SHENIKA ALICEA
Bartow,FL
Summary
Experienced Auto Claims Associate with a strong background handling high-volume and complex insurance claims, including Auto Property Damage, Personal Injury Protection (PIP), Medical Payments (MedPay), Bodily Injury (BI), Uninsured/Underinsured Motorist (UM/UIM), and Subrogation claims. Skilled in investigating claims, evaluating coverage and liability, reviewing vehicle damage and repair estimates, analyzing supporting documentation, and resolving claims accurately and efficiently. Proven ability to manage complex claim files, communicate effectively with policyholders and third parties, and make sound claim decisions while maintaining compliance with company guidelines and applicable regulations.
Overview
13
13
years of professional experience
Work History
CLAIMS REPRESENTATIVE ASSOCIATE -SIU
State Farm
03.2022 - Current
- Manage a high-volume inventory of auto insurance claims from initial loss report through investigation, evaluation, negotiation, and resolution.
- Handle Auto Property Damage, PIP, Medical Payments, Bodily Injury, and Uninsured/Underinsured Motorist claims in accordance with applicable policies and procedures.
- Investigate claims by evaluating coverage, liability, vehicle damage, repair estimates, medical documentation, statements, and other supporting evidence.
- Handle mid-to-high complexity Auto Property claims, reviewing damage assessments and repair estimates to determine appropriate claim payments and resolutions.
- Evaluate liability and damages associated with Bodily Injury and UM/UIM claims, including review of medical treatment, injuries, documentation, and applicable policy provisions.
- Process PIP and Medical Payments claim, reviewing first-party medical coverage, medical bills, treatment records, and supporting documentation for accuracy and eligibility.
- Communicate professionally with policyholders, claimants, attorneys, medical providers, repair facilities, insurance representatives, and other stakeholders throughout the claim lifecycle.
- Review and maintain accurate claim documentation to ensure files are complete, properly supported, and compliant with company standards and regulatory requirements.
- Prioritize multiple claims and competing deadlines while maintaining accuracy, productivity, quality, and a high level of customer service.
- Apply critical thinking and sound judgment when analyzing claim information, resolving discrepancies, and determining appropriate claim outcomes.
- Utilize claims systems and internal resources to document claim activity, review information, and facilitate timely resolution.
SENIOR CLAIMS RESOLUTION SPECIALIST – TOTAL LOSS
Progressive
06.2021 - 02.2022
- Maintained 100% claim file accuracy through detailed documentation and consistent updates across the claim lifecycle.
- Processed 200-250 claims weekly while balancing multiple customer and provider inquiries in a fast-paced environment.
- Investigated and evaluated total loss claims using customer, provider, and supporting documentation to determine appropriate resolution.
- Reviewed, adjusted, and processed claims in line with company policies, state requirements, regulatory guidelines, and plan provisions.
- Analyzed claim discrepancies and researched supporting information to determine corrective action for accurate processing.
- Served as a primary contact for customers and providers, explaining claim decisions, adjustments, benefits, and resolutions clearly.
- Used claims management systems and procedural resources to research claims, document activities, and apply established procedures.
COURT CLERK / CUSTOMER SERVICES SPECIALIST
Polk County BOCC
Bartow, FL
10.2014 - 05.2021
- Resolved an average of 150 customer inquiries daily by telephone and in person while providing accurate information and timely solutions.
- Investigated customer concerns, reviewed records, and researched information to resolve issues effectively.
- Maintained accurate databases, records, reports, financial transactions, and official documentation.
- Processed cash, check, and electronic transactions while ensuring accuracy and proper recordkeeping.
- Conducted detailed legal research and fact-checking to support code violation cases and administrative hearings.
- Processed lien search requests and coordinated with title companies to provide accurate and timely information.
- Supported legal proceedings by preparing official documents, recording court minutes, and maintaining confidential records.
- Provided professional and empathetic customer service while handling sensitive and complex situations.
SECRETARY I / CODE ENFORCEMENT SPECIALIST II
Polk County Clerk of Courts
Bartow, FL
06.2013 - 09.2014
- Performed data entry, maintained records, generated reports, and organized documentation.
- Prepared professional correspondence, including letters, memoranda, and emails.
- Responded to telephone and in-person inquiries and directed issues to the appropriate department.
- Developed and maintained organized filing systems for efficient document retrieval.
- Provided administrative support to management while maintaining accuracy, confidentiality, and attention to detail.
Education
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Devry University
03-2027
Skills
Auto claims investigation
Auto property damage
Bodily injury claims
Coverage evaluation
Liability investigation
Claim file management
Claims documentation
Claims management systems
Claim negotiation & settlement
Regulatory compliance
Xactimate
Salvage title processing
Diminished value claims
Personal Information
Title: AUTO CLAIMS | CLAIMS ASSOCIATE SIU
Timeline
CLAIMS REPRESENTATIVE ASSOCIATE -SIU
State Farm
03.2022 - Current
SENIOR CLAIMS RESOLUTION SPECIALIST – TOTAL LOSS
Progressive
06.2021 - 02.2022
COURT CLERK / CUSTOMER SERVICES SPECIALIST
Polk County BOCC
10.2014 - 05.2021
SECRETARY I / CODE ENFORCEMENT SPECIALIST II
Polk County Clerk of Courts
06.2013 - 09.2014
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Devry University