Hi, I’m
Tia Breaux
Spring,TX
Each small task of everyday life is part of the total harmony of the universe.
Saint Thérèse de Lisieux
Summary
Customer service professional with robust background in claims processing, known for achieving high standards and delivering results. Adept at managing complex customer interactions and resolving disputes effectively. Proven ability to collaborate with team members and adapt to changing demands, ensuring seamless service delivery and customer satisfaction.
Overview
10
years of professional experience
Work History
Travelers Insurance
Claims Adjuster
02.2022 - Current
Job overview
- Investigated insurance claims, reviewed coverage and liability, prepared reports and recommended payment or denial of claims.
- Researched relevant laws, regulations, legal decisions and precedents to determine appropriate course of action.
- Interpreted policy language to determine coverage for insureds under various lines of business.
- Analyzed facts of loss including photographs, diagrams and other evidence to identify potential sources of recovery.
- Maintained accurate documentation of all claim activity within designated system.
- Utilized computer systems such as Microsoft Office Suite and specialized software programs used by the company.
- Attended continuing education classes in order to stay abreast of changes in industry standards.
- Performed special projects upon request from management; completed tasks efficiently while meeting deadlines.
- Reviewed, evaluated and adjusted claims to promote fair and prompt settlement.
- Identified and obtained evidence to ascertain claim value.
- Gathered information from various third parties to determine claim acceptability.
- Conducted witness interviews to assist claim information gathering process.
GEICO
Claims Specialist
06.2017 - 02.2022
Job overview
- Reviewed and analyzed insurance claims to determine validity, completeness, accuracy, and eligibility for payment.
- Facilitated communication between claimants, providers, attorneys, adjusters, employers, and other parties involved in a claim.
- Processed payments for valid claims according to established procedures.
- Analyzed settlement offers against liability limits set by insurers.
- Collaborated with other departments within the organization to resolve issues related to claims processing.
- Communicated with other departments to establish action plans and manage open claims to closure.
- Assessed and conducted negotiations within authority limits to settle claims.
- Researched and reviewed information to determine validity of insurance claims and contacted companies and customers about decisions.
- Conducted interviews with involved claims parties and witnesses to gather detailed information and arrange investigations.
- Examined claims, records and procedures to grant approval of coverage.
- Processed claims for payment or forwarded to appropriate personnel for further investigation
Alltran Financial
Collections Specialist
05.2015 - 06.2017
Job overview
- Reviewed delinquent accounts and contacted customers via phone, email or mail to negotiate repayment terms and payment arrangements.
- Drafted letters outlining repayment plans; sent correspondence informing customers of their rights under state law regarding collections practices.
- Processed incoming payments accurately using computerized systems; verified amounts against invoices and statements before posting transactions.
- Received payment and posted to appropriate customer accounts.
- Processed payments over phone and set up recurring drafts.
- Recorded and updated customer personal accounts with accurate contact information.
- Reviewed accounts to determine payment plan compliance.
Education
Kaplan UniversityDavenport, IA
Bachelor of Science from Criminal Justice
05.2018
Houston Baptist UniversityHouston, TX
Bachelor of Arts from Religious Studies
Brown Mackie College - SalinaSalina, KS
from Criminal Justice
06.2016
Skills
- Risk Assessment
- Property Claims
- Insurance Fraud Expertise
- Policy Investigations
- Strong Interpersonal and Communication Skills
- Report Writing
- Highly Motivated
- Coverage Assessments
- Best Practices Implementation
- Claims File Management Processes
- Claims Investigations
- Advanced Computer Skills
- Regulatory Compliance
- Customer Service
- Customer Service Excellence
- Problem Resolution
- Inbound Call Management
- Call Metrics
- MS Office
- Calm Under Pressure
- Customer Data Confidentiality
- Work Prioritization
- Microsoft Office
- Professional Telephone Demeanor
- High-Energy Attitude
- Microsoft Office Expertise
- Claims investigation
- Critical thinking
- Active listening
- Highly motivated
- Team collaboration
- Advanced oral and written communication skills
- Decision-making
- Risk assessment
- Caseload management
- Policy interpretation
- Casualty and property loss
- Regulatory compliance
- Report writing
- Policy investigations
- Damage assessment
- Best practices implementation
- Advanced computer skills
- Coverage assessments
- Problem-solving
- Customer service
- Attention to detail
- Multitasking and organization
- Empathy and patience
- Verbal and written communicationF
- Customer relations
- Problem resolution
- Relationship building
- Call center experience
- Conflict resolution
- Microsoft outlook
- Professional telephone demeanor
- Call management
- Product knowledge
Chairman Club
Maintains a minimum of 80% persistency. Maintaining a minimum of 87% in Customer Satisfaction. Maintaining a minimum of 85% in Quality
Certification
- Licensed Independent Insurance Adjuster – Department of Financial Services or equivalent regulatory body where licensing is required by the state.
- Certified Professional Public Adjuster (CPPA) - National Association of Public Insurance Adjusters.
Accomplishments
- Maintained a consistent closing ratio of 88%
- Collaborated with team of 8 in the development of creating A Onenote based resource guide for all claim operations
- Conflict Resolution - Responsible for handling customer account inquiries, accurately providing information to ensure resolution of product/service complaints and customer satisfaction.
- Customer Follow-up - Ensured that customers were satisfied with experience and services by doing
- customer feedback follow-up calls.
- Telephone Service - Professionally processed 80+ calls per day, providing information and service to ensure customer satisfaction.
Availability
See my work availability
Not Available
Available
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Work Preference
Work Type
Full TimePart TimeWork Location
RemoteHybridImportant To Me
Work-life balanceCompany CultureWork from home option4-day work weekStock Options / Equity / Profit SharingCareer advancementTimeline
Claims Adjuster
Travelers Insurance
02.2022 - Current
Claims Specialist
GEICO
06.2017 - 02.2022
Collections Specialist
Alltran Financial
05.2015 - 06.2017
Houston Baptist University
Bachelor of Arts from Religious Studies
Brown Mackie College - Salina
from Criminal Justice
Kaplan University
Bachelor of Science from Criminal Justice
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