Summary
Overview
Work History
Education
Skills
Licensure Certifications
Licensure/ Certifications
Timeline
Generic

Taylor Moore

Dallas,TX

Summary

With extensive experience in claims processing, I excel in negotiation, policy interpretation, documentation, and regulatory compliance. I am adept at investigating and evaluating diverse insurance claims, ensuring accuracy and fairness in settlements. Building rapport with insured individuals comes naturally to me, while I maintain professionalism and uphold industry regulations. I am committed to continuous learning and growth within the field of insurance claims, always striving to enhance my skills and knowledge. My dedication to excellence drives me to deliver optimal results in every aspect of my work.

Overview

2
2
years of professional experience

Work History

CUSTOMER ENGAGEMENT SPECIALIST

Chico's FAS
10.2023 - 05.2024

Uses customer service skills to optimize the opportunity of each customer contact.

• Identifies and handles customer phone call/email/chat inquiries or concerns completely and accurately.

• Resolves customer complaints and problems to the satisfaction of the customer.

• Educated the customer about the products and services

• Maximizes opportunities to upsell or cross-sell company products and services.

• Performed all financial and administrative activities effectively and in accordance with policy including credit card handling, PCI compliance and reporting.

• Partnered with management if necessary, to ensure first contact resolution. Alert management of issues or concerns that require escalation for complete resolution or which may indicate a larger, underlying problem.

  • Clarified customer issues and determined root cause of problems to resolve product or service complaints.


  • Utilized customer service software to manage interactions and track customer satisfaction.
  • Provided exceptional customer service, addressing inquiries related to transaction statuses promptly and professionally.
  • Demonstrated strong problem-solving skills by identifying discrepancies in financial data and resolving them promptly.

CLAIMS/ DATA SPECIALIST

SEDGWICK CLAIMS MANAGEMENT
03.2023 - 09.2023
  • Successfully managed a caseload of over 250 claims, resulting in timely and accurate settlements
  • Reviewed, evaluated and adjusted claims to promote fair and prompt settlement
  • Negotiated and settled claims according to information presented
  • Identified and collected evidence pertaining to claim to properly assess conditions
  • Verifying vehicle details such as VIN, Mileage, and Repair Order number and date of service
  • Examined claims forms and other records to determine eligibility
  • Conducted full claim investigations and reported updates and legal actions
  • Reviewed and analyzed suspicious and potentially fraudulent claims
  • Receives and reviews new claims and maintains data integrity in the claims system
  • Verified client information by analyzing existing evidence on file
  • Reviewed insurance and claims documents to verify required information and secure any missing data for settlements
  • Redact and compile documents into a single file and upload to claimants' case as proof of related expenses
  • Confirmed vehicle warranty and associated Campaign
  • Speaking with claimants to provide updates on case
  • Approve/ Deny cases based on relevance to warranty and/or Campaign enrollment
  • Processed and recorded new policies and claims.

LICENSED CLAIMS SPECIALIST

HIPPO INSURANCE
03.2022 - 03.2023
  • Notified insurance agents and accounting departments of policy cancellations and changes
  • Coordinated with contracting department to resolve payer issues
  • Reviewed new files to determine current status of injury claim and to develop a plan of action
  • Responded to inquiries by answering questions, providing information and directing customers to appropriate resources
  • Prepared insurance claim forms or related documents and reviewed for completeness
  • Create an FNOL when insureds have experienced a loss and needs to file a claim Gather relevant information from insured while filing claim, adding details occurred from loss and/or damage
  • Provide information to insured regarding deductible amounts for specific Perils
  • Addressed an average of 80 customer inquiries and complaints each day, de-escalating calls
  • Established contact with HIPPO insurance support team to discuss policies and individual homeowners' policy
  • Create task for Desk Adjuster to follow up with insured and provide detailed information pertaining to policy holders claim status
  • Analyze/ Assess coverage in insureds policy and provide relevant details.
  • Worked productively in fast-moving work environment to process large volumes of claims.
  • Examined reports, accounts, and evidence to determine integrity and accuracy of information.
  • Developed strong relationships with clients, facilitating trust and open communication during the claims process.
  • Maintained accurate and up-to-date records of claim information for future reference.

Education

High School Diploma -

Penn Foster High School
Scranton, PA
05.2012

Skills

  • Proficient in Xactimate & Symbility Software
  • State Farm Property/Auto Certified
  • Strong Analytical Skills
  • Proficient in MS (Excel, PP, Word, Outlook)
  • Excellent written and verbal communication
  • Auto Claims
  • Excellent customer service skills
  • Account management
  • Thorough claims reviews
  • Strong interpersonal communication skills

Licensure Certifications

  • All Lines Adjuster License in TX, LA & FL
  • State Farm Property/Auto

Licensure/ Certifications

  • Texas, Florida & Louisiana Adjuster License

• State Farm Property/ Auto

Timeline

CUSTOMER ENGAGEMENT SPECIALIST

Chico's FAS
10.2023 - 05.2024

CLAIMS/ DATA SPECIALIST

SEDGWICK CLAIMS MANAGEMENT
03.2023 - 09.2023

LICENSED CLAIMS SPECIALIST

HIPPO INSURANCE
03.2022 - 03.2023

High School Diploma -

Penn Foster High School
Taylor Moore