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senior claims representative resume example with 5+ years of experience

Jessica Claire
  • , , 609 Johnson Ave., 49204, Tulsa, OK 100 Montgomery St. 10th Floor
  • Home: (555) 432-1000
  • Cell:
  • resumesample@example.com
  • :
Websites, Portfolios, Profiles
  • www.linkedin.com/in/Jessica-Claire
Professional Summary

Talented Customer Experience manager successful at satisfying all types of customers with creative and knowledgeable solutions. Bringing a 15- year background successfully managing all facets of insurance productions with strong project management and decision-making skills. Clear understanding of positive customer experience and problem identification and training in customer engagement. Proven history of driving operational goals actioned by forward- thinking leadership strategies, assessing customer needs and team supervision to make lasting impacts on company and customer success. Skilled at coordinating documentation, production plans and personnel resources to complete work under tight schedules and enhance technical operations. Highly effective and comfortable working with people at all organizational levels offering an engaging and pleasant personality with expertise improving customer relationships.

Accomplishments
  • Exceeded month quota 6 times achieving "Top Biller" in 2020
  • Documented and resolved over 20 customer detractors which led to 25% increase in promoters department wide using closed-loop practices
  • Responsible for handling customer account inquiries, accurately providing information to ensure resolution of product/service complaints and customer satisfaction.
  • Increased productivity 18% by implementing several process improvements.
  • Created and implemented "Mentor Program" for low producing employees.
Skills
  • Strategic planning and execution
  • Process improvements
  • Communications Management
  • Monitoring
  • Issue resolution
  • Script review and revision
  • Client communication
  • Brand development
  • Complaint resolution
  • Report preparation
  • Performance Metrics
  • Customer Experience
  • Member Engagement
  • Audit
  • Market Analysis
Work History
Senior Claims Representative, 08/2020 to Current
Cleveland-Cliffs Inc.Butler, PA,
  • Championed insurance claims process by investigating, negotiating and resolving 150 claims within first 70 days with organization. Demonstrating expert time management skills, providing transparent knowledge and building positive, trusting relationships to support clients during challenging times.
  • Analyzed key aspects of business to evaluate factors driving results and summarized into presentations.
  • Handled complaints, provided appropriate solutions and alternatives within appropriate timeframes, and followed up to achieve resolution.
  • Suggested new procedure to persuade cancelling customers to stay with company, resulting in 25% decrease in cancellations.
  • Documented procedures and business processes and shared information with appropriate stakeholders.
Senior Claims Examiner, 05/2018 to 05/2020
Sedgwick Claims Management Services, Inc.Sunnyvale, CA,
  • Supervised team of 10 employees and assessed performances to determine training needs and define accurate plans for decreasing process lags.
  • Prepared and presented both oral and written reports of investigative findings on high value losses to executives, internal stakeholders, and leading reinsurance directors by leveraging clear communication of initiatives and action plans .
  • Directed claims negotiations within allowable limit of $200,000 and supported successful litigations for advanced issues while generating over $500k in third party consulting services and project management.
  • Established performance and service goals and held associates accountable for individual performance.
  • Partnered with business leaders to deliver services that support company objectives and consistent with corporate values.
  • Trained, managed and mentored local personnel on best practices and protocols to maximize productivity.
Claims Analyst, 08/2017 to 05/2018
Edgewood Partners Insurance CenterLos Angeles, CA,
  • Determined liability outlined in coverage by conducting agent and claimant interviews, examinations of claims documentation and related records from police and third party experts.
  • Successfully managed large caseload of property and commercial claims for both Admitted and Non Admitted lines to efficiently investigate and negotiate identifying fraud, denials, legal letters and reservations of rights letters in line with individual state law and support successful litigations for advance issues.
  • Substantiated validity and admissibility of evidence and preserved data integrity for court hearings.
  • Led Catastrophe Claims team of 8 senior claims personnel to research, negotiate, and settle high risk claims while improving and maintaining positive team morale and culture.
  • Met performance standard of 98% Compliance with Good Faith Claim Handling Best Practices and State DOI Regulations.
Property Adjuster, 09/2015 to 08/2017
NationwideGrandview Heights, OH,
  • Successfully prepared and organized file case summary and property caption reports for Domestic Carrier on all assigned losses, prepared statement of loss and final settlement letters within granted authority of $50k.
  • Achieved numerous high percentage contact and closures results relating to 24 hour contact and 30 day closure.
  • Trained and mentored 4 new hires and 3 summer interns successfully by creating and executing training and on boarding plan and timeline in accordance with company and Department of Insurance standards.
  • Received promotions during first 12 months from Associate Adjuster to Property Adjuster 1, and then within 6 months was promoted to Property Adjuster 2.
Education
: Business Administration, Expected in to Saginaw Valley State University - Bay City, MI
GPA:
Certifications
  • Licensed Independent Property & Casualty Insurance Adjuster - Active licenses held in all states except for HI
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Resume Overview

School Attended

  • Saginaw Valley State University

Job Titles Held:

  • Senior Claims Representative
  • Senior Claims Examiner
  • Claims Analyst
  • Property Adjuster

Degrees

  • Some College (No Degree)

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