Marchelle Hall
Tucker
Summary
Experienced insurance claims adjuster with a strong background in claims evaluation and compliance auditing. Demonstrates proficiency in negotiating settlements and managing complex customer issues through effective communication. Committed to enhancing customer satisfaction by resolving disputes and ensuring timely claim processing.
Overview
1
1
Certification
17
17
years of professional experience
Work History
Insurance Claims Adjuster
State Farm
Atlanta
06.2022 - 07.2026
- Evaluated insurance claims for accuracy and compliance with company policies.
- Reviewed and evaluated insurance claims for coverage, accuracy, completeness and compliance with company standards.
- Reviewed policy coverage to ensure proper claim processing and approvals.
- Ensured that all claims were settled promptly and equitably according to established procedures.
- Negotiated settlements with customers to resolve claims efficiently. within prescribed authority limits.
- Resolved claim disputes through mediation and negotiation, minimizing the need for litigation.
- Conduct investigations including interviews via over the phone and in person, Public Records such as courthouse research and obtaining supporting documentation upon completing of interview.
- Investigated financial institutions and credit agencies to uncover hidden assets or fraudulent activities.
- Maintained current knowledge of relevant laws, regulations and industry trends affecting claims processing operations.
- Developed strategies that facilitated resolution of difficult or contentious claims cases, enhancing overall claims handling.
- Researched complex cases and developed appropriate solutions in a timely manner.
- Managed caseload effectively, prioritizing urgent or high-value claims for prompt attention.
- Collaborated with other departments to ensure timely resolution of customer complaints.
- Communicated effectively with internal departments to ensure timely updates on pending matters related to assigned files.
- Advised customers on the status of their claim payments or denials.
- Handled customer highly escalated inquiries, complaints and billing questions.
- Ability to calm angry customers, repair trust, and locate resources for problem resolution.
- Provided clear and concise two-way communications with customers to resolve complicated and controversial issues pertaining to their cases.
- Demonstrated composure in situations that are highly argumentative or abusive from customers.
- Delivered exceptional customer service to clients by communicating information and actively listening to concerns.
- Communicated effectively with policyholders, providing updates and explaining claim processes.
- Collaborated with law enforcement and other agencies to support claims investigations.
- Worked closely with repair facilities and contractors to ensure quality repairs for policyholders.
- Maintained accurate records of all claim activities in accordance with company guidelines.
- Participated in continuing education programs related to industry best practices.
- Attended continuing education seminars and webinars related to best practices in claim handling.
- Assisted in the development of new policies and procedures related to claim adjudication.
- Managed caseload effectively, prioritizing urgent or high-value claims for prompt attention.
- Delivered exceptional customer service to clients by communicating information and actively listening to concerns.
Customer Care Team Lead/Escalation Senior Customer Care Specialist
Assurant Specialty Property
Duluth
08.2009 - 2022
- Managed daily operations to ensure effective handling of customer inquiries.
- Led customer care team to enhance service delivery and support.
- Monitored team performance and provided feedback for continuous improvement.
- Resolved escalated customer complaints promptly to enhance customer satisfaction and retention.
- De-escalated customer issues with proven conflict mediation and problem-solving abilities.
- Served as a resource to others when there is a complex problem or issue.
- Facilitated communication between departments to resolve customer issues swiftly.
- Conducted regular team meetings to share updates and address concerns.
- Coached team members on problem solving techniques when dealing with challenging customers.
- Reviewed and validated Quality Team Auditor's work audits to ensure compliance with standards.
- Ability to summarize and provide findings of audits on a daily basis to meet compliance of the Client’s expectations.
- Monitored associates' calls to ensure adherence to company requirements and improve service quality.
- Strong focus and responsiveness to client service levels and quality goals.
- Provide advanced level verbal and written communication skills.
- Ability to handle the daily pressure to deliver results in a production environment.
- Ability to recognize and make recommendations for process/procedural improvements.
- Coordinated inspections with the Internal Inspection Department for Loss Draft Claims.
- Review Insurance Adjuster report with customer for understanding of how Inspector determines if Client’s expectations of a 50% or 90% are met according to damages of each room and percentage Or repairs to be completed.
- Conference calls with Insurance Companies and or Public Adjuster and Customer to clarify if property loss date, amount and damages are accurate.
- Provide fax/address for Insurance company to resubmit information via company’s letterhead if the Contractor’s Bid is used in lieu of Adjuster Report.
- Educated customers to reduce the need for future contact.
- Resolved complex issues to enhance customer satisfaction.
- Ensured compliance with all applicable laws, regulations, and standards related to customer service operations.
- Resolved complex issues to enhance customer satisfaction.
Education
Job Related Training - Investigative Techniques
On The Job Training
06-2022
Job Related Training - Classroom Instructor Training
On The Job Training
06-2022
Job Related Training - Communication Skills
On The Job Training
06-2022
Job Related Training - Compliance Issue
On The Job Training
06-2022
Job Related Training - Oral Communication and Listening Skills, Classroom Instructor Training, Communication Skills, Compliance Issue, Investigative Techniques
On The Job Training
06-2022
High School -
Booker T. Washington High
Atlanta, GA06-1985
Skills
- Claims analysis
- Negotiation strategies
- Compliance review
- Claims processing
- Risk assessment
- Investigative analysis
- Customer relationship management
Certification
- Court Appointed Special Advocate-Clayton County
- Georgia Insurance Adjuster License
- Florida Insurance Adjuster License
Qualifications Summary
- Excellent 39 Years of Customer Service Experience.
- 20 Years of Operational Audit Experience
- Ability to manage multiple tasks effectively.
- Strong work ethic and commitment to excellence.
- Highly organized and detailed-oriented
- Strong Analytical, Listening, Problem solving and Negotiating Skills
Timeline
Insurance Claims Adjuster
State Farm
06.2022 - 07.2026
Customer Care Team Lead/Escalation Senior Customer Care Specialist
Assurant Specialty Property
08.2009 - 2022
Job Related Training - Investigative Techniques
On The Job Training
Job Related Training - Classroom Instructor Training
On The Job Training
Job Related Training - Communication Skills
On The Job Training
Job Related Training - Compliance Issue
On The Job Training
Job Related Training - Oral Communication and Listening Skills, Classroom Instructor Training, Communication Skills, Compliance Issue, Investigative Techniques
On The Job Training
High School -
Booker T. Washington High