Summary
Overview
Work History
Education
Skills
Work Availability
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Hi, I’m

LATISA GILES

Frisco,TX
LATISA GILES

Summary

Professional in claims management, prepared to lead and enhance claims operations. Strong focus on team collaboration and achieving impactful results. Skilled in analyzing claims, resolving discrepancies, and ensuring compliance with regulations. Reliable and adaptable, consistently meeting evolving needs and challenges. Effective communicator with keen eye for process improvement and proactive approach to problem-solving.

Organized and detail orientated with great time management skills and Remarkable Customer Service.

Overview

11
years of professional experience

Work History

The Best Claims Solutions

Claims Supervisor
07.2024 - 11.2024

Job overview

  • Monitored performance metrics regularly, identifying areas for improvement and implementing corrective measures accordingly.
  • Assisted in the recruitment and selection of new claims adjusters, ensuring they possessed the necessary skills and expertise to excel in their roles.
  • Fostered a positive work environment that promoted collaboration, teamwork, and open communication among staff members.
  • Managed a diverse caseload, prioritizing tasks effectively to meet strict deadlines and maintain quality standards.
  • Enhanced team productivity by providing ongoing training and mentorship to claims adjusters.
  • Contributed to the development and implementation of departmental goals and objectives, aligning them with broader organizational strategies.
  • Optimized resources allocation by monitoring workload distribution among team members, leading to increased efficiency within the department.
  • Achieved high customer satisfaction ratings by maintaining open lines of communication and addressing concerns promptly.
  • Monitored team performance, enforcing compliance with corporate claims processes and procedures.
  • Conducted regular audits of claim files, ensuring compliance with company policies and industry regulations.
  • Coordinated resources efficiently during high-volume periods, ensuring seamless operations without compromising service levels.
  • Spearheaded internal process reviews aimed at enhancing overall productivity through continuous improvement efforts.
  • Reviewed historical records, current operational data and forecasting information to identify and capitalize on system enhancement opportunities.
  • Established internal audit procedures to validate and improve accuracy of financial reporting.
  • Established and checked coding procedures, monitored reports and updated internal files.
  • Improved overall financial reporting by streamlining control processes and reporting structures.
  • Built talented teams of 10 claims administrators dedicated to timely and compliant resolutions.
  • Negotiated disputed bills or invoices totaling up to $ 5500, achieving successful resolution.

Progressive

Auto Damage Adjuster
01.2024 - 07.2024

Job overview

  • Proactively communicated with clients throughout the claim process, setting clear expectations and delivering updates as needed.
  • Contributed to the continuous improvement of internal processes by identifying areas for optimization and implementing change initiatives.
  • Negotiated fair settlements with claimants, balancing their needs with company interests.
  • Improved customer satisfaction by efficiently addressing and resolving auto damage claims.
  • Consistently met or exceeded performance targets related to claim cycle time, accuracy, and customer satisfaction scores.
  • Conducted comprehensive vehicle inspections to accurately assess damage and determine repair costs.
  • Maintained positive relationships with policyholders, providing exceptional customer service throughout the claims process.
  • Reduced fraudulent claims through thorough investigations and detailed documentation.
  • Increased efficiency in claims handling through effective use of technology tools and systems.
  • Updated client records diligently, ensuring accurate information for future reference and communication.
  • Demonstrated versatility in adapting approach based on individual claim complexity or unique circumstances that may arise during handling.
  • Leveraged strong negotiation skills when working with external partners such as body shops or salvage vendors.
  • Examined photographs and surveillance and any other documents relating to claims.
  • Reviewed police reports, photographs and other documentation to gain complete understanding of accident.
  • Successfully negotiated settlements with claimants and insurers.
  • Identified suspicious claims, escalating issues to supervisor for further investigation and analysis.
  • Evaluated and investigated over 7 auto claims per day and decided whether insurer should pay claim.

AllState

Property Adjuster - Inside Catastrophe
01.2023 - 07.2023

Job overview

  • Carefully reviewed claim information to verify accuracy and avert fraudulent claims.
  • Increased accuracy of damage estimates by utilizing advanced software programs for appraisal calculations.
  • Provided exceptional customer service while navigating sensitive situations involving property loss or destruction due to natural disasters or accidents.
  • Reduced costs for the company by accurately estimating repair and replacement expenses.
  • Used Xactimate to compile estimates for personal property and structure damage.
  • Developed effective techniques to mitigate losses.
  • Prepared sketch of floor plan and roofline and entered data into Xactimate to develop line-by-line item costs of damages.
  • Developed and maintained working relationships with independent adjusters and contractors to assist in prompt claims handling.
  • Conducted day-to-day administrative tasks to maintain information files and process paperwork.
  • Investigated claims by reviewing policy contracts to determine claim coverage based on cause and facts of loss.

The Best Claims Solution

Auto Catastrophe Claims Adjuster for Progressive
07.2019 - 11.2023

Job overview

  • Contact and communicate process with insured timely
  • Review claims for coverage
  • Set inspections for repairs and help insured through the process
  • Handle total loss, go over settlement offers with insured, contact lienholder, provide the correct documents
  • Negotiate with shops, vendors to ensure insured is taken care of
  • Negotiate with repair service providers, customers, and salvage vendors
  • Document each call appropriately and assist with moving claims forward
  • Monitor claims for changes until completely closed
  • Issue payments to appropriate party
  • Send correct documents, notices and letters
  • Directed claims negotiations within allowable limit of $15000 and supported successful litigations for advanced issues.

York Risk Services Group

Claims Adjuster II – Commercial Policies
08.2018 - 11.2019

Job overview

  • Knowledgeable of procedures and Jurisdictional for all 50 states
  • Complete coverage analysis
  • Investigate all parties to conclude liability decision
  • Settle BI claims under $5000
  • Prepare correspondences for coverages, settlements, denials and provide proper file documentation
  • Negotiate with attorneys to reach a reasonable settlement
  • Review Subrogation request and issue payment
  • Close files efficiently to maintain a low pending

State Farm Insurance

Auto Claims Associate
03.2017 - 08.2018

Job overview

  • Knowledgeable of procedures and Jurisdictional for all 50 states
  • Evaluate all claims and policy information to ensure applicable coverage
  • Set up correct inspection option
  • Gather detailed facts from all parties and make liability decisions
  • Prepare correspondences for coverages, settlements, denials and provide proper file documentation
  • Working as a team to ensure effective resolutions to handle claims efficiently and effectively

Department of Public Safety

Paralegal -temp
10.2016 - 12.2016

Job overview

  • Complete Monthly Calendars
  • Review Police Reports
  • Prepare cases for court dates
  • File case loads
  • Correspond with Judges Secretary, Attorneys, Witnesses, and State Patrol officers to schedule and reschedule Court dates, send subpoena notifications
  • Document all Dispositions
  • Maintain Excel spread sheets for monthly reports

Doubletree by Hilton Hotel

Front Desk Agent
03.2015 - 10.2016

Job overview

  • Knowledgeable of the Hilton system and standards
  • Provide information about services available in the hotel and in the community
  • Verify credit cards and establish method of payment
  • Review accounts before checking out
  • Up Selling guest rooms and promoting hotel services
  • Handle all customers’ concerns

Waffle House Inc.

Tax & Unemployment Claims Clerk
01.2014 - 01.2015

Job overview

  • Answered an average of 100 calls per day and addressing customer inquiries and solving problems
  • Sorted daily mail and distributed to appropriate department
  • Data entry
  • Converted/ scanned claims and determinations
  • Completed calls for Unemployment specialist, to determine reasons for terminations for claims to be sent to state for review
  • Responded to wage audits and assisted management in creating spread sheets of data weekly

Education

Grand Canyon University

BS from Behavioral Health
05-2025

University Overview

Alonzo A. Crim High School

High School Diploma
01.2007

University Overview

Skills

  • Policy interpretation
  • Claims auditing
  • Microsoft Word Excel
  • PowerPoint Outlook
  • 10-Key
  • Claims management expertise
  • Policy interpretation
  • Investigation techniques
  • Liability management
  • Time management
  • Attention to detail
  • Teamwork and collaboration
  • Critical thinking
  • Property damage assessment
  • Relationship building and management
Availability
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Quote

Don’t judge each day by the harvest you reap, but by the seeds you plant.
Robert Louis Stevenson

Timeline

Claims Supervisor
The Best Claims Solutions
07.2024 - 11.2024
Auto Damage Adjuster
Progressive
01.2024 - 07.2024
Property Adjuster - Inside Catastrophe
AllState
01.2023 - 07.2023
Auto Catastrophe Claims Adjuster for Progressive
The Best Claims Solution
07.2019 - 11.2023
Claims Adjuster II – Commercial Policies
York Risk Services Group
08.2018 - 11.2019
Auto Claims Associate
State Farm Insurance
03.2017 - 08.2018
Paralegal -temp
Department of Public Safety
10.2016 - 12.2016
Front Desk Agent
Doubletree by Hilton Hotel
03.2015 - 10.2016
Tax & Unemployment Claims Clerk
Waffle House Inc.
01.2014 - 01.2015
Alonzo A. Crim High School
High School Diploma
Grand Canyon University
BS from Behavioral Health
LATISA GILES