Customer Service Complex Claims

John Foster

***********@*****.*** 678-***-**** Lithonia, GA 30058

Summary

Investigates,evaluates, disposes and settles less complex claims with moderate supervision and includes the investigation, determination and evaluation of coverage,liability and damages and the setting of proper reserves. Incumbents at this level typically hold claims reserve. Exercises proper judgment and decision making to analyze the claims exposure to determine the proper course of action and to appropriately settle the claim. Interacts extensively with various parties involved in the claim process. Handles claims consistent with clients and corporate policies, procedure and "best practices" and also in accordance with any statutory,regulatatory and ethics requirements. Documents and communicates all claim activity timely and effectively and in a manner which support the outcome of the claim file incumbents at this level should be able to work at full case load capacity.

Skills

•Strong written,verbal and interpersonal communication skills.

•Ability to apply policy,law and regulations to ensure proper resolution of claims.

•Strong analytical skills along with high competence in the following:critical thinking,customer focus,quality, Resourcesfulness, Technical/Functional Expertise

•Ability to think critically, solve problems, plan and organize activities,serve clients, negotiate,effectively communicate verbally and in writing and embrace new challenges.

Experience

State Farm Mutual Automobile Insurance Company Dunwoody, GA

Insurance Claims Representative

10/2017 - Current

• Delivered quality customer service to assigned, insured and claimants throughout entire claims lifecycle to promote effective service times for all parties.

• Managed asset recoveries for claims, including salvage and subrogation.

• Verified details with policyholders and requested additional information.

• Processed high volumes of bodily injury claims efficiently while working in fast-paced environment.

• Prioritized and organized tasks to efficiently accomplish service goals.

• Investigated and compared insurance policies, including fire, homeowners, personal line, liability and commercial coverage.

• Examined automobile policies such as government automobile insurance plans with third-party liability, accident benefits and collision benefits.

Computer Generated Solutions Inc. Dunwoody, GA

Technical Support / Direct Resolution Owner

02/2014 - 10/2017

• Delivered local and remote Tier 1 IT support for hardware and software to company personnel.

• Conferred with vendors to obtain replacement hardware or software and escalate more complex concerns.

• Maintained composure and patience in face of difficult customer situations, applying de-escalation techniques and positive customer support.

• Kept customers informed about issue resolution progress and provided updated estimated times of resolution on ongoing basis.

• Assisted customers with various types of technical issues via email, live chat and telephone.

• Supported customers having data connectivity issues, assisting with troubleshooting steps and rebooting of hardware.

• Troubleshot daily IT desktop client issues, supporting multiple departments and various offices.

• Boosted sales through customer education, competitor knowledge and strategic upselling techniques.

Bagcraft Papercon Norcross, GA

Warehouse Associate

12/2012 - 08/2013

• Utilized pallet jacks to move items to and from different warehouse locations.

• Moved boxes, containers and pallets with special-purpose equipment to meet demanding production targets.

• Noted current product inventory levels to support completion of order requests and audits.

• Unloaded cargo with mechanized equipment to enable receipt of pre-ordered inventory.

• Positioned products between receiving, storage and shipping areas as part of just in time inventory supply for major manufacturers.

• Monitored work areas for cleanliness and functionality and removed obstacles to promote safe work environment.

• Picked and prepared numerous daily shipments in large warehouse environment to facilitate customer order fulfillment.

• Recognized defective material and reported issues to management to facilitate prompt resolution.

• Identified safety hazards and notified management to determine proper resolution of issues.

Education and Training

Georgia Perimeter College Decatur, GA

Harrisburg Area Community College Harrisburg, PA

General Studies

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