentation Review
- Claim Amount Calculations
- Client Interviews
- Insurance Claim Forms Review
- Teamwork and Collaboration
- Customer Service
- Attention to Detail
- Claims Processing
- Policy Review
- Claims Adjustment
- Coverage Determination
- Policy and Procedure Explanations
- Payment and Investigation Escalations
Certification
- CPCU
- Associate in Claims Management
- Associate in General Insurance
- Associate in Personal Insurance
- Adjusters Licensed in TX & all states that required licenses.
Timeline
WCCS Deployed Catastrophe Claim Specialist
State Farm Insurance
06.2018 - 11.2023
Bodily Injury Trainer
State Farm Insurance
Express Team Lead
State Farm Insurance
Auto Claim Central - Claims Specialist
State Farm Insurance
Bodily Injury Claims Specialist
State Farm Insurance
High School Diploma -
Normandy Senior High School
No Degree - Arts/Business
Ohio University
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