LaFern Reynolds
Surprise,Arizona
Summary
Professional with several years of experience conducting claim investigations to determine value and appropriate action. Focus on customer service and providing prompt and accurate claim responses.
Overview
18
18
years of professional experience
Work History
Auto Injury Adjuster - 3rd Party
USAA - P&C Auto Insurance
Phoenix, AZ
10.2022 - Current
- Completed required investigations on referred files within established timeframes.
- Investigated insurance claims to determine liability and damages.
- Assisted in fraud detection and prevention efforts by identifying suspicious claim activities.
- Analyzed policy provisions, legal documents and medical records.
- Assessed potential losses for insureds in accordance with applicable laws and regulations.
- Resolved claims for insureds by providing relevant policy details and excellent customer service.
- Resolved claim disputes through mediation and negotiation, minimizing the need for litigation.
- Established reserves for each claim based on analysis of the facts and applicable law.
- Coordinated with medical professionals to assess injury claims and determine compensation.
- Developed relationships with clients, underwriters, adjusters, brokers and other internal and external stakeholders.
- Negotiated total loss settlements by reasonably applying company estimates to benefit both client and company needs.
- Negotiated settlements with claimants, attorneys and other parties.
- Decreased loss ratios through fair and timely claim processing.
- Drafted correspondence related to claim investigations and settlements.
- Evaluated subrogation opportunities to identify recoverable funds.
- Documented date, parties involved and specific details about incidents.
- Coordinated activities between multiple departments within the company.
- Performed quality control reviews of claims files prior to closure.
- Utilized claim handling software to document and manage claim files efficiently.
- Engaged in continuous learning to stay current with industry trends and best practices in claims management.
- Advised management regarding trends in litigation costs or settlement values.
Auto Claims Representative
USAA - P&C Auto Insurance
Phoenix, AZ
05.2019 - 10.2022
- Delivered support to members, claimants, providers, and insurance agencies concerning claims
- Fostered trust among members using various communication channels
- Interpreted and processed claim-related transactions
- Performed detailed analysis of complex claims to determine appropriate course of action.
- Assess contract terms to justify approval or denial of claims
- Conducted recorded interviews for claim investigation
- Reviewed and interpreted police reports and witness statements to establish facts of claims.
- Communicated effectively with policyholders, explaining claim processes and decisions clearly.
- Examined claims, records and procedures to grant approval of coverage.
- Facilitate negotiation processes among insured individuals, claimants, and lien holders for determining settlement outcomes.
- Oversaw vehicle restoration and rental coordination
- Developed and maintained professional relationships with external partners, including tow companies and rental agencies.
- Collaborated with external partners to research and resolve discrepancies
- Ensure comprehensive record-keeping of all interactions
- Utilized claims software and databases for tracking and managing active claims.
- Achieve results through consistent performance
- Collaborated with fellow team members to manage large volume of claims.
- Participated in claims review meetings, presenting cases and justifying decisions.
Customer Service Supervisor
Cox Communications
Phoenix, AZ
06.2006 - 02.2019
- Fostered commitment to delivering friendly customer service
- Responded promptly to service associate inquiries via phone and email
- Monitored metrics and developed actionable insights to improve efficiency and performance.
- Assessed personnel performance and implemented incentives and team-building events to boost morale.
- Exceeded team goals and collaborated with staff members to implement customer service initiatives.
- Resolved account issues to build rapport and relationships with clients.
- Kept abreast of new company products and services to effectively answer questions and resolve complaints.
- Compiled and analyzed customer feedback data to develop new strategies and corrective action.
- Assisted with preparing information required for quotes and addressed potential service concerns.
- Directed process enhancements and resolution initiatives to develop standardized procedures.
- Established and updated work schedules to account for changing staff levels and expected workloads.
Education
Bachelor of Arts - Business And Managerial Economics
University of Phoenix
Tempe, AZ05-2026
Skills
- Insurance regulations
- Claims investigation
- Policy Interpretation
- Settlement management
- Natural disaster experience
- Claims file documentation and management
- Time management
- Organizational abilities
Affiliations
- Volunteer
- Tutoring
- Photography
- Swimming
Timeline
Auto Injury Adjuster - 3rd Party
USAA - P&C Auto Insurance
10.2022 - Current
Auto Claims Representative
USAA - P&C Auto Insurance
05.2019 - 10.2022
Customer Service Supervisor
Cox Communications
06.2006 - 02.2019
Bachelor of Arts - Business And Managerial Economics
University of Phoenix
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