Shana Riggins
Port Orange,FL
Summary
Results-driven claims management professional prepared for this role with strong background in assessing and processing claims, resolving disputes, and ensuring compliance with regulations. Skilled in risk analysis, negotiation, and policy interpretation, with proven track record of fostering team collaboration and adapting to changing needs. Known for reliability, effective communication, and focus on achieving optimal outcomes.
Overview
14
14
years of professional experience
Work History
Claims Manager
Monarch National Insurance
04.2023 - Current
- Collaborated with other departments to improve overall organizational effectiveness in addressing client needs.
- Implemented quality assurance measures, monitoring staff performance and providing constructive feedback for continuous improvement efforts.
- Managed a team of adjusters, providing coaching and performance feedback for improved productivity.
- Mentored new hires on company policies/procedures enabling them to quickly become proficient in managing claims.
- Assisted in the hiring process by conducting interviews and selecting top candidates who contributed positively to the overall success of the Claims Team Manager role.
- Facilitated regular team meetings to review progress, address concerns, and share best practices for improved results.
- Reduced claim processing time by implementing efficient workflow management strategies.
- Enhanced team performance by providing consistent coaching and feedback to team members.
- Evaluated team member performance through ongoing monitoring and assessment tools, identifying areas for growth and development opportunities.
- Demonstrated exceptional leadership qualities throughout tenure as Claims Manager, resulting in high employee satisfaction and retention rates.
- Established team priorities, maintained schedules and monitored performance.
- Defined clear targets and objectives and communicated to other team members.
- Established performance goals for employees and provided feedback on methods for reaching those milestones.
- Participated in mediations
- Completed Notice of Intent to Litigate responses
- Reviewed time off requests and timecards
Claims Representative II
Tower Hill Insurance Group
03.2022 - Current
- Interviewed policyholders to verify information and obtain additional details.
- Proposed settlements for uncomplicated issues to resolve claims.
- Examined claims forms and other records to determine insurance coverage.
- Coordinated and managed field investigations, outside engineers, contractors and cause and origin experts.
- Investigated and assessed damage to property and reviewed property damage estimates.
- Delivered exceptional customer service to policyholders by communicating important information and patiently listening to issues.
- Handled represented claims with public adjusters and attorneys.
Claims Adjuster
Olympus Insurance
10.2021 - 03.2022
- Reviewed, evaluated and adjusted claims to promote fair and prompt settlement
- Analyzed first reports of loss and underlying file material to determine if claim was suspect
- Completed required investigations on referred files within established timeframes
- Maintained thorough understanding of fraudulent and illegal practices
- Entered claim transactions, including payments, reserves, and other documentation
- Reviewed and resolved open claims and change orders to determine entitlement for additional payment
- Handled and processed variety of claims, including water, mold and fire
- Paid and processed claims within designated authority level
- Documented and communicated all claim activity quickly and efficiently
- Determined insurance coverage levels and restrictions by thoroughly examining claims forms and associated records
- Demonstrated self-reliance by meeting and exceeding workflow needs
- Recognized by management for providing exceptional customer service
- Improved operations by working with team members and customers to find workable solutions
- Review and issue payments on claim supplements
- Negotiations with contractors and water mitigation companies
- Answered claims department que calls
Claims Adjuster
Progressive
04.2021 - 10.2021
- Reviewed, evaluated and adjusted claims to promote fair and prompt settlement
- Analyzed first reports of loss and underlying file material to determine if claim was suspect
- Completed required investigations on referred files within established timeframes
- Maintained thorough understanding of fraudulent and illegal practices
- Entered claim transactions, including payments, reserves, and other documentation
- Reviewed and resolved open claims and change orders to determine entitlement for additional payment
- Handled and processed variety of claims, including water, mold and fire
- Paid and processed claims within designated authority level
- Documented and communicated all claim activity quickly and efficiently
- Determined insurance coverage levels and restrictions by thoroughly examining claims forms and associated records
- Demonstrated self-reliance by meeting and exceeding workflow needs
- Recognized by management for providing exceptional customer service
- Improved operations by working with team members and customers to find workable solutions
- Review and issue payments on claim supplements
- Negotiations with contractors and water mitigation companies
- Answered claims department que calls
Claims Examiner
Security First Insurance Company Inc
05.2016 - 03.2021
- Reviewed, evaluated and adjusted claims to promote fair and prompt settlement
- Analyzed first reports of loss and underlying file material to determine if claim was suspect
- Completed required investigations on referred files within established timeframes
- Maintained thorough understanding of fraudulent and illegal practices
- Entered claim transactions, including payments, reserves, and other documentation
- Reviewed and resolved open claims and change orders to determine entitlement for additional payment
- Handled and processed variety of claims, including water, mold and fire
- Paid and processed claims within designated authority level
- Documented and communicated all claim activity quickly and efficiently
- Determined insurance coverage levels and restrictions by thoroughly examining claims forms and associated records
- Demonstrated self-reliance by meeting and exceeding workflow needs
- Recognized by management for providing exceptional customer service
- Improved operations by working with team members and customers to find workable solutions.
Commercial Lines Account Manager
USI Insurance Services
05.2014 - 04.2016
- Liaised with clients to aid in purchasing appropriate insurance products to protect commercial assets
- Worked with insurance company representatives to address customer needs
- Capitalized on opportunities to enhance customer experiences and bring in repeat business
- Improved service quality and increased sales by developing strong knowledge of company's products and services
- Delivered fast, friendly and knowledgeable service for routine questions and service complaints
- Exceeded team goals and collaborated with staff to implement customer service initiatives
- Wrote various commercial insurance products for businesses
- Ade policy changes per request of clients
Insurance Underwriter
Mercury Insurance
03.2013 - 05.2014
- Underwrote personal lines for multiple states
- Etermined level of acceptable risk by reviewing applications for coverage and loss control reports
- Worked with colleagues to review and accept or deny new and renewal business
- Improved operations by working with team members and customers to find workable solutions
- Improved customer satisfaction by finding creative solutions to problems
- Demonstrated self-reliance by meeting and exceeding workflow needs
- Recognized by management for providing exceptional customer service
- Provided excellent service and attention to agents when face-to-face or through phone conversations
- Performed agency visits
Customer Service Representative
Holder Insurance Agency
03.2011 - 02.2013
- Asked probing questions to determine service needs and accurately input information into electronic systems
- Assessed customer needs and upsold products and services to maximize insurance sales
- Informed customers about billing procedures, processed payments and provided payment option setup assistance
- Consulted with customers to determine best methods to resolve service and billing issues
- Delivered service and support to each customer, paving way for future business opportunities
- De-escalated problematic customer concerns, maintaining calm, friendly demeanor
- Documented conversations with customers to track requests, problems and solutions
- Educated customers on special pricing opportunities and company offerings.
Education
Certificate -
Florida State College At Jacksonville
Jacksonville, FL2019
Customer Service Representative - Certificate
College of Central Florida
Ocala, FL03.1996
High School Diploma -
Lake Weir High School
Ocala, FL 01-1993
Skills
- Highly motivated
- Excellent customer service skills
- Performance monitoring
- Insurance regulations
- Teamwork and collaboration
- Problem-solving
- Time management
- Multitasking Abilities
- Reliability
- Excellent communication
References
available upon request
Timeline
Claims Manager
Monarch National Insurance
04.2023 - Current
Claims Representative II
Tower Hill Insurance Group
03.2022 - Current
Claims Adjuster
Olympus Insurance
10.2021 - 03.2022
Claims Adjuster
Progressive
04.2021 - 10.2021
Claims Examiner
Security First Insurance Company Inc
05.2016 - 03.2021
Commercial Lines Account Manager
USI Insurance Services
05.2014 - 04.2016
Insurance Underwriter
Mercury Insurance
03.2013 - 05.2014
Customer Service Representative
Holder Insurance Agency
03.2011 - 02.2013
Certificate -
Florida State College At Jacksonville
Customer Service Representative - Certificate
College of Central Florida
High School Diploma -
Lake Weir High School
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