Michelle Paul
Graceville
Summary
Experienced with managing claims processes and leading teams to ensure efficient and accurate handling. Utilizes strong analytical skills and attention to detail to identify issues and implement effective solutions. Track record of fostering teamwork and maintaining high standards in claims management.
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.
Demonstrates strong analytical, communication, and teamwork skills, with proven ability to quickly adapt to new environments. Eager to contribute to team success and further develop professional skills. Brings positive attitude and commitment to continuous learning and growth.
Overview
8
8
years of professional experience
1
1
Certification
Work History
Claims Supervisor
Integrity Adjusters, LLC
10.2018 - Current
- Assisted in the recruitment and selection of new claims adjusters, ensuring they possessed the necessary skills and expertise to excel in their roles.
- Monitored performance metrics regularly, identifying areas for improvement and implementing corrective measures accordingly.
- 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.
- Maintained up-to-date knowledge on industry trends, best practices, and regulatory changes to ensure optimal decision-making in the claims management process.
- Enhanced team productivity by providing ongoing training and mentorship to claims adjusters.
- Increased accuracy in claim evaluations through comprehensive documentation and attention to detail.
- 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.
- Developed strong relationships with external partners such as public adjusters, attorneys, and field adjusters to facilitate effective information exchange during claim investigations.
- Ensured timely resolution of escalated claims.
- Monitored team performance, enforcing compliance with corporate claims processes and procedures.
- Achieved high customer satisfaction ratings by maintaining open lines of communication and addressing concerns promptly.
- Oversaw the negotiation process between policyholders and insurance carriers, achieving equitable settlements on behalf of clients.
- Conducted regular audits of claim files, ensuring compliance with company policies and industry regulations.
- Resolved complex claims issues with thorough investigation, resulting in fair settlements for all parties involved.
- Coordinated resources efficiently during high-volume periods, ensuring seamless operations without compromising service levels.
- Optimized case management with establishment of best practices.
- Negotiated disputed bills or invoices, achieving successful resolution.
- Determined proper course of action for claims processing.
- Documented and communicated timely claims information while supporting accurate outcomes.
- Championed insurance claims process by providing expert knowledge and building positive, trusting relationship to support clients during challenging times.
- Handled claims consistent with client and corporate policies, procedures, best practices and regulations.
- Complied with established internal controls and policies.
- Claim settlement reviews from my team, payment issuance and authority, review of coverage determination letters, and oversight of vendor issues to bring the claims to a resolve.
Commercial Claims Desk Adjuster
Siebels
08.2017 - 09.2018
- Used prescribed guidelines or policies in analyzing situations.
- Reduced errors in claims handling by conducting thorough investigations and consistently verifying information accuracy.
- Improved claim processing efficiency by streamlining workflows and implementing time-saving strategies.
- Streamlined communication channels between internal teams for improved coordination during major loss events or catastrophe situations, minimizing response delays.
- Performed extensive research into policy coverage details for accurate application within each unique case scenario.
- Effectively managed claim expenses by accurately estimating repair costs and utilizing cost-effective solutions when possible.
- Investigated origin and cause of claims by contacting appropriate parties.
- Acted as a mentor to new team members by providing guidance and support, contributing to overall office morale and cohesion.
- Increased client retention rates through empathetic communication and swift resolution of concerns during the adjustment process.
- Developed strong relationships with policyholders by providing exceptional customer service throughout the claims process.
- Balanced competing priorities in a fast-paced environment, ensuring timely completion of all assigned tasks without compromising quality or attention to detail.
- Consistently met or exceeded performance metrics, demonstrating a strong commitment to excellence in desk adjusting work.
- Maintained compliance with industry regulations while ensuring accurate documentation of all claim files.
- Responded to customer inquiries, made appropriate decisions and closed files.
- Managed high-volume caseloads to ensure rapid resolution for clients and maintained customer satisfaction levels.
- Expedited claim settlements with skilled negotiation tactics that led to fair resolutions for all parties involved.
- Evaluated damages and handled claim negotiations with insureds, claimants, attorneys and public adjusters.
- Examined claims forms and other records to determine insurance coverage.
- Answered customer questions regarding deductibles.
- Verified insurance claims and determined fair amount for settlement.
- Prepared summaries of damage, payments, and policy coverage.
- Negotiated with policyholders and claimants to reach mutually satisfactory resolutions.
- Delivered exceptional customer service to policyholders by communicating important information and patiently listening to issues.
- Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
- Read over insurance policies to ascertain levels of coverage and determine whether claims would receive approvals or denials.
- Conducted day-to-day administrative tasks to maintain information files and process paperwork.
- Researched claims and incident information to deliver solutions and resolve problems.
- Analyzed information gathered by investigation and reported findings and recommendations.
- Investigated and assessed damage to property and reviewed property damage estimates.
- Documented information gathered in field and uploaded data to company database for efficient processing.
- Clarified coverage of losses to policyholders and provided assistance in itemizing damages and finding alternative living arrangements.
- Negotiated commercial claim settlement agreements to resolve disputes.
- Assisted homeowners by coordinating vendor services, emergency repair, cleaning and contractors.
Education
Associates Degree in Business - Business
University of Phoenix
Tempe, AZSkills
- Claims management expertise
- Policy interpretation
- Claims auditing
- Planning and organization
- Team motivation
- Claims analysis
- Claims processing
- Team management
- MS office suite
- Investigation techniques
- Performance monitoring
- Customer expectations management
- Claims investigation and research
- Insurance policy review
- Insurance regulations
- Willing to learn
- Teamwork
- Teamwork and collaboration
- Customer service
- Problem-solving
- Time management
- Attention to detail
- Problem-solving abilities
- Multitasking
- Multitasking Abilities
- Reliability
- Excellent communication
- Critical thinking
- Organizational skills
- Team collaboration
- Active listening
- Effective communication
- Adaptability and flexibility
- Decision-making
- Team building leadership
- Relationship building
- Relationship building and management
- Prioritizing and planning
- Customer relationship development
- Proactive and focused
- Team building
- Task prioritization
- Self motivation
- Client relationship management
- Interpersonal skills
- Analytical thinking
- Conflict resolution
- Recruitment and hiring
- Know your customer
- Professionalism
- Staff management
- Staff training
- Time management abilities
- Continuous improvement
- Adaptability
- Written communication
- Work planning
- Workflow coordination
- Professional demeanor
- Problem-solving aptitude
- Performance management
- Fraud prevention
Certification
- Licensed Adjuster in multiple states
Timeline
Claims Supervisor
Integrity Adjusters, LLC
10.2018 - Current
Commercial Claims Desk Adjuster
Siebels
08.2017 - 09.2018
Associates Degree in Business - Business
University of Phoenix
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