Miriam Jean-Charles
Orlando,FL
Summary
Detail-oriented professional with a strong understanding of auto damage assessment, seeking an Auto Claims Adjuster role to leverage analytical skills in investigating claims, accurately evaluating vehicle damage, and delivering fair settlements to policyholders. Committed to maintaining compliance with insurance guidelines, aiming to provide efficient and effective resolution for all parties involved.
Overview
7
7
years of professional experience
Work History
LICENSE AND CONTRACTING ANALYST
The Hartford
05.2024 - Current
- Provided guidance on interpreting complex rules and regulations governing licenses or certifications
- Kept informed regarding pending industry changes, trends, and best practices
- Verified documentation, implementation and communication of firm and regulatory policies and procedures
- Ensured that all required documentation was accurately prepared before submitting it for approval by regulatory agencies
- Ensured that all employees were aware of their responsibilities regarding corporate compliance matters
- Coordinated and managed license renewal processes for clients, ensuring compliance with applicable regulations
- Advised clients on best practices regarding the maintenance of their licenses and certifications
- Evaluated potential risks associated with noncompliance with local or federal regulations pertaining to licensure or certification
- Facilitated communication between internal teams and external stakeholders involved in the process of obtaining a license or certification
- Conducted audits of client records to verify accuracy of information provided in applications for licensure or certification
- Created detailed reports summarizing findings from research into new state and federal laws affecting licensing requirements
OPERATION SUPPORT SPECIALIST
The Hartford
07.2022 - 05.2024
- Analyzed trends in claim losses to identify areas where additional training or process improvements were needed
- Collaborated with various departments including Core Claims and Finance to resolve complex claim issues
- Communicated effectively with both internal staff members and external customers via phone, email, mail or other methods
- Provided guidance on proper protocol for handling sensitive customer information during the claims process
- Provided timely feedback on claim performance metrics for management review and evaluation
- Corresponded with insured and agent to obtain information and to inform them of account status and changes
- Composed business correspondence for supervisors, managers and professionals
- Identifies daily/weekly capacity requirements based on workload
MEMBER SERVICES - CARE GUIDE
Oscar Health
10.2021 - 05.2022
- Prepared reports for management related to customer service performance metrics
- Filed appeals on denied claims when necessary using existing appeal processes
- Adhered to departmental guidelines ensuring compliance with applicable state and federal regulations
- Educated members on their rights under their health care plans as well as any applicable state or federal laws governing those plans
- Conducted research to provide accurate information on plan options, benefits, eligibility requirements, and claim status updates
- Utilized various computer systems for data entry and retrieval of health insurance records
CUSTOMER CARE ASSOCIATE
Travelers
05.2021 - 10.2021
- Collaborated closely with other departments to ensure customer satisfaction
- Utilized problem-solving skills to resolve customer inquiries quickly and efficiently
- Resolved escalated issues from customers that were beyond standard protocols or procedures
- Ensured compliance with company policies and legal regulations related to customer care activities
- Identified opportunities for process optimization within the department
- Developed product knowledge to provide detailed information about products and services offered
ACCOUNT MANAGER - ORLANDO HEALTH
Enablecomp
07.2019 - 02.2021
- Resolved complex customer issues in a timely manner while maintaining positive relationships with clients
- Managed a portfolio of accounts by providing timely support and guidance
- Collaborated with cross-functional teams such as marketing, sales, operations and finance to meet customer needs
- Analyzed sales data to identify trends, opportunities and risks
- Updated client information, contract changes and product prices in company databases
- Assisted in the development of policies, procedures and guidelines related to liaison coordination activities
- Facilitated effective collaboration between departments and stakeholders to meet organizational objectives
STUDENT CONCIERGE
Kaplan Test Prep
07.2017 - 11.2019
- Resolved escalated customer complaints promptly and professionally
- Trained and mentored team members on best practices in customer service skills
- Identified areas of process improvement within the call center environment
- Managed difficult situations calmly and effectively while maintaining a positive attitude towards customers
- Proficiently handled high call volumes while maintaining quality service standards
Education
BACHELOR OF SCIENCE (B.S.) - CYBER SECURITY AND INFORMATION ASSURANCE CANDIDATE
Western Governors University
11.2025
Skills
- Documentation And Reporting
- MS Excel
- Analytical Thinking
- Excel proficiency
- Legal Research
- License Management
- Intellectual property
- Teamwork and Collaboration
- Policy analysis
- Adaptability and Flexibility
- Time management abilities
- Effective Communication
- Professionalism
- Human Resources Support
- Employee Relations
- Insurance regulations knowledge
- Claims investigations
- Claims process explanation
- Insurance policy knowledge
- Problem-solving abilities
- Decision-making skills
References
References available upon request
Timeline
LICENSE AND CONTRACTING ANALYST
The Hartford
05.2024 - Current
OPERATION SUPPORT SPECIALIST
The Hartford
07.2022 - 05.2024
MEMBER SERVICES - CARE GUIDE
Oscar Health
10.2021 - 05.2022
CUSTOMER CARE ASSOCIATE
Travelers
05.2021 - 10.2021
ACCOUNT MANAGER - ORLANDO HEALTH
Enablecomp
07.2019 - 02.2021
STUDENT CONCIERGE
Kaplan Test Prep
07.2017 - 11.2019
BACHELOR OF SCIENCE (B.S.) - CYBER SECURITY AND INFORMATION ASSURANCE CANDIDATE
Western Governors University
Similar Profiles
Latisha A. CuylerLatisha A. Cuyler
Claims Relationship Specialist III at The HartfordClaims Relationship Specialist III at The Hartford
John HowlandJohn Howland
Customer Service Representative/Personal Lines at The HartfordCustomer Service Representative/Personal Lines at The Hartford
Megan StephensonMegan Stephenson
Group Benefits Recovery Team Lead at The HartfordGroup Benefits Recovery Team Lead at The Hartford
Angela RuffinAngela Ruffin
Disability Analyst at The HartfordDisability Analyst at The Hartford
Santiago BustamanteSantiago Bustamante
Safety Officer at Funtastic DepoSafety Officer at Funtastic Depo