Lawrene Sherman

• Evaluated and processed insurance claims to ensure compliance with company policies and procedures.
• Collaborated with clients to gather necessary documentation for claim submission and resolution.
• Analyzed claims data to identify trends and recommend process improvements for efficiency.
• Provided exceptional customer service by addressing inquiries and resolving issues promptly.
• Using various resources, (CCC, Mitchell, Xactimate, etc) to determine accurate total loss vehicle valuations;
• Maintained accurate records of claims activities in internal systems to support audit processes.
• Applying knowledge of policies and insurance regulations when determining coverage, liability, & damages
• Timely interaction with Insured's, Claimants, Agent's and Internal Customers not limited to contacting customers by telephone, written correspondence and/or various electronic media
• Effectively managing work through task driven queues while multi-tasking in a fast-paced call center environment
• Send appropriate DMV forms and company-required documents, and review them upon return;

• Serve as the support contact for Amazon employees with questions about their time away from work due to illness.

• Take ownership of employee contacts ensuring that each contact is accepted and resolved with a high degree of customer focus.

• Build trust with employees by empathetic handling of sensitive issues. Resolve queries by referring to documentation such as frequently asked questions and standard operating procedures and escalate when these cannot be resolved.

• Receive queries via phone or web and log contacts into the shared service case management system.

• Handle customer absence claims end to end and contact customers to inform them of resolution, when appropriate. • Assess new claims and make accurate classifications about the type of absence required. Ensure all tasks and decisions are rendered within SLA.

• Navigate ambiguous claim requests and apply good judgement about how to apply policy and regulations to the case in question.

• Maintained employee records in HRIS, ensuring data accuracy and confidentiality.

• Evaluated claim documentation to determine coverage eligibility and appropriate payment amounts.
• Collaborated with cross-functional teams to resolve complex claims issues and enhance customer satisfaction.
• Serve as first point of contact with customer for customers with disability insurance claims, explaining benefits, coverage terms, and claim status.
• Supported disability claim adjusters by gathering medical, vocational, and financial information needed for accurate claim decisions.
• Maintain thorough documentation of claims actions, including, rationales, to ensure transparency and accountability in all claims decisions. Escalated complex issues to senior team members or management as needed
• Provides accurate, timely and highly routine information meeting the customer's needs through problem resolution.
• Introduced clients to available online resources and services to increase convenience
• Examined reports, accounts and evidence to determine integrity and accuracy of information.
• Escalated complex claims and collaborated with adjusters to ensure accurate outcomes.

• Handle/adjudicate all customer calls for a particular claim.

• Perform highly routine research to respond to customer inquiries.

• Provide accurate, timely and highly routine information meeting the customer's needs through problem resolution. • Keep record of the phone call and transmits claim form to Dealership or Repair Facility.

• Order an appraisal when claim is over a pre-determined amount or possible fraud is detected.

• If denied, send denial letter to customer and dealership.

• Adheres to Quality Assurance Guidelines.

• Prior to sending payments, ensure premium is received from Dealership.

• Performs other duties as assigned by the Claims Center Manager or Team Lead.