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Claims Resolution Representative-Auto Resume Example

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CLAIMS RESOLUTION REPRESENTATIVE-AUTO
Summary
15 plus years of experience providing customer support in a call center environment for various industries including pharmaceutical, Mortgage and Insurance. Previous Leadership experience as both a Call Center Customer Service Lead and Call Center Supervisor.  An unwavering commitment to customer service, with the ability to build productive relationships, resolve complex issues and win customer loyalty. Strategic-relationship/partnership -building skills; listen attentively, solve problems creatively, and use tact and diplomacy to find common ground and achieve win-win outcomes for customers.
Qualifications
Account Management
Critical Thinking
Creative Problem Solving
Customer Service
Data Entry
Organizational Skills
​

Experience
Claims Resolution Representative-Auto
November 2015 to July 2016Company Name － City, State
  • Licensed in various states including Texas, Illinois, California and several other states.
  • Provided superior customer experience while managing claim handling and resolving the most complex claims as assigned.
  • Evaluated liability, coverage and settles claims within prescribed procedures and authority.
  • Obtained information and maintains accurate records about accidents from customers and claimants through telephone and written reports.
  • Responded to various written and telephone inquiries including status reports.
  • Arranged and rescheduled appraisals, reviews appraisal reports, communicates with customers, claimants, witnesses, attorneys, 3rd party carriers and repair shops, etc.
  • Secured title or other documentation required to sell vehicle for salvage.
  • Secured the essential facts about accidents, assesses liability/compensability, negotiate settlements and explain denials to policyholders, claimants, and 3rd party carriers.
  • Evaluated loss details for additional parties to be notified or involved in the claim such as PIP/Med Pay, Subro, Rental, SIU and Legal.
  • Registered claims, update status notes, establish target dates, communicate with others, and release payments on automated system within limit of authority.
  • Executed on outstanding items and moves files to closure expediently.
  • Ensured payments processed timely as needed or releases payments once liability decided.
  • Ability to handle total loss, collision, property damage liability, and comprehensive claims.
Customer Care Representative II
June 2013 to October 2015Company Name － City, State
  • Assisted Walgreen customers with placing product orders, checking product availability, and entering claims related to shortage, overage and damaged products.
  • Assisted Walgreen customers by offering product substitutions and alternatives whenever possible; contact manufacturers for delivery information, prices and availability.
  • Responsible for providing customers with accurate answers to questions, documenting call interactions according to ABC processes and procedures and addressing complaints regarding products and/ or ordering management system.
  • Performed data entry for purposes such as processing orders, accessing previous orders and special orders, and providing customers with current pricing; research any other inquiries as requested.
  • Served as a liaison between Walgreen customers and Distribution Centers.
  • Communicates with different departments within the Distribution Center to resolve customers request or concerns.
  • Complied with all appropriate policies, procedures, safety rules and regulations.
  • Completed special projects as assigned by Supervisor and Manager.
Customer Account Executive
November 2012 to June 2013Company Name － City, State
  • Troubleshoot and resolved technical problems over the phone in a single customer interaction to maximize the customer experience, with demonstrated ability to articulate relevant information and direction in an organized and concise manner.
  • Demonstrated ability to establish and maintain effective relationship with customers.
  • Researched and identified tends in service/equipment problems and document processes used to correct issues, reported consistent problems to the escalation agent.
  • Prepared work orders when required and ensured appropriate procedures were followed.
  • Consistently met or exceeded established goals and performance metrics and achieved overall performance goals of the organization.
Quality Coach
August 2009 to April 2011Company Name － City, State
  • Played a critical role in supporting Benefit Service Center efforts that aimed at building and promoting understanding of the customer experience.
  • Provided support as a strategic consultant to an assigned group; analyzing, reporting and educating quality through the lens of the customer.
  • Collaborated many sources of customer service data, metrics' and call behavior information to develop analytical and behavioral team trends that are delivered in an executive presentation.
  • Actively participated as a member of the customer service operations team; building teams and supporting a holistic support model for the customer service center.
  • Identified individual and team training needs- participating in the design of training materials to ensure quality messages are embedded in training content.
  • Facilitated various quality meeting with stakeholders throughout the month.
  • Supported HR information systems with related problem, resolution through effective troubleshooting and communication.
  • Assisted with new system implementation.
  • Assisted Training department with ad hoc projects as needed.
Performance Improvement Coach
November 2005 to April 2009Company Name － City, State
  • Monitored customer service / collection calls to ensure excellent customer service and adherence to policies and procedures. 
  • Coached and developed customer service skills, collections skills, system application proficiency, etc.Appraised individual performance according to Citi's' Call monitoring guidelines.
  • Provided written and verbal feedback regarding observations to Supervisors and managers.
  • Provided performance improvement recommendations.Partnered with representatives to ensure established goals were met or exceeded 100% of the time.
  • Maintained documentation of call coaching sessions, performance evaluations and monitoring evaluations.
  • Tracked, analyzed and maintained statistics (Key performance indicators) and the impact of coaching efforts.Facilitated team meetings and calibrations sessions.
  • Conducted workshops and training sessions aimed at introducing new processes, addressing changes in policies or procedures or reviewing current guidelines.
Quality Coach
November 1999 to September 2004Company Name － City, State
  • Supported employee development through leadership, coaching and mentoring.
  • Served as interim Team Lead for customer service
  • Fostered environment which encouraged individual development and supported "team" concept to ensure both individual and team goals were achieved.
  • Provided administrative support and performance feedback to support the achievement of organizational goals.
  • Contributed to customer satisfaction by resolving external customer escalations related to service, products, price plans, promotions and billing.
  • Participated in several focus groups and special projects including; Assist desk pilot program.
Education
Bachelor of Arts : Business Administration Business Management, 2000Robert morris college － City, StateBusiness Administration Business Management
Highlights
MS Office (Word, Access, Excel, PowerPoint, Outlook)
Salesforce.com
Web/Multimedia: Internet Explorer
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Resume Overview

School Attended

  • Robert morris college

Job Titles Held:

  • Claims Resolution Representative-Auto
  • Customer Care Representative II
  • Customer Account Executive
  • Quality Coach
  • Performance Improvement Coach

Degrees

  • Bachelor of Arts : Business Administration Business Management , 2000

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