Laterica Clethen
Chattanooga,TN
Summary
Dynamic insurance professional with over 10 years in claims and policy management. Focused on enhancing patient satisfaction through effective communication and streamlined processes. Recognized for building strong client relationships and improving service efficiency.
Overview
14
14
years of professional experience
Work History
Patient Resolution Expert
IKS Health (Inventurus Knowledge Solutions)
Coppell, Texas
12.2024 - Current
- Resolved complex patient inquiries using effective communication strategies to enhance patient satisfaction.
- Collaborated with cross-functional teams to streamline service delivery processes, resulting in improved patient experiences.
- Developed and updated documentation for best practices in conflict resolution to ensure consistent handling of patient issues.
- Provided training and support on patient resolution protocols to staff.
Customer Service Supervisor
Burlington
College Park, GA
07.2022 - 11.2024
- Directed associates' activities to maintain efficiency and productivity within the team, ensuring adherence to departmental processes and procedures.
- Developed employee training programs to clarify roles and improve team efficiency.
- Resolve customer and employee concerns with clarity and empathy.
- Recognized for maximizing sales through effective training, development, and coaching of direct reports.
- Collaborate with internal partners to stay updated on safety guidelines.
- Promote workplace safety by communicating safety information to associates and customers.
- Facilitated adherence to employee time schedules, enhancing punctuality and accountability. and attendance adherence.
- Fostered positive workplace environment by promoting open-door policy for communication.
Customer Service Advocate II
Farmers Insurance Group
Dallas, TX
04.2022 - 03.2023
- Acted as the primary contact for policyholders, potential clients, and internal business partners.
- Collaborated with auto agents to quickly resolve billing issues, improving customer satisfaction.
- Delivered accurate information to customers across various communication channels, ensuring clarity and understanding.
- Enhanced customer experience by implementing feedback mechanisms, contributing to increased client retention.
- Utilized multiple databases to manage customer accounts and policies.
- Evaluated insurance risks and provided underwriting services.
Senior Liability Claims Adjuster
The BestIRS
Dallas, TX
10.2018 - 12.2022
- Conducted detailed coverage and liability investigations, analyzing recorded statements, police reports, scene investigations, and policy contracts to ensure accurate claim assessments.
- Negotiated liability with other carriers and referred files to subrogation for collection.
- Managed and closed an average of 80 to 100 claims monthly through strong organizational and multitasking skills.
- Coordinated with insureds, claimants, and service providers to facilitate timely claim resolutions, enhancing overall customer experience.
- Investigated and resolved property claims as a licensed adjuster for TX, OK, NM, and WY.
- Detected and addressed suspicious and fraudulent claims.
- Partnered with management and the Special Investigation Unit to determine claim legitimacy.
Claims Subrogation Adjuster
Allstate Insurance
Irving, TX
04.2020 - 04.2021
- Negotiated settlements with insurance carriers, contractors, and legal representatives to resolve claims effectively.
- Recovered third-party property-casualty claims while maintaining accuracy in a fast-paced environment.
- Managed and finalized high volume of claims, ensuring timely resolution and compliance with industry standards.
- Managed claims with expertise and collected outstanding funds.
- Conducted detailed coverage and liability investigations using multiple resources.
Claims Customer Service Representative
GEICO
Richardson, TX
07.2012 - 10.2018
- Managed multi-state auto and property claims as a licensed adjuster.
- Provided timely status updates and resolutions to customers.
- Determined liability and closed a substantial number of claims.
- Collaborated with external vendors to effectively resolve client claims issues.
- Conducted research using multiple internal and external resources to obtain claims history and coverage information.
- Proposed and implemented process improvements that enhanced accuracy and optimized time management.
- Facilitated bi-weekly team meetings to provide consistent, up-to-date information.
- Assisted team members proactively with a welcoming attitude.
Education
Associate in Business Administration Management -
Tarrant County College
Arlington, TX08-2023
Skills
- Patient support
- Claims Processing
- Claims assessment
- Insurance
- Conflict resolution
- Customer relationship management
- Process improvement
- Cross-functional collaboration
- Customer Service
- Documentation management
- Data Entry
- Data entry accuracy
- Time management
- Training design
- Team leadership
- Performance coaching
- Negotiation strategy
- Creative solutions
- Service level agreements
- Client retention
- Retention strategies
- Calm under pressure
- De-escalation techniques
- Administrative and office support
- Contact Center
- Microsoft Office
- MS Teams/Zoom/Slack
- Microsoft exchange
- Medical terminology
- Order documentation
- Cross-border claims
- Data analysis
- Service enhancement
- Assertiveness
- Microsoft exchange
- Cross-border claims
- Service enhancement
Personal Information
Claim Adjuster certification
Property and causality Certification
Epic certification
Nexgen certification
Timeline
Patient Resolution Expert
IKS Health (Inventurus Knowledge Solutions)
12.2024 - Current
Customer Service Supervisor
Burlington
07.2022 - 11.2024
Customer Service Advocate II
Farmers Insurance Group
04.2022 - 03.2023
Claims Subrogation Adjuster
Allstate Insurance
04.2020 - 04.2021
Senior Liability Claims Adjuster
The BestIRS
10.2018 - 12.2022
Claims Customer Service Representative
GEICO
07.2012 - 10.2018
Associate in Business Administration Management -
Tarrant County College