Winter Daniels
Austell,GA
Summary
Dedicated, detail-oriented and compliance-driven professional with proven expertise in ensuring adherence to regulatory standards and providing supporting insurance operations in a highly regulated environment.
Overview
13
13
years of professional experience
Work History
Customer Resolution Specialist- Customer Complaint Resolution-Auto
State Farm
Atlanta, GA
05.2024 - Current
- Investigates escalated auto claim inquiries through in-depth review of claim files, policy provisions, and applicable insurance regulations, ensuring compliant, accurate resolutions while reducing repeat complaints and regulatory exposure.
- Produces clear, written, and verbal explanations of coverage determinations, liability assessments, settlement decisions, and claim handling practices.
- Analyzes claim data and complaint trends to identify compliance risks; coordinates with the claims team to recommend and implement corrective actions that strengthen controls and support continuous improvement initiative.
- Consistently exceeds productivity, quality and timeliness benchmarks while managing complex, time-sensitive auto claim issues; recognized by leadership for reliability, efficiency, and high-impact results.
Claim Specialist- Weather & Catastrophe Claims Services
State Farm
Atlanta, GA
02.2020 - 05.2024
- Demonstrated a collaborative mindset that enhanced overall efficiency, resolution of 100+ claims monthly and improved customer satisfaction by maintaining a direct inbound dialer objective of 50% or above weekly and monthly basis.
- Exhibited flexibility and adapted to decisions based on changing circumstances and new information in the fast-paced environment.
- Exhibited a strong willingness to learn, took accountability, and incorporates feedback for future decision making to achieve the goals and metrics, which improved efficiency.
- Took the initiative to influence and mentor new team members in adhering to policies, procedures for streamlining the claims process, learn new applications which resulted in fostering a positive impact on both the team and the organization.
Human Resources Associate (VACO Contractor)
Home Depot
Atlanta, GA
12.2019 - 02.2020
- Ensured confidentiality and integrity in handling sensitive information which established trust and credibility.
- Adapted communication strategies to be inclusive and culturally sensitive.
- Navigated and resolved conflicts in a fair and impartial matter which led to ethical decisions.
- Fostered a positive and collaborative team culture within HR and across the organization.
Claims Investigator
Criminal Justice Coordinating Council
Atlanta, GA
04.2016 - 04.2019
- Conducted interviews through active listening to involved parties with a consultative approach, which resulted in developing a rapport, conducting thorough investigation and effective interviews with victims, legal professionals, law enforcement, executives, and employers.
- Developed effective strategies which led to offering recommendation and resolving investigative challenges.
- Effectively managed and prioritized multiple cases simultaneously which resulted in maintaining accurate and detailed records of investigation activities, audits, findings, communications, and meeting service level objectives.
- Presented findings and conclusions verbally and in written correspondence suitable for legal or organizational review.
Claims Specialist (Hail Reconciliation Unit)
State Farm
Atlanta, GA
04.2013 - 03.2016
- Improved agency partners and customer experience by applying knowledge of state and federal laws, statues, and insurance regulations by moving the claim to the furthest point for a faster complex claim settlement.
- Stayed informed about relevant policies, endorsements and codes which resulted in adhering to requirements and ensuring compliance with internal company policies and procedures.
- Identified and assessed potential compliance risks in claims processes which improved the review and documenting claim files for the prevention and detection of possible fraudulent claim reporting.
- Participated in continuous improvement initiative to optimize efficiency.
Education
B.A. - Criminal Justice
Clark Atlanta University
Atlanta, GASkills
- Communication
- Accountability
- Strategic Business Focus
- Compliance Management
- Critical Thinking
- Decision Making/Judgement
- Technical/Functional
- Team Building
Accomplishments
- Received a Remarkable Award.
- Received Good Act Award.
- Consistently meets and exceeds the service level objectives.
- Processed over 3,825 claim queue items, over twice as many as prior year.
- Administered over $1.64 million dollars in claims.
- Acknowledged for account reconciliation to reduce overpayment in claims.
Timeline
Customer Resolution Specialist- Customer Complaint Resolution-Auto
State Farm
05.2024 - Current
Claim Specialist- Weather & Catastrophe Claims Services
State Farm
02.2020 - 05.2024
Human Resources Associate (VACO Contractor)
Home Depot
12.2019 - 02.2020
Claims Investigator
Criminal Justice Coordinating Council
04.2016 - 04.2019
Claims Specialist (Hail Reconciliation Unit)
State Farm
04.2013 - 03.2016
B.A. - Criminal Justice
Clark Atlanta University