Michael W. Sims
Dallas
Summary
Business professional with over 10 years of experience in auto insurance claims management. Specializes in efficiently reviewing and processing claims while ensuring customer satisfaction through effective communication and problem resolution.
Overview
8
8
years of professional experience
Work History
Claims Associate
State Farm
Richardson
01.2024 - Current
- Reviewed 40-50 claims across multiple jurisdictions to ensure accuracy and compliance using ECS tool.
- Verify coverage under policy.
- Initiated first contact with named insureds completing QFC template guiding through the claims process.
- Reviewed body shops estimates and supplements issuing payments via draft or EFT to name insured, rental vendors, body shop.
- Managed claims from intake through resolution, ensuring timely and accurate completion.
Claims Associate
State Farm
Richardson
01.2022 - 01.2024
- Reviewed and processed auto insurance claims
- Verified coverage and determined liability
- Managed estimates, supplements, and payment processing
- Handled arbitration and subrogation tasks
- Communicated with insureds, claimants, and vendors to resolve claims efficiently
Customer Service Representative
Adecco Staffing
Dallas
01.2018 - 01.2021
- Assisted customers with mail-order prescription inquiries to facilitate timely access to medications
- Supported customers with inquiries about insurance benefits to clarify coverage and resolve issues
- Reviewed medical claims for accuracy in ICD/CPT coding to ensure proper reimbursement
- Corrected and submitted claims to Medicare and Medicaid for payment
- Adapted to multiple assignments, demonstrating flexibility and strong work ethic
Education
Bachelor of Science -
University of Phoenix
Dallas, TX09-2028
Associate of Arts -
University of Phoenix
Dallas, TX08-2026
Skills
- Auto Insurance Claims Management
- Liability Assessment
- Claims analysis
- Quality assurance
- Customer Service
- Customer Retention
- Complaint Handling
- Satisfaction enhancement
- CRM management
- CRM Software Proficiency
- Data Entry and Documentation
- Call Center Operations
- Multichannel support
- Active Listening
- Problem Resolution
- Verbal Communication
- Written Communication
- Phone etiquette
- Interdepartmental Coordination
- Issue Identification
- Prioritization
- Time Management
- Multitasking
- Change adaptability
- Team Collaboration
- Stress Management
- Interpersonal Skills
- Empathy and Professionalism
- Building Customer Trust
- Meeting Performance Metrics
- Persuasive speaking
- Conflict resolution
- Persuasive speaking
- Conflict resolution
Timeline
Claims Associate
State Farm
01.2024 - Current
Claims Associate
State Farm
01.2022 - 01.2024
Customer Service Representative
Adecco Staffing
01.2018 - 01.2021
Bachelor of Science -
University of Phoenix
Associate of Arts -
University of Phoenix