Multi-line Claims Representative dedicated to quality investigation, adjustment and supervision of diverse cases. Blends strategic planning and leadership strengths to establish top-performing claims departments. Trains and mentors staff, optimizing compliance with policies, procedures and applicable laws.
Overview
18
18
years of professional experience
Work History
Commercial Lines Claims Generalist, Intermediate
Progressive Insurance
06.2023 - Current
Responsible for investigating coverage, liability, and damages for commercial lines heavy equipment vehicles
Corresponds with insured, claimants, attorneys and other interested parties through the life of the claim
Establish and maintain reserves ad payments, presents large loss reports, and communicate with management, along with internal and external customers
Conducts interviews with claimants and witnesses, obtains and gathers all claim related information including police reports and recorded statements
Initiates analyses of liability and damages, while documenting all correspondence. reports, discussions, and decisions
Commercial Lines Claims Generalist Associate
Progressive Insurance
05.2022 - 06.2023
Worked productively in fast-moving work environment to process large volumes of claims.
Analyzed and addressed escalated claims to resolve issues quickly.
Collaborated with internal departments and external vendors to achieve fast resolution of claims.
Followed up with customers on unresolved issues.
Worked claims expeditiously to resolve claims quickly and in a timely manner
Identified all exposures related to the loss and determined coverage
Claims Customer Care Representative
Lincoln Financial Group
06.2019 - 05.2022
Act as the main point of contact communicating through email/phone with external stakeholders including medical professionals and employers to obtain necessary documents/medical information related to the claim
In addition, inform employers on the status of their employee and any anticipated changes based on the claim
Create transparency with individuals by providing detailed information about the claims process including policy coverage and utilization, while recognizing what needs to be done to meet customer expectations
Process complex claims for payment or denial in accordance with established procedures and guidance ensuring that the claimant is updated in a timely manner by demonstrating flexibility/responsiveness to meet customer needs on routine work independently
Identify, recommend and champion process improvements and organizational initiatives to positively influence the team and quality
Administrative Support Specialist 3
Department Of Family And Children Services
12.2014 - 06.2019
Called customers as needed to verify information as needed Processed all expedite cases in a timely manner
Maintained between 30-100 cases registered per day
Registered clients through Compass, UCM and Gateway databases
Provided excellent customer service
Registered Senior, Unexpedited and Expedited SNAP cases Registers various Medicaid cases (ABD, P01, FM, RSM, Peachcare for kids).
Managed filing system, entered data and completed other clerical tasks.
Identified and recommended changes to existing processes to improve accuracy, efficiency, and quality service.
Assistant Finance Manager
Mid State RV
01.2014 - 06.2014
Pulled customers credit reports
Entered new customers into company database
Entered and created stock tags for new inventory
Offered vehicle financing, extended warranties and insurance to customers
Processed financed deals
Secured approval for financed deals
Operated calls switchboard
Set up appointments with customers for salesmen
Forwarded finished sales packets to Accounts Receivable.
Assistant to the Business Unit Leader
ReadyPac
09.2012 - 04.2013
Conducted research as it pertained to current products
Scheduled and arranged
Monthly conference calls
Prepared various memorandums, reports, and statistics on a daily basis
Coordinated inter-departmental meetings on a weekly basis
Assisted with the execution of payroll on a biweekly basis.
Salvage Specialist
GEICO
10.2009 - 09.2012
Handled incoming phone calls daily from customers, lien holders, and field adjusters
Gathered pertinent information to process total loss claims in a timely manner
Followed up with phone calls to ensure all information from various customers was understood and correctly executed
Monitored and maintained files for the resale of a large quantity of salvaged vehicles per month
Posted proceeds to claim file candidates Issued payments to lien holders and customers monthly.
Mac Attack Inc
06.2005 - 08.2009
Selected to open and close office on a daily basis over other employees
Received over 100 incoming office related phone calls
Selected to place over 35 phone administrative calls Pulled daily company deposits from various report programs Monitored 11 different bank accounts for company Maintained filing system for office staff and restaurant employees Completed paperwork for new hires and terminations, as well as scheduled and conducted new hire orientations Prepared separation notices for terminated employees Handled all customer complaints Completed various tasks for EOM, including preparing reports and monthly figures to accountant Paid all company bills using QuickBooks Input new employee data into WINSPOC and Millennium(payroll system) Conducted payroll twice a month for 400 employees Balanced payroll and prepared checks to be distributed to employees Maintained uniform inventory (ordering, discarding, cleaning) Scheduled travel for owners ,supervisors, and manager Split company credit card bills, allocated charges to correct accounts Scheduled meetings with owner for vendors Ordered restaurant parts and maintained inventory and distribution for restaurant equipment.
Education
MBA - Business
Clayton State University
Morrow, GA
05.2022
Bachelors of Applied Science - Administrative Management
Clayton State University
Morrow, GA
Associate of Applied Science - Business Administration
Central GA Technical College
Macon, GA
Certificate: Administrative Support Assistant - undefined
Central GA Technical College
Certificate: Microsoft Word Application Professional - undefined
Central GA Technical College
Macon, GA
Skills
Party Service
Claims Inspections
High-Value Traces
Corporate Policies and Procedures
Efficient Service
Service Delivery
Service Quality
Claims Evaluations
Timeline
Commercial Lines Claims Generalist, Intermediate
Progressive Insurance
06.2023 - Current
Commercial Lines Claims Generalist Associate
Progressive Insurance
05.2022 - 06.2023
Claims Customer Care Representative
Lincoln Financial Group
06.2019 - 05.2022
Administrative Support Specialist 3
Department Of Family And Children Services
12.2014 - 06.2019
Assistant Finance Manager
Mid State RV
01.2014 - 06.2014
Assistant to the Business Unit Leader
ReadyPac
09.2012 - 04.2013
Salvage Specialist
GEICO
10.2009 - 09.2012
Mac Attack Inc
06.2005 - 08.2009
MBA - Business
Clayton State University
Bachelors of Applied Science - Administrative Management
Clayton State University
Associate of Applied Science - Business Administration
Central GA Technical College
Certificate: Administrative Support Assistant - undefined
Central GA Technical College
Certificate: Microsoft Word Application Professional - undefined
Central GA Technical College
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