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Skills

  • Audit compliance and preparation
  • Budgets
  • Insurance policy interpretation
  • Policyholder relationship management
  • Project organization
  • Multi-vehicle accident reconciliation
  • Collaborative team leadership
  • Customer service
  • Auto claims adjudication
  • Performance reporting and trend analysis

Work Experiences

  • Achieved efficient communication and timely resolutions.
  • Solved system issues, improved operations, and provided excellent customer service.
  • Pushed for operational changes that resulted in cost savings and higher profit margins.
  • Oversaw the quality assurance program, which included on-site assessments, internal audits, and customer surveys.
  • Was able to effectively communicate with members of the operations, finance, and clinical departments.
  • Oversaw the delivery of framework project by process team, which resulted in framework.
  • Aimed at improving customer service standards.
  • Achieved results within two years.
  • Kept patient finances, records, and health statuses confidential.
  • Analyzed documentation carefully.

Summaries

  • Listening to customers, meeting productivity goals, and staying current on company offerings are all skills she possesses.
  • Award-winning Auto Claim Representative.
  • Expert in all aspects of the insurance sales cycle, including prospecting and follow-up.
  • Auto Claim Representative committed to increasing efficiency, regularly processing up to 6 claims daily while maintaining a high standard of accuracy below 51% error rate.
  • Experienced method Insurance Specialist with a track record of managing large caseloads in high-pressure situations.
  • Auto Claim Representative with 2 years of experience, dedicated to providing personalized, courteous service.
  • Bringing 18 years of insurance experience to the table.
  • Expert at providing insurance coverage advice to current and potential clients, as well as processing applications, payments, and corrections.
  • Strengths in process improvement and cross-functional collaboration backed up by Miscellaneous training.
  • Achieved results in just several months.

Accomplishments

  • Maintained up-to-date documentation and records for all open claims using Asana, ensuring compliance with state audits and achieving 48% audit approval.
  • Utilized claims data to identify patterns of underreported damages, leading to a $194,000 year-over-year reduction in potential policyholder fraud.
  • Earned Six Sigma in auto claims investigation, positioning the department as a competitive industry leader in claim verification processes.
  • Reviewed and adjusted policyholder coverage limits based on risk assessments, saving policyholders an estimated $4 in unnecessary premiums over several months.
  • Worked closely with policyholders involved in high-tension accidents, improving customer satisfaction rates by 52% through effective case communication and follow-up procedures.
  • Resolved over 7 claims disputes that significantly reduced escalations and customer complaints from 48% to 71%, meeting client service KPIs.
  • Used Microsoft Excel to develop inventory tracking spreadsheets.
  • Documented and resolved procedure which led to standard.
  • Reduced overall claims processing time by 24% by automating components of the documentation review and compliance check process.
  • Monitored high-risk claims, coordinating with legal counsel to ensure compliance with national and state-level insurance regulations, avoiding potential fines exceeding $13.

Affiliations

  • Lions Club
  • North American Reinsurance Conference
  • National Association of Mutual Insurance Companies (NAMIC)
  • Insurance Institute of America (IIA)
  • Automotive Insurance Adjuster Training 2024
  • American Society of Safety Professionals
  • Association for Claims Professionals
  • Claims and Litigation Management Alliance (CLM)
  • Collision Industry Conference (CIC)
  • Insurance Institute for Highway Safety (IIHS)

Certifications

  • Project Management Professional (PMP)
  • Property Damage Estimator License - Oregon
  • National Association of Subrogation Professionals (NASP) Certification - 2023
  • Advanced Auto Damage Appraisal - Power BI
  • Xactimate Certification for Estimators - Salesforce
  • Certified Insurance Fraud Investigator (CIFI) – Harbor & Co.
  • Certified Auto Claims Adjuster (CACA) - Vantage
  • CompTIA A+ Technician
  • CompTIA Security+
  • Insurance Regulatory Compliance Certification Cedar Works

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