Tia Cunningham
Dunwoody
Summary
Dynamic Claim Specialist with extensive experience excelling in claims processing and regulatory compliance. Proven track record in enhancing customer satisfaction through effective claims negotiation and resolution. Adept at managing high-volume caseloads while fostering teamwork and collaboration, resulting in improved operational efficiency and client retention.
Overview
25
25
years of professional experience
Work History
Claim Specialist
State Farm Insurance Inc
06.2018 - 05.2024
- Reviewed and maintained accurate claim files, ensuring all necessary documentation was in place for future reference.
- Maintained compliance with industry regulations by staying up-to-date on changes in policies and procedures, ensuring proper handling of sensitive information.
- Conducted thorough investigations into insurance claims to determine coverage eligibility and appropriate compensation amounts.
- Enhanced customer satisfaction with prompt and accurate claim resolutions, resulting in positive feedback and increased client retention.
- Provided exceptional customer service during difficult situations, displaying empathy while explaining complex claim issues clearly to clients.
- Managed high-volume caseloads effectively, prioritizing urgent cases while maintaining attention to detail for all claims.
- Coordinated with legal teams when necessary to accurately represent clients'' interests during litigation proceedings.
Claim Automation and Procedures Specialist
State Farm Insurance Inc
01.2015 - 01.2018
- Achieved enhanced levels of procedural consistency across the organization by establishing a centralized resource repository for sharing and accessing relevant documentation.
- Facilitated successful interdepartmental collaboration on projects, enhancing overall project efficiency and results delivery timeframes.
- Reduced errors in the execution of procedures by developing intuitive checklists and reference materials for staff use.
- Spearheaded the development of new procedures to support organizational growth and expansion into new markets.
- Enhanced overall procedural effectiveness through regular analysis of key performance indicators and process optimization efforts.
- Developed comprehensive training materials for new employees, resulting in faster onboarding and increased productivity.
- Communicated with team members to enforce deadlines and quality standards.
- Compiled research data and gave professional presentations highlighting finds and recommended optimizations.
- Restructured procedures through coordination with compliance director to create and execute projects.
Claim Specialist - Auto
State Farm Insurance Inc
01.1999 - 01.2015
- Reviewed and maintained accurate claim files, ensuring all necessary documentation was in place for future reference.
- Maintained compliance with industry regulations by staying up-to-date on changes in policies and procedures, ensuring proper handling of sensitive information.
- Conducted thorough investigations into insurance claims to determine coverage eligibility and appropriate compensation amounts.
- Enhanced customer satisfaction with prompt and accurate claim resolutions, resulting in positive feedback and increased client retention.
- Managed high-volume caseloads effectively, prioritizing urgent cases while maintaining attention to detail for all claims.
- Negotiated favorable settlements with policyholders and third-party representatives, minimizing financial losses for the company.
- Mentored junior team members by providing guidance on navigating complex claim scenarios efficiently.
- Organized and led workshops on best practices in claim handling, elevating team's overall performance.
- Negotiated settlements for complex claims to ensure fair outcomes for all parties involved.
Education
Associate of Science - Business Administration And Management
Davenport University
Grand Rapids, MI05-1988
Skills
- Claims processing
- Insurance investigations
- Regulatory compliance
- Claims negotiation
- Customer service
- Time management
- Claims investigation
- Teamwork and collaboration
- Coverage determination
- Policy analysis
- Regulatory compliance adherence
- Decision-making
- Eligibility determination
- Claims analysis
- File management
Timeline
Claim Specialist
State Farm Insurance Inc
06.2018 - 05.2024
Claim Automation and Procedures Specialist
State Farm Insurance Inc
01.2015 - 01.2018
Claim Specialist - Auto
State Farm Insurance Inc
01.1999 - 01.2015
Associate of Science - Business Administration And Management
Davenport University
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