INSURANCE CLAIMS PROCESSOR - ALL LINES
Seasoned professional with more than 7 years of combined experience in the medical, automobile and property insurance fields. Strong orientation towards details. Proven problem solver and mediator. Experienced and comfortable with assisting and serving a diverse population. Effectively manage multiple, high-priority projects and take pride in providing exemplary customer service.
Claims Handling and Documentation
Superb Oral & Written Communication
Research and Analytical Skills
Texas Notary Public
Confidential Records Management
All-line Texas Adjuster License
State Farm Auto Certification
State Farm Property Certification
Multiple State licenses ELR; ECS; SharePoint; NextGen, XactAnalysis; Microsoft Excel, Word, Access, OutlookProperty adjusting
Claims file management processes
Insurance fraud expertise
Insurance fraud expertise
07/2016 to 06/2017
Catastrophe & National Claims -State Farm － West Lafayette, IN
Zone Total Loss- TOTAL LOSS.
Review claims coverages.
Review vehicle images and cost of repair from AEI or BS to determine if vehicle is a TL.
It is put into consideration based on the year, make model, options and mileage & condition to determine ACV (Actual Cash Value).
Based on each state, if repair exceed specific percentage normally at 75% the vehicle is deemed a TL or if below it is repairable and claim will be reassigned to claim Owner.
Calling Insured to make settlement offer or option to OR (Owner retail vehicle).
Forms are to be signed include original title before processing of payment.
Contacts, interviews and obtains statements (recorded or in person) from insureds, claimants, witnesses.
Evaluates facts supplied by investigation to determine extent of liability of the insured.
Evaluate and negotiate settlement of automobile first and third party physical damage claims within established settlement authority limits and negotiates any excessive storage charges.
Prepares reports on investigation, settlements, denials of claims, individual evaluation of involved parties.
Explains procedures and answer inquiries for adjusting auto total loss claims.
Document the loss, address immediate questions regarding the claims process and reviews and analyzes the vehicle settlement value.
Provides coordination with internal functions to include appraisal operations, SIU, Counsel, Subrogation and Salvage.
Refers claims to subrogation as appropriate.
May arrange for salvage disposition or other recovery.
Apply claim handling procedures to process claims, initiate payments, and close claim files.
Communicate with customers and associates by phone and through other channels.
Use State Farm systems and technology.
07/2013 to 11/2015
Claims Customer Care AssociateLiberty Mutual Group － Plano, TX
Provides efficient customer service by promptly and courteously responding to all inbound inquiries regarding Personal Insurance claims.
Performs initial capture of new Auto claims; Processes all "First Notice of Loss" and performs enhanced capture steps as needed.
Capture new claims and service existing claims through effective collaboration with internal and external partners.
Set expectations with customers on when updates on their claim status will be provided.
Provides contacts for temporary resources such as rental cars locations and or tow trucks to assist callers.
Demonstrates understanding of policies and provides guidance and assistance to callers based on their needs; and may make limited recommendations on enhancements as needed.
Processes caller transactions accurately and within established Contact Center time standards.
Manages and utilizes time effectively to ensure the required service levels for call capture and service handle time as well as quality and customer satisfaction standards are met.
Efficiently utilizes on-line reference materials to provide accurate and timely information and counsel to customers.
Effectively operates systems and applications including computer desktop, Microsoft Outlook, call center specific phone systems and the internet.
Develops and continuously builds product, procedural and technical systems knowledge.
Completes licensing and continuing education requirements as required.
11/2011 to 03/2013
Security GuardDallas, TX
Performs security duties in and around County property and assists in controlling disturbances on County property, takes necessary action to prevent injury to persons and loss of property, and reports all circumstances to immediate supervisor.
Responds to fire alarms, bomb threats, medical emergencies, burglar alarms and other calls for service.
Assists in the process of screening persons entering the Courts buildings of Dallas County, and documents any problems that occur.
Reports maintenance needs identified while performing rounds and operates as dispatch for maintenance after hours and weekends.
Enforces County policies (i.e.
smoking, soliciting, parking violations, etc.) on County property.
Extinguishes lights and secures doors on County property during non-business hours, patrols and escorts County personnel.
Documents lost and found merchandise, confiscated items and contraband; notifies next shift.
Performs other duties as assigned.
Education and Training
Bachelor of Science: Business Computer Information SystemUNIVERSITY OF NORTH TEXAS － Denton, TX.Business Computer Information System
Associate: ScienceNetwork Administrator and Support RICHLAND COLLEGE － Dallas, TX.Science