Customer Service Insurance

FEONNA TRAN, MBA **********@*****.***

**** *********** ****: 949-***-****

Irvine, CA 92612

Qualifications

( Self-motivated with high-performance standards and strong

emphasis on goals, deadlines and quality of work.

( Driven insurance professional trained in all aspects of

insurance billing, claims and collections.

( Strong time management skills with the ability to execute a

variety of projects simultaneously.

( Works independently in a confidential role or as a team player

with excellent interpersonal skills.

o Creative, people-oriented communication and organizational skills.

Professional Experience

5/10-present Claims Operations Specialist - QBE FIRST (formerly Balboa

Insurance), Irvine CA

. Manage escheat (non-negotiated) check process for multiple

programs.

. Investigate daily incoming research and adjustment

inquiries; resolve differences.

. Answer service requests and inquiries received from various

channels.

. Evaluate accounting entries and make appropriate decisions.

. Analyze financial data to reconcile stale-dated checks.

. Correct and report discrepancies found in the financial

records.

. Maintain internal operational and financial controls and

ensure that they are observed for all assigned cases.

. Identify, streamline and correct inefficiencies; recommend

process improvement.

. Ensure that all cases are resolved in compliance with

industry regulations and approved procedures.

. Uphold integrity of the department's case management

system.

. Identify payments by line of business (LOB) including:

Homeowners, Auto, Collateral Protection and Lender Placed

Hazard.

. Assign bulk research tasks to LOB designees utilizing

SharePoint site

. Diligently monitor all tasks and validate the information

utilizing multiple systems.

. Provide direction and guidance to less experienced

department researchers.

. Remediate scheduling and process errors.

. Work with business analysts and IT department to resolve

identified issues.

. Prepare recurring monthly reports and analysis of reported

data.

. Assist Central Claims Support Representative with the

returned check analysis.

. Audit all tasks to ensure appropriate remediation has

occurred.

. Complete on-site agent audits. Report deficiencies in the

agent's claim handling in regard to Company procedures and

DOI regulations

. Analyze Payee Modification Report; review checks prior to

release for accuracy.

. Identify errors and trends; communicate findings to

management for resolution.

3/09-5/10 Claim Adjuster - BANK OF AMERICA; Irvine, CA

Contract employee responsible for handling American Express Account

Protector Plan Benefits/Credit Insurance claims for covered loan

protection events including: Involuntary Unemployment, Disability,

Hospitalization, or Loss of life.

Conducted prompt and thorough evaluation of the borrower's benefit request

based on specifications outlined in the policy and addendums.

Maintained accuracy level of 97% or higher on all audit results.

1/07- 6/08 Master Claims Examiner - WESTERN UNITED INSURANCE;

Irvine, CA

Investigated, evaluated, negotiated, and settled complex first and third

party bodily injury claims for personal auto within approved company

guidelines.

Well-versed in claimant and lawyer representation

Commended for maintaining a maximum response time within a 4-hour window;

kept detailed and systematic documentation of liability and injury claims.

Negotiated settlements within acceptable target value range objectives.

Managed a caseload of 180+ claims concurrently.

Analyzed and interpreted insurance policies, statutes, laws and

regulations.

6/06- 1/07 Senior Claims Adjuster - BRISTOL WEST INSURANCE;

Orange, CA

Investigated, evaluated, negotiated and concluded first and third party

bodily injury claims, including verification of coverage.

Managed a caseload of 180+ non-standard claims concurrently.

Determined legal liability and extent of damages to persons and property.

Worked with attorneys in litigation defense.

Examined claims submitted by insured and/or third parties, or those

referred by other claim units, to determine whether additional or

specialized investigation was necessary for claim resolution.

Maintained a diary system in order to process and close claims in a timely

manner.

4/02- 5/06 Claims Representative - NATIONWIDE INSURANCE;

RICHMOND, VA

Investigated automobile insurance liability claims involving bodily injury

and/or property damage.

Managed workflow and exceeded company goals consistently for claims

pending and file quality, while providing excellent customer service.

Determined the exposure to the company under the governing insurance

policy.

Established coverage and policy limits available for each loss.

Negotiated bodily injury and property damage settlements with insured

parties, third parties, medical providers, and claimant attorneys.

Interviewed and obtained statements from all involved parties and

witnesses.

Determined the liability exposure to the company by interpreting

applicable statutes and case law.

Resolved any coverage and liability issues.

Investigated for possible rate evasion and material misrepresentation.

Education Master Business Administration (MBA) - Averett University,

Richmond VA

B.S., Business Administration - California State University, Long Beach

Computer Skills Proficient in PAC, Siebel and Advanced Claim Systems; ODS

and TCEPS accounting systems; Sharepoint; Window XP/Vista, Microsoft

Office 2010 (Word, Excel, PowerPoint, Access and Outlook)

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