Summary
Overview
Work History
Education
Skills
Languages
Timeline
Generic

Temilah Jones

Duncanville,TX

Summary

Proven professional with a background at Allstate, adept in claims investigation and demonstrating exceptional critical thinking. Excelled in enhancing claim processing efficiency and customer satisfaction through innovative solutions and empathetic communication. Skilled in policy interpretation and active listening, significantly contributed to team success and efficient catastrophe response efforts.

Developed skills in high-pressure environments, excelling in conflict resolution and decision-making. Demonstrates ability to analyze complex situations and provide clear, fair outcomes. Seeking to transition into new field, leveraging strong analytical and negotiation skills.

Experienced with evaluating insurance claims and determining appropriate actions. Utilizes analytical skills to assess damage and liability. Strong understanding of policy coverage and effective negotiation techniques.

Offering strong communication and interpersonal skills with commitment to learning and growing within member service environment. Brings foundational understanding of customer service principles and ability to quickly learn new systems and processes. Ready to use and develop problem-solving and data entry skills in Member Service Representative role.

Overview

8
8
years of professional experience

Work History

Outside Adjuster Assistant

Allstate
06.2020 - 12.2024
  • Maintained strong relationships with policyholders, agents, and colleagues by consistently demonstrating professionalism, empathy, and effective communication skills.
  • Ensured compliance with state regulations and company policies through diligent review of all claim-related materials.
  • Assisted clients in understanding their insurance coverage by explaining complex terms and conditions clearly and concisely.
  • Improved claim processing efficiency by conducting thorough investigations and promptly addressing discrepancies.
  • Contributed to team success by participating in regular training sessions, sharing best practices, and mentoring new adjusters.
  • Examined claims forms and other records to determine insurance coverage.
  • Analyzed information gathered by investigations to report findings and recommendations.
  • Managed catastrophe response efforts during natural disasters, ensuring prompt service to affected policyholders and efficient resource allocation within the team.
  • Reduced backlogs of pending claims using effective time-management strategies such as prioritizing tasks based on urgency or complexity levels.
  • Prepared summaries of damage, payments, and policy coverage.
  • Negotiated with policyholders and claimants to reach mutually satisfactory resolutions.

Member Service Representative

Kaiser Permanente
01.2017 - 05.2020
  • Helped large volume of customers every day with positive attitude and focus on customer satisfaction.
  • Provided exceptional service through active listening, understanding member needs, and offering appropriate solutions.
  • Enhanced customer satisfaction by efficiently addressing and resolving inquiries and concerns.
  • Maintained high-quality service by adhering to company policies and standards in all member interactions.
  • Verified customer identification and documentation for compliant transactions.
  • Assisted members with account management, including updating personal information and setting up automated payments.
  • Processed account transactions accurately, ensuring proper documentation and timely processing.
  • Handled complaints with prompt, courteous service to uphold professional reputation.
  • Promoted a positive work environment by fostering open communication between colleagues and supervisors.
  • Educated members on financial literacy topics, empowering them to make sound financial decisions for their future success.
  • Collaborated with team members to ensure seamless operations during peak hours or staff shortages.

Education

High School Diploma -

WW Samuell High School
Dallas, TX
06-2013

Skills

  • Claims investigation
  • Damage assessment
  • Policy interpretation
  • Property valuation
  • Critical thinking
  • Decision-making
  • Active listening
  • Risk assessment
  • Advanced computer skills
  • Coverage assessments
  • Data analysis
  • Record preparation
  • Innovation and creativity

Languages

English
Native or Bilingual

Timeline

Outside Adjuster Assistant

Allstate
06.2020 - 12.2024

Member Service Representative

Kaiser Permanente
01.2017 - 05.2020

High School Diploma -

WW Samuell High School
Temilah Jones