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Insurance / Sr. Personal Lines Claims Examiner

Location:
McKinney, Texas, United States
Salary:
68,000.00
Posted:
February 23, 2019

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Resume:

ARNETTA G. VELEZ

McKinney, TX *****

Email: ac8kwc@r.postjobfree.com

972-***-****

SKILLS OVERVIEW:

Team Lead and Point of Contact often acting as a liaison between management and clients

Critical Thinker with a strong ability to use logic and reasoning to quickly identify problems as well as provide an alternative solution

Excellent Interpersonal skills with the ability to efficiently communicate with upper management, C Suites as well as clients

Ensure legal compliance by following guidelines, company policies, state and federal insurance regulations

Well-organized, proficient in Microsoft Office, Kronos and multiple software systems

Responsible for training new employees on new system updates requirements,

company policies and procedures

Experience working in an Agile environment particularly within the catastrophe

insurance claim arena

Able to work independently taking initiative on new projects or multi-task working in a

team environment delegating task while exhibiting quality technical acumen and analytical skills

Expertise in providing seamless insurance claim support and customer service

Attention to detail with the ability to carefully investigate situations and provide exceptional solutions while successfully multitasking

EMPLOYMENT HISTORY:

Kohl’s Corporation (Jan 2018 – Present)

Customer Collections Advocate

Routinely take ownership and create a solid experience by efficiently resolving sensitive issues regarding customer’s accounts

Assist individuals/customer with distressed accounts, payments, account information and updates

Support first contact resolution by connecting patterns to improve consistency and efficiency

Solve multi-faceted issues using business and product knowledge as well as best practices

Provide resolutions for customer accounts that are within 60 days of delinquency

Assist store associate calls regarding account information, potential fraud activity/

reporting/investigation

Ask targeted questions to diagnose the root cause of complex issues and quickly identify solutions that best fit the diagnosis of the situation

Certified Life Coach & Insurance Consultant (Oct 2015- Present)

Corporate and Independent Life Coach providing both individual and group empowerment sessions

Insurance SME providing Continuing Education via Lunch and Learns to help teams build better processes to thrive in a fast-paced environment

Reliable point of contact assisting insurance companies with 1st and 3rd Party investigations, written as well as recorded statements

Insurance Policy Q & A

Provide contracted sourcing & recruitment to both Insurance agencies providing quality candidates both licensed and unlicensed

E.A Renfroe (Nov 2012 – July 2016)

Sr. Loss Control Specialist

Client: State Farm Insurance

Gathered required documents pertaining to auto claims as well as prepared required documents as they related to the respective party, or insurance company.

Worked in a fast pace Agile environment delivery quality results.

Efficiently explained coverages as well as repair options to customers

Coordinated rentals, managed settlement accordingly as well as managed and salvaged recoveries

Initiated subrogation

Seamlessly coordinated vehicle inspections & determined liability

Communicated effectively with repair facilities to coordinate supplements when necessary

Obtained titling documentation

Acted as a liaison for adjusters between policyholders, third parties, attorneys, body shops and vendors

Used an analytical and methodical approach to successfully close out claims – reducing any errors or possible discrepancies.

Administered daily correspondence and reports regarding payments to be issued

Amica Mutual Auto Insurance (Jan 2009 to Nov 2012)

Insurance Claims Examiner II

Selected and issued appropriate acknowledgement letters & submitted claims payment requests within a timely manner

Opened and closed files via the Electronic Claim File System (ECF)

Responsible for investigating and settling first and third party auto and homeowner losses

Detail oriented, providing updates to litigation teams, upper management, customers regarding claims information & payments.

GAINSCO Auto Insurance (June 2006 to Dec 2007)

Trainer & Bodily Injury Insurance Investigator

Successfully communicated with co-workers, management customers, vendors, and others in a courteous and professional manner

Excellent negotiation skills with the ability to gather and analyze information to evaluate results and chose the best solution to resolve injury investigation and customer complaints

Ensured legal compliance by following guidelines, company policies as well as state and federal insurance regulations

Kemper Auto and Home Insurance (Jan 2000 to June 2006)

General Liability Specialist /Team Lead

Maintained a Property and Casualty Insurance License with the State of Texas & Oklahoma

Compiled information to negotiate and execute settlement offers within a timely manner involving auto loss claims for property damage and bodily injury losses

Incorporate time management skills within daily work schedule to perform task in a

Used and have working knowledge of ADP program, used to settle auto losses and repairs, along with information obtained from NADA program

Overall Knowledge of the ICD9 medical coding program to assist in determining fair cost on medical billing

EDUCATION / CERTIFICATIONS / LICENSES:

University of Phoenix

Associate degree - Human Service Management

Coaching:

Quantum Success Coaching Academy (QSCA_

Life Coach Institute of Orange County

Certified Professional & Life Coach

Licenses:

Texas All-Lines Insurance License

Oklahoma P&C Adjusters License

Louisiana P&C Adjusters License

New York P&C Adjusters License

Georgia P&C Adjusters License

Wyoming P&C Adjusters License

Kansas P&C Adjusters License

Alaska P&C Adjusters License



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