Shelly Fosdick
Tenino,WA
Summary
Accomplished Claim Specialist with a proven track record at State Farm, adept in policy interpretation and critical thinking. Excelled in reducing claim processing times and enhancing customer satisfaction through meticulous claims analysis and empathetic service. Skilled in fostering collaborative relationships, demonstrated by mentoring junior team members and leading by example at Xerox, ACS. Experienced [Type] Insurance Specialist successful at managing high caseloads in fast-paced environments. Organized, driven and adaptable with excellent planning and problem-solving abilities. Offering [Number] years of experience and willingness to take on any challenge.
Overview
11
11
years of professional experience
Work History
Claim Specialist
State Farm
10.2016 - 05.2024
- Reviewed and maintained accurate claim files, ensuring all necessary documentation was in place for future reference.
- Maintained compliance with industry regulations by staying up-to-date on changes in policies and procedures, ensuring proper handling of sensitive information.
- Conducted thorough investigations into insurance claims to determine coverage eligibility and appropriate compensation amounts.
- Enhanced customer satisfaction with prompt and accurate claim resolutions, resulting in positive feedback and increased client retention.
- Provided exceptional customer service during difficult situations, displaying empathy while explaining complex claim issues clearly to clients.
- Participated in ongoing professional development courses to stay updated on best practices within the industry.
- Managed high-volume caseloads effectively, prioritizing urgent cases while maintaining attention to detail for all claims.
- Identified fraudulent activity through meticulous analysis of claim data, protecting company resources from potential losses.
- Reduced claim processing time by implementing efficient workflow procedures and organization systems.
- Mentored junior team members by providing guidance on navigating complex claim scenarios efficiently.
- Developed expertise in specific areas such as property damage or worker''s compensation claims through targeted training programs.
- Assisted in the development of company-wide policies related to claims management, striving for continuous improvement within the department.
- Followed up with customers on unresolved issues.
- Worked with claims adjusters and examiners to expedite processing in alignment with procedures.
- Evaluated and settled complex insurance claims in strict timeframes.
- Generated, posted and attached information to claim files.
- Notified insurance agents and accounting departments of policy cancellations and changes.
Team Lead
Xerox, ACS
09.2013 - 10.2016
- Trained new team members by relaying information on company procedures and safety requirements.
- Promoted a positive work environment by fostering teamwork, open communication, and employee recognition initiatives.
- Served as a role model for the team by demonstrating commitment to excellence, professionalism, and adherence to company values at all times.
- Coached team members in techniques necessary to complete job tasks.
- Enhanced overall team performance by providing regular coaching, feedback, and skill development opportunities.
- Worked different stations to provide optimal coverage and meet production goals.
- Evaluated employee skills and knowledge regularly, training, and mentoring individuals with lagging skills.
Education
High School Diploma -
South Kitsap High School
Port Orchard, WA06.2001
Skills
- Policy Interpretation
- Legal Compliance
- Financial Acumen
- Claims Investigation
- Claims analysis
- Critical Thinking
- Decision-Making
- Customer Service
- Attention to Detail
- Eligibility Determination
- Documentation abilities
- Payment and Investigation Escalations
- Organizing and Prioritizing Work
- Teamwork and Collaboration
- Active Listening
- Insurance Coverage Verification
- Coverage Determination
- Claims Processing
- Policy analysis
- Information Verification
- Regulatory Compliance Adherence
- Microsoft Office
- Insurance Claim Forms Review
- Reporting abilities
- Claims adjustment
- Documentation skills
- Collaborative relationships
Timeline
Claim Specialist
State Farm
10.2016 - 05.2024
Team Lead
Xerox, ACS
09.2013 - 10.2016
High School Diploma -
South Kitsap High School
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