Customer Service Claims Specialist
Resume:
Gloria Bryfogle
Austin, TX *****
**************@*****.***
SUMMARY
Current **-*** ***** *******, ******* Number. Dedicated, professional, skilled and builds strong relationships with fellow co-workers. Also, interested in working remote.
RELATED SKILLS
Claims handling management * High priority projects
Risk management & mitigation * Policy interpretation
Damage assessment * Word, Office 354, OnBase Excel
Evaluation of liability exposure * Processed salvage/subrogation
Identified subrogation/recovery * Self motivated, dependable, organized
Catastrophic claims * Bi-lingual - Spanish read/write
Ability to work with all employees * Ability to work without supervision
EXPERIENCE
10-10-19 to 3-30-20 End of contract. Pharmacists Mutual Insurance Company.
Claims Specialist - Duties include, but not limited to the following. Investigate, evaluate, reserve, negotiate and resolve assigned claims in accordance with Company guidelines. Provides timely, professional claim handling and excellent customer service.
1-2008 to 07-2017 - Texas Association of Counties - APD/AL Claims Specialist. Managed claims for 219 Texas Counties. All Members/Insured were Governmental related. Investigated and processed various lines of coverage (APD, AL, GL) claims Responsible for managing a third party administrator (TPA) to oversee a block of claims on various lines of business. Responsible to assist the clerical staff, claimants, vendors, field service representatives and underwriting with coverage scenarios/issues, etc. Made approval or denial decisions and negotiate settlements with claimants in accordance with provisions. Acted as liaison to Members, who were Governmental entities (254 Texas Counties). Collaborate with third party carriers, interview claimants, statements for confirmation of facts, rectify omissions and investigate questionable issues, etc. Excelled on subrogation recoveries. During my employment, I received 3 perfect audits out of 3 audits completed. Handled on average of 200-425 claims. Took pride in providing excellent customer service.
1-1992 to 04-2007 - Texas Property & Casualty Ins. Guaranty Assoc. Litigation Specialist. Responsible for handling different lines of business. About 75% of assigned claims were in litigation. Prepared claims for mediation/trial. These included settlement, salvage, subrogation, retained defense counsel. Provided periodic current status of claims/cases to insured.
5-89 to 12-1991 - JI Specialty Services - Claims Adjuster. Responsible for handling files assignment from beginning to closure. All insureds were
Governmental related. Claims were automobile, auto liability, general liability, errors & omission claims and litigation as well. Handled claims from beginning to closure.
EDUCATION
Canterbury Christ Church University - Bachelor of Arts; Liberal Arts; Minor in Spanish
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