Lindsey Hertel
Louisville,KY
Summary
Results-driven Claims Resolution Specialist recognized for productivity and efficiency in task completion. Specialize in claim analysis, negotiation strategies, and regulatory compliance to navigate complex claims environments. Excel in problem-solving, communication, and decision-making, ensuring optimal outcomes in high-stakes situations. Bring focused approach to managing caseloads and achieving resolution goals.
Overview
8
8
years of professional experience
Work History
Sr. Field Claims Resolution Specialist I
LIBERTY MUTUAL INSURANCE COMPANY
Louisville, KY
07.2017 - Current
- Detailed coverage, liability and reasons for denial of claims to policyholders, attorneys, and third-party providers.
- Assessed potential fraud cases by conducting investigations into suspicious activity.
- Investigated and resolved customer inquiries related to the status of their claims.
- Investigated potentially fraudulent claims with focus on thoroughness, quality, and cost control.
- Input claim information and payments into company database.
- Reviewed policies to determine appropriate levels of coverage and assist with approval or denial decisions.
- Organized estimation, repair, and rental services to support claims processing and policyholder needs.
- Supported efficient handling of complex claims and followed up on open, denied, or suspended claims to complete required line items.
- Delivered exceptional customer service to clients by communicating information and actively listening to concerns.
- Reviewed, evaluated and processed incoming claims to determine eligibility for coverage based on policy provisions.
- Coordinated emergency repair, cleaning companies and contractors to optimize customer claim handling.
- Researched claims in order to evaluate correct coverage and liability.
- Ensured compliance with applicable laws, regulations, policies and procedures when processing claims.
- Maintained accurate records of all communications with customers regarding their claims.
- Traveled to customer sites to evaluate fallen trees, leaking roofs and other issues to create accurate cost estimations.
- Initiated contact with customers by phone or mail concerning claim status updates.
- Explained loss coverage, assisted policyholders with itemizing damages and coordinated alternative living arrangements.
- Adhered to established workflow processes and timelines in order to meet performance goals.
- Prepared detailed reports summarizing all activities pertaining to each claim.
- Gathered and reviewed rejected claim information in order to develop successful resolutions.
- Investigated properties, classified damages and created estimates outlining repair costs.
- Processed payments promptly upon approval of a valid claim.
- Collaborated with other departments to obtain additional information needed for claim resolution.
- Reduced loss ratios through fair and prompt processing of claims.
- Assisted with customer requests and answered questions to improve satisfaction.
- Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
- Managed time effectively to ensure tasks were completed on schedule and deadlines were met.
- Identified needs of customers promptly and efficiently.
- Demonstrated strong problem-solving skills, resolving issues efficiently and effectively.
- Utilized various software and tools to streamline processes and optimize performance.
- Am currently enrolled in the Large Loss Mentorship Program.
Education
Bachelor of Arts - Accounting
Indiana Wesleyan University
Marion, IN05-2012
Skills
- Claims processing
- Fraud investigation
- Policy evaluation
- Customer communication
- Data entry
- Cost estimation
- Customer service
- Time management
- Conflict resolution
- Analytical thinking
- Professionalism
- Time management abilities
- Settlement negotiation
- Problem-solving
- Onsite evaluation
- Claims investigation
- Property inspection
- Active listening
- Coverage determination
- Claims evaluation
- Determine coverage
- Policy investigations
- Claims adjustment
Affiliations
- I have volunteered with Habitat for Humanity
Timeline
Sr. Field Claims Resolution Specialist I
LIBERTY MUTUAL INSURANCE COMPANY
07.2017 - Current
Bachelor of Arts - Accounting
Indiana Wesleyan University