Olivia Felix
Phoenix,AZ
Summary
Thorough team contributor with strong organizational capabilities. Experienced in handling numerous projects at once while ensuring accuracy. Effective at prioritizing tasks and meeting deadlines.
Overview
11
11
years of professional experience
Work History
Claims Specialist
State Farm
08.2013 - 07.2024
- Managed a high volume of claims effectively by prioritizing tasks and maintaining excellent organizational skills.
- Enhanced customer satisfaction with timely communication, empathy, and clear explanations of claim .
- Settled complex claims fairly by applying critical thinking, negotiation skills, and detailed knowledge of insurance policies.
- Handled high-pressure situations with professionalism and composure, consistently achieving positive outcomes for both clients and the organization.
- Followed up with customers on unresolved .
- Provided exceptional customer service during stressful situations by offering empathy and support while resolving issues efficiently.
- Delivered comprehensive training sessions for new hires on claims handling procedures, policy interpretation basics, negotiation techniques, and other core competencies related to the role of a Claims .
- Achieved performance targets consistently through attention to detail, effective time management, and strong decision-making abilities.
- Reviewed insurance and claims documents to verify required information and secure any missing data for settlements.
- Maintained accurate records by diligently updating claim files and ensuring all required documentation was submitted in a timely manner.
- Analyzed claim documents to ensure accuracy and compliance, mitigating risk of financial loss.
- Conducted regular audits of claim files, ensuring compliance with internal and external regulations and standards.
- Negotiated settlements with claimants and attorneys, achieving favorable outcomes for all parties involved.
- Streamlined documentation workflow, enabling quicker claim resolution and enhancing customer satisfaction.
- Enhanced data integrity and security in claim management systems, protecting sensitive information from potential breaches.
- Verified client information by analyzing existing evidence on file.
- Checked documentation for accuracy and validity on updated systems.
- Posted payments to accounts and maintained records.
- Determined appropriateness of payers to protect organization and minimize risk.
- Generated, posted and attached information to claim files.
Education
No Degree - Accounting
Maricopa Community Colleges, Rio Salado Community College
Tempe, AZHigh School Diploma - General Studies
Camelback High School
Phoenix, AZ05.1995
Skills
- Claims
- Coverage assessments
- Settlement determinations
- Claims analysis
- Multitasking Abilities
- Claims Investigation
- Claims adjustment
- Documentation skills
- Policy Interpretation
- Documentation processing
- Great mathematical skills
- Number-savvy
- Data Management
- Problem-solving abilities
- Reliability
- Teamwork skills
- Computer Proficiency
- Conflict Resolution
- Professionalism
- Quality Control
- Adaptability
- Time management abilities
- Office Equipment Operation
- Problem-solving aptitude
- Dispute Resolution
- Claims documentation
- Detail orientation
- Research skills
- Communication
- Microsoft Office knowledge
Languages
Spanish
Native or Bilingual
English
Native or Bilingual
Timeline
Claims Specialist
State Farm
08.2013 - 07.2024
No Degree - Accounting
Maricopa Community Colleges, Rio Salado Community College
High School Diploma - General Studies
Camelback High School
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