Summary
Overview
Work History
Education
Skills
Timeline
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SHAUNTA MILFORD

Summary

Highly skilled Senior Claims Administrator with over 5 years of experience managing complex claims processes from initiation to resolution. Proven expertise in coordinating claims with insurance adjusters, third-party administrators (TPAs), vendors, and clients to ensure efficient and accurate claims management. Adept at utilizing advanced claims management software such as Xactimate, DASH, XactAnalysis, and other industry-specific portals like Alacrity and Contractor Connection. Known for delivering timely and effective solutions while adhering to company policies, industry regulations, and legal requirements. Strong background in team leadership, claims documentation, and enhancing operational workflows to drive efficiency and reduce claims cycle times. Exceptional communicator with a focus on maintaining strong client and stakeholder relationships.







Overview

9
9
years of professional experience

Work History

Senior Claims Admin

A.Molly Restoration & Remediation
05.2019 - Current
  • Manage and process incoming claims from Insurance companies,TPA's Private clients ensuring all information is accurate and thoroughly documented.
  • Managed and coordinated property claims and repair projects in collaboration with multiple third-party administrators (TPAs), including Alacrity, Sedgwick, Lionsbridge, and Contractor Connection.
  • Ensured compliance with each TPA’s unique guidelines, service level agreements (SLAs), and documentation requirements.
  • Built and maintained strong relationships with TPA representatives to streamline project approvals and resolve escalations promptly.
  • Adapted quickly to the policies and platforms of various TPAs to meet client expectations and performance metrics.
  • Handled high-volume inbound and outbound calls supporting insurance and private clients, collecting key information from policyholders, private clients, and adjusters to resolve inquiries or efficiently route them to the appropriate parties.
  • Ensured accurate and timely distribution of information across departments to support smooth operational workflows and effective communication company-wide.
  • Independently performed responsibilities with minimal supervision, contributing directly to team efficiency and management outcomes.
  • Collaborated cross-functionally to support problem-solving efforts and assist with project planning and execution.
  • Working knowledge of computerized estimating software and portals, including Xactimate, DASH, XactAnalysis, Alacrity Portal, Lionsbridge Portal, Contractor Connection Portal, and various other industry-specific platforms.
  • Stay informed about the various programs we participate in, proactively engaging in continuing education to remain up-to-date with industry changes and program updates
  • Managed contract preparation and distribution, coordinating with accounting for prompt processing of deposit requests.Sent required work authorizations and completion documents via DocuSign or Postal mail to customers and insureds for digital signature, ensuring timely processing
  • Possess comprehensive knowledge of all business operations, providing support to customers and Claims Admin by addressing inquiries and resolving concerns.
  • Supported Large Loss Inspectors by organizing and updating files, while proactively following up on estimate approvals to ensure project timelines were met.
  • Oversaw and prioritized incoming emails, claims, and private requests, ensuring prompt and efficient handling on a daily basis.
  • Provided comprehensive support to the Claims Management Division Head, assisting with various tasks and ensuring smooth operations across different departments.


Retention Specialist

COMCAST
01.2017 - 05.2019
  • Retain consumer accounts through the strategic use of sales tools and techniques, focusing on meeting customer needs and enhancing long-term loyalty.
  • Address customer inquiries and concerns, clearly outlining how continued service will fulfill their unique needs and resolve any issues.
  • Follow company-approved scripts to ensure consistency and effectiveness during calls, maintaining high standards of professionalism and customer service.
  • Respond promptly and accurately to all billing dispute inquiries, resolving issues in a timely manner and ensuring customer satisfaction.
  • Introduce and explain new services and products to existing customers, highlighting their value and benefits to enhance retention rates.
  • Develop and nurture strong, empathetic relationships with customers, creating an environment of trust and long-term engagement.
  • Collect key information from customers to ensure accurate documentation and provide effective follow-up on service-related issues.
  • Investigate customer complaints and resolve problems in a manner that reinforces customer trust and reduces churn.
  • Manage customer accounts, ensuring all details are up to date, and monitor ongoing interactions to ensure satisfaction and loyalty.
  • Perform calculations related to fees, time periods, pro-rations, or competitive pricing comparisons to provide customers with accurate and fair pricing information.

Terminal Clerk

NEW PENN
07.2016 - 01.2017
  • Enhanced financial processes by creating and maintaining billing, invoice, and analysis spreadsheets, ensuring accuracy and efficiency.
  • Strengthened daily operations by handling paperwork, managing phone calls, and coordinating schedules to ensure smooth office functions.
  • Identified and flagged freight bills requiring special delivery instructions, and matched driver paperwork with dispatch information for accuracy.
  • Operated office machines (photocopiers, scanners, fax machines, and PCs) to support daily administrative tasks.
  • Distributed phone messages, drafted correspondence, and authored/edit company letters to ensure clear communication both internally and externally.
  • Managed and organized office documentation, maintained filing systems, and updated in/out sheets and location tickets for secure and efficient record-keeping.
  • Fostered relationships with vendors and third-party partners to ensure smooth operations and timely service delivery.
  • Scheduled appointments, organized meetings, compiled reports, and ensured all tasks were completed within deadlines.
  • Oversaw and managed activities associated with the import and export of totes, ensuring adherence to logistical procedures.









Education

A.S., Business Management -

Hudson County Community College
Jersey City, New Jersey

Skills

  • End-to-End Claims Coordination
  • Vendor & TPA Relationship Management
  • Expertise in Claims Software (Xactimate, DASH, XactAnalysis, other softwares
  • Claims Documentation & Compliance
  • Cross-Functional Team Leadership
  • Time Management
  • Client Relations & Customer Service Excellence
  • Strong Communication & Negotiation Skills

Timeline

Senior Claims Admin

A.Molly Restoration & Remediation
05.2019 - Current

Retention Specialist

COMCAST
01.2017 - 05.2019

Terminal Clerk

NEW PENN
07.2016 - 01.2017

A.S., Business Management -

Hudson County Community College

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SHAUNTA MILFORD