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Customer Service Claims Processor

Location:
Vancouver, WA, 98684
Posted:
October 31, 2022

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Resume:

DONYETTA GREEN

LICENSED ADJUSTER/AGENT

CONTACT ME AT:

Vancouver, WA 98684

470-***-****

ads9tv@r.postjobfree.com

SKILLS & QUALITIES:

Business Development Performance Management Value-Added Selling

Business Growth and Retention Profit and Loss Analysis

Goals and Performance

Consultative and Relationship Selling Deal Closing

Market and Competitive Analysis Sales Presentations

New Account Development Solution Selling

Staff Evaluation

Staff Development Strategic Planning Sales Tracking

Sales Leadership Multi-Tasking Ability Self-Motivated

Administrative Management Innovative & Motivating

Client Relationship Management Excellent Interpersonal Skills Organization Skills

Brand Awareness

Creative Problem Solver Flexibility and Adapting Skills Customer Service Skills

Calm Under Pressure Event Logistics

Time Management Detail-Oriented Project Management Report Generation

Data Analysis

Business Operations Hiring and Training Proficient in Microsoft Office

REFERENCES:

Reference available on request.

ABOUT ME:

Extremely well-organized and hardworking with years of experience in Claims Adjustment, Sales, and Marketing management. A talented and results-producing marketing leader with a record of accomplishment in planning, developing and executing high-performing marketing strategies that deliver on business goals and objectives. Expert at creating/capitalizing on networks, liaisons, and business connections that maximize profitability. Well-versed in all aspects of new business development and client engagement, with a keen capacity for executing effective, data-driven, targeted marketing & sales campaigns that deliver tangible results for both company and client. Capable of handling multiple projects simultaneously with a high degree of accuracy. Completed adjuster licensing and have taken a Xactimate course to enhance my skill set. I have hands-on expertise in processing and investigating claims, interviewing policyholders and witnesses, assessing property damage, and verifying policy coverage.

ACADEMIC HISTORY:

M.S. MANAGEMENT

Troy State University, Augusta, Georgia 12/2004

B.A. SOCIOLOGY

Paine College, Augusta, Georgia 05/2002

HIGHLIGHTS:

Management: An outstanding work ethic and management ability in both team-oriented and self- directed environments.

Communication: Ability to develop a strong, productive, and enjoyable working relationship with clients and colleagues.

Claims Adjustment: Experienced in specialized claim handling, policy interpretation, damage assessment, legal issues, adjustment documentation, and evaluation of cases.

Negotiation: Ability to hold discussions with people in order to reach positions of mutual satisfaction and agreement.

Leadership: Developed a strong team that successfully supports the culture and personal goals. Customer Service: Possess an unwavering commitment to customer service, with the ability to learn new skills quickly, resolve complex issues, and win customer loyalty.

Decision Making: Ability to identify data, gather information, and then choose the best option with less than perfect information.

CAREER HISTORY:

LICENSED SALES AGENT

The Hartford 08/2022 - Present

Design and implement effective marketing strategies to sell new insurance contracts or adjust existing ones.

Contact potential clients and create rapport by networking, cold calling, using referrals, etc. Appraise the wishes and demands of business or individual customers and sell suitable protection plans.

Collect information from clients on their risk profiles in order to offer them the proper solution. Prepare reports to shareholders on the success of your business endeavors.

Retain continuous awareness of transactions, sales, and terms and keep relative records. Check insurance claims to solidify trust and safeguard the reputation.

Frequently replenish job-specific knowledge and apply it in the field. Fulfill all company-established policy obligations.

Identify, qualify, and develop insurance opportunities and prospective clients.

Foster and maintain excellent relationships with clients and prospects through regular follow-up, accurate and timely quotations, and general account support.

Obtain the best coverage for the insured, process quotes, and bind insurance coverage; follow up as necessary with inspection, photos, and other documentation. Present policies to insured and educate them on coverages and rates.

Support and prepare clients for renewal and retention.

LICENSED INBOUND SALES AGENT

Allstate Insurance Remote 01/2021 – 04/2022

Answer 30-40 inbound calls per day and provide recommendations on auto, home, PUP, boat etc. products.

Provide coverage option information to assist clients in protecting assets across different lines and companies.

Utilize advanced sales skills to overcome objections, persuade clients to purchase policies, and close deals.

Promote insurance products using upselling and other sales strategies.

Develop sales leads from direct referrals, networking, and targeted marketing campaigns. Exceed corporate quotas for monthly policy sales.

Assist with customer service requests: policy changes, billing questions, and claims help. Work in an efficient manner while writing quality business.

Check for daily guideline updates to stay within company/state compliance and regulations.

Utilize outbound calling to prospective customers and local companies to generate more business for Agency.

Provide consultative advisement and education to callers based on their current and/or future needs.

Engage customers throughout the call and quickly enter customer information into quoting system.

AUTO ADJUSTER

Travelers Insurance Alpharetta, GA 01/2019 - 08/2020

Holistically managed 4-6 new claims per day.

Investigated and assessed damages to any covered property.

Investigated, evaluated, negotiated and adjusted auto claims to confirm coverage, determine legal liability, and equitably settle/defend in compliance with all state regulatory requirements.

Built rapport and trust with each member via phone and email; identified, understood and interpreted customer needs to implement resolutions, and processed all claim-related transactions accurately and within established time standards.

Investigated claims, analyzed individual state auto insurance contracts, negotiated settlements with customers and lien-holders, and effectively communicated policies and procedures, and initiated appropriate action to ensure timely resolution.

Resolved claims-related problems and grievances by compassionately and promptly taking members' and claimants' escalation calls, and escalating calls as needed to ensure resolution.

Collaborated with vendors and third-party administrators to research, mitigate and resolve discrepancies, member concerns, issues, and complaints.

Documented all status calls and emails thoroughly, accurately, and concisely; and wrote official state communications (i.e., denial and coverage letters) as needed. Produced results by meeting all metrics consistently and have received multiple manager commendations for providing excellent customer service.

INSIDE PROPERTY ADJUSTER

QA Claims (Hurricane Florence and Michael), Atlanta, GA 09/2018 - 10/2018

Inspected claim damages and situations using internal and external resources. Inspection steps included speaking with the insured and/or other involved parties such as contractors, requesting and receiving a field investigation report, research on past claim activity, research on external websites for CAT event confirmation, and engaging vendors for services, material supply and/or pricing.

Verified policy coverage through evaluating investigation data and policy terms, including claim approval or denial. After reserve levels were set at the beginning of claim handling/adjustments, then communicated with policyholder of coverage and/or any issues.

Identified and processed claims as needed for subrogation

Maintained accurate and current claim file documentation and communication throughout the life cycle of claim case.

Alerted underwriting, marketing and/or risk management regarding questionable risks encountered to ensure potential hazards were clearly documented.

Reviewed recommendations for causation, approval / denial made by Independent Adjusters to determine whether to approve / deny the claim. Approves recommendations for reserve and settlement/payment schedule amounts.

PROPERTY FILE EXAMINER

Ryze (Remote Assignment: Hurricane Irma) 10/2017 - 11/2017

Reviewed 20+ claims per day including coverage verification, investigation, evaluation, and disposition of the claim. Provided oversight of first- and third-party property claims of up to $50,000.

Assisted with closing 5000 claims in a 30-day period with accuracy and proficiency.

Examined various types of claims including homeowners, commercial, inland marine, condominium/cooperative, and valuable articles for high-profile clients. Set proper reserves, negotiated settlements, confirmed the validity of all claims for payment, set timely follow-ups, and managed claims inventory.

Reviewed policies to determine appropriate levels of coverage and assisted with approval or denial decisions.

Delivered exceptional customer service to all clients by effectively communicating information and actively listening to concerns. Demonstrated leadership by making improvements to work processes and helping to train others.

Analyzed case facts and monitored activity in order to identify possible fraudulent activities.

DESK ADJUSTER

Worley Catastrophe (Hurricane Harvey and Irma), Atlanta, GA 09/2017 - 10/2017

Utilized leadership skills to train over 35 adjusters in preparation for major catastrophes.

Contacted affected policyholders within 24 hours instead of 48 hours (standard initial contact). Effectively managed a high volume of claims, phone calls, and paperwork during major catastrophes. Researched and documented causes of loss and communicated investigated information to the insured. Created, reviewed and approved estimates for the repair/replacement cost of the damaged property.

Met company goals such as initial contact within 24 hours, closing necessary claims during claim inventory, etc. Explained policy coverage and assisted policyholders with itemization of damages during the claims process. Identified suspicious claims and investigated questionable and possible fraudulent activities.

Aided new hires in becoming more effective claims representatives by coordinating with system (ECS) training during onboarding. Developed and maintained trusting working relationships with insured to gain facts of loss during claim process.

Maintained compliance with legal, statutory and service standards.

CLAIMS ADJUSTER

State Farm, Dunwoody, Georgia 05/2017 - 09/2017

Identified and saved over $50+k in subrogation claims within the first 60 days of being hired. Provided excellent customer service for policyholders and agents for State Farm Insurance.

Effectively and efficiently wrote estimates and ensure the policyholder understands the policy coverage for property and auto field. Interviewed agents and claimants to correct errors or omissions and investigate questionable claims.

Examined claims forms and other records to determine insurance coverage.

Established productive working relationships with public officials and law enforcement officers. Reviewed and analyzed suspicious and potentially fraudulent insurance claims.

Followed up with insured individuals regarding premium and deductibles payments.

Negotiate settlements with policyholders, approve payments and close the claim for property and auto field. Validate/Settle claims according to company practices and procedures.

Compiled computer-generated estimates while ensuring strict adherence to all jurisdictional claim practices.

CLAIMS PROCESSOR

Arise Virtual Solutions, (Remote Assignment) SEP 2009 - MAY 2017

Received incoming calls from policyholders to start a new claim.

Supported claim adjusters in managing automobile and property claims.

Provided independent decision-making skills for investigating and determining causes of loss and damage extent. Researched, analyzed, and managed claims according to state guidelines and coverage.

Identified fraudulent claim schemes, saving the company thousands in wrongful and/or overpayment. Administered payments to third-party vendors, policyholders and to claimant (when necessary).



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