Summary
Overview
Work History
Education
Skills
Timeline
Generic

Kimberley Duncan

Anaheim,CA

Summary

Experienced in processing claims in high-volume environments. Successful at managing complete claims process with minimal direction. . Highly-motivated employee with desire to take on new challenges. Strong work ethic, adaptability, and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills.

Overview

10
10
years of professional experience

Work History

Claims Service Representative

Auto Club of Southern California
Anaheim, CA
12.2021 - Current

Investigate claims and obtain relevant facts to determine coverage, loss and liability.

Interact effectively with customers, insurance agents, police, attorney and other public personnel involved in claim process.

Assist Supervisor in analyzing, planning, decision-making and problem-solving activities to support claim settlement.

Oversee legal and medical aspects of claims.

Document claim file activities in accurate and timely manner.

Resolve claim issues promptly and follow-up on outstanding issues.

Perform negotiation with insured and claimant to achieve claim settlements.

Communicate claim status to supervisor and customers on regular basis.

Contact outside agents for claim investigation if needed.

Recommend claim and expense reserves

Obtain state licenses as required.

Work in compliance with state regulations and applicable jurisdictions.

Perform claim assignments received from Supervisor in timely and accurate manner.

Work under the guidance and assistance of Supervisor to ensure accurate claim settlement.

Manage claim settlements within authority limits.

Attend educational workshops on claim filings.

  • Reviewed legal documents related to claims processing as needed.
  • Researched policy provisions to determine appropriate coverage.
  • Participated in training sessions to stay up-to-date with industry standards.
  • Assisted with training new staff members on proper procedures for claim processing.
  • Provided guidance and assistance to junior colleagues when necessary.
  • Monitored progress of outstanding claims to ensure timely resolution.
  • Delivered quality customer service to assigned, insured and claimants throughout entire claims lifecycle to promote service times.

Branch Operations Specialist

AAA- Auto Club of Southern California
Fullerton , CA
12.2014 - 11.2016
  • Process DMV registrations, distribute member publications and provide other services for members
  • Identify cross-sell opportunities based on members' product needs and service requests
  • Process membership payments and upgrade memberships, order membership cards and other products
  • Provide support to reception, maintain and update member information in POS system, identify new or potential members and inform them of club benefits
  • Order supplies and receive shipments, send and distribute mail and maintain inventory for the branch
  • Provide administrative support to Travel Agency.
  • Provided training for new employees on operational processes, systems, products, services, banking regulations and customer service standards.
  • Developed and maintained relationships with customers, responding to inquiries and resolving complaints in a timely manner.
  • Facilitated interdepartmental communications between branches and corporate headquarters.
  • Participated in meetings with senior management team members regarding strategic planning initiatives.
  • Planned and implemented branch operations procedures to ensure compliance with established policies and regulations.
  • Created documents such as memos, letters or emails for internal use within the organization.

Travel Agent

AAA- Auto Club of Southern California
01.2016 - 06.2016
  • Learned and developed skills to sell foreign and domestic travel and related products and services
  • Effectively utilizes all lead management tools and resources to cultivate new business while building a solid base of repeat business
  • Advise clients on all foreign and domestic travel requirements, travel insurance protection plans, and any related trip advisory information
  • Learn and follow all policies and procedures set forth by the organization to ensure accurate documentation of all transactions
  • Developed product knowledge to support the organization's Preferred Supplier Program, and achieve Club established sales, and cross-sell goals
  • Issue international driving permits and passport photos
  • Gain knowledge and skill to provide air, car, hotel, rail reservations and ticketing for members and non-members
  • Utilize appropriate computer systems such as Galileo, Apollo, Scripts to fulfill travel requests
  • Track and maintain all transactions for the highest level of accuracy, including required supporting documentation to include but not limited to signature requirements, accuracy in processing payment, review of documents required for travel, maintain confidentiality of all client information by securing it in accordance with Federal/State laws and club policies and procedures
  • Develop and maintain expertise regarding all club related products and services member value offers and remain current with industry trends and product knowledge to make recommendations with each transaction as appropriate
  • Research and compare suppliers' rates for competitive prices and make adjustments based on client's need
  • Identify cross-sell opportunities based on member's' product need and service request
  • Enhance the member relationship by diversifying use of products and services
  • Maintain all administrative requirements at acceptable levels, i.e
  • Wage and hour compliance, expense reports, meetings and training attendance, adhere to schedule duties and activities.
  • Provided detailed information about destinations such as climate conditions or points of interest at requested locations.
  • Maintained up-to-date knowledge of airline regulations concerning ticketing procedures and restrictions.
  • Processed payments from clients via cash or credit cards.
  • Prepared customized itineraries based on customer needs and preferences.
  • Organized flights, insurance, and accommodations for travelers according to their preferences.

Education

Bachelor's degree - Psychology with an emphasis in Behavioral Studies

California State University, Fullerton

Skills

  • Sales and customer service
  • Travel planning and reservations
  • Knowledge of travel requirements and insurance
  • Familiarity with travel management tools and systems (Galileo, Apollo, Scripts)
  • Issuing international driving permits and passports photos
  • Cross-selling and identifying opportunities for additional products and services
  • Researching and comparing supplier rates
  • Administrative tasks such as processing payments, maintaining inventory, and ordering supplies
  • Proficiency in Microsoft Excel, Word, and PowerPoint
  • Event coordination and special events planning
  • Accounts payable and receivable
  • Strong organizational and time management skills
  • Decision-Making
  • Documentation research
  • Settlement Negotiation
  • Time Management
  • Conflict Resolution
  • Coverage Determination
  • Settlement determinations
  • Interpersonal Communication
  • Stress Tolerance
  • Insurance knowledge
  • Claims Investigation
  • File Management

Timeline

Claims Service Representative

Auto Club of Southern California
12.2021 - Current

Travel Agent

AAA- Auto Club of Southern California
01.2016 - 06.2016

Branch Operations Specialist

AAA- Auto Club of Southern California
12.2014 - 11.2016

Bachelor's degree - Psychology with an emphasis in Behavioral Studies

California State University, Fullerton
Kimberley Duncan