Insurance Customer Service

Letha E. Lombardi

*** ****** ****** ***** ( Durham, NC 27713

919-***-**** (Home) 919-***-**** (Mobile)

ablejd@r.postjobfree.com

Objective

OPERATIONS POSITION THAT WILL UTILIZE MY LEADERSHIP, ORGANIZATIONAL,

ANALYTICAL, AND PROBLEM SOLVING SKILLS TO ENHANCE AN ORGANIZATION'S

EFFICIENCY AND CONTRIBUTE TO ITS SUCCESS.

Qualifications & Skills

. EXCELLENT WRITTEN & VERBAL COMMUNICATIONS SKILLS

. Excellent organizational and problem solving skills

. Extensive customer support and office management experience

. Proficient with computers and Microsoft Office software

. Hardworking, dependable, energetic, adaptable, quick learner

. Ability to resolve disputes and negotiate fair resolutions involving

complex situations

Professional Experience

North Carolina Department of Insurance - Raleigh, NC August, 2007 to

Present

MARKET REGULATION ANALYST I

Conduct market examinations of personal / commercial lines of property and

casualty insurance companies doing business in NC.

. Investigate insurance companies to determine compliance with

underwriting criteria, consistency, rate accuracy, compliance with

policy provisions, NC statutes and rules with regards to new business

and policy terminations.

. Review claims practices to determine compliance with claim handling

manuals, policy provisions, NC statutes and rules.

. Developed new Workers Compensation claim examination standards.

. Present oral and written reports regarding all examination findings.

. Provide / prepare spreadsheet analysis and reports of examination

findings

. Recommend refunds to consumers regarding errors found during

examinations.

. Market Regulation Teams recovered $979,279 in underpayments for over

53,000 NC consumers in calendar year 2009.

Lee-Moore Insurance Agency - Carrboro, NC January, 2001 to August, 2007

LICENSED PROPERTY AND CASUALTY AGENT

Responsible for the day-to-day operations of a small independent insurance

agency.

. Quote, evaluate, process new lines of property and casualty insurance

for personal and commercial customers.

. Provide customer service support regarding all aspects of insurance

transactions including billing disputes, claims concerns and rating of

new and renewal insurance policies.

. Respond to changing insurance needs of individuals and businesses.

. Learn and adapt to rating programs of dozens of insurance companies.

. Annually obtain 12 hours of continuing education hours.

Reliance Insurance Company - Durham, NC August,1994 to November, 2000

RELIANCE INSURANCE COMPANY - COLUMBIA, MD JULY, 1984 TO AUGUST, 1994

REGIONAL CLAIMS EXAMINER

Held various claims positions from trainee to regional claims examiner in

the workers' compensation and commercial property lines of business.

. Licensed to adjudicate and investigate workers compensation and

commercial property claims in a multi-state area.

. Managed and maintained a large case load of claims; at times in excess

of 130.

. Demonstrated thorough knowledge of state laws governing the

adjudication of claims including fatalities.

. Interacted on a daily basis with defense and claimant attorneys as

well as medical professionals including physicians and nurses.

. Developed trusting relationships with injured workers and employers to

facilitate a favorable outcome for all parties.

. Trained employees on case law, company best practices including

negotiation skills, time management, case reporting and documentation.

. Helped to train employees on new software programs implemented by the

company to enhance claims adjusting.

. Held financial authority to settle complex workers compensation

claims.

. Reviewed and evaluated new and existing state statutes involving

workers compensation law and commercial property insurance.

. Annually performed audits of claim files to insure compliance with

state laws and company guidelines to determine if each claim was

settled and closed fairly and accurately.

. Assigned and evaluated cases for expert opinions including accident

analysis, second opinions on medical issues, legal review, and fraud

analysis.

Blue Cross and Blue Shield SW Virginia - Roanoke, VA July, 1983 to

July, 1984

MULTI-STATE MEDICAL CLAIMS PROCESSOR

Education & Training

Bachelor of Science: Business Administration, Management Major (1983)

Virginia Polytechnic Institute & State University

Virginia Tech - Blacksburg, VA

Professional Certifications

. Associate in Claims; Insurance Institute of America

. Licensed Property and Casualty Insurance Agent; NC Department of

Insurance

. Licensed Property and Casualty Insurance Adjuster: NC Department of

Insurance

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