Customer Service Representative

Cheryl L. Graham

**** *. ******** ***. ***********, Illinois 62703 217-***-**** **********@*****.***

Summary of Education

University of Illinois at Springfield (UIS), Springfield, IL

Masters of Public Administration – Criminal Justice

Southern Illinois University – Edwardsville (SIU-E), Edwardsville, IL

Bachelor of Arts – Liberal Studies

Professional Training & Credentials

The Institutes – Chartered Property Casualty Underwriter (CPCU)

Associate in Claims (AIC)

American Educational Institute

Law of Claims Fraud Investigation and Defense (FCLS)

John E. Reid and Associates, Inc.

Reid Technique of Interviewing and Interrogation – Advanced Course

National Institute for Trial Advocacy – Loyola University

Expert Testimony and Arson Defenses

International Association of Arson Investigators

Fire Investigation Training – 150 hours

International Association of Special Investigative Units (IASIU)

Certified Insurance Fraud Investigator (CIFI)

Inter-Industry Conference on Auto Repair

I-CAR Certification

Tools & Technology

●Xactimate Estimating Software

●Marshall & Swift/Boeck: Symbility Estimating Software

●IntegriClaim Estimating Software

●Britecore Claim Management Systems

●Box Data Management Systems

●RingCentral Communication Software

●Microsoft Office Suite

Professional & Civic Affiliations

●International Association of Arson Investigators

●International Association of Special Investigative Units

●Central Illinois Fire Investigators Association

●Meals on Wheels

●Shadow Home

Summary of Experience

U.S Insurance Claims and Risk Management, Field and Remote 01/2021-Present

Property Claims Manager

Supervise independent adjusters and claim staff.

Vet independent adjusters and new employees, establish contracts and workflows.

Analyze coverage, prepare non-waivers and reservation of rights letters when appropriate.

Obtain recorded statements of insureds, claimants, and witnesses.

Prepare complex reports of investigations, inspections, and settlements.

Inspect commercial and residential properties for damage and underwriting.

Complete damage estimates using the Xactimate system and negotiate settlements.

Investigate, evaluate, and settle property and casualty insurance claims.

Prepare newsletters for agency.

Communicate with underwriting regarding loss frequency and increased hazards.

Apprise agency of investigations, coverage questions, settlements, and claims processes.

Christian County Probation Department, Taylorville, IL 11/2015 – 12/2020

Probation Officer

●Interview probationers regularly to evaluate their progress in accomplishing goals and maintaining the terms specified in their probation orders and rehabilitation plans.

●Recommend remedial action or initiate court action in response to noncompliance with terms of probation.

●Administer drug and alcohol tests, including random drug screens of offenders, to verify compliance with substance abuse treatment programs.

●Prepare and maintain case folders for each assigned offender.

●Conduct pre hearing and pre sentencing investigations and testify in court regarding offenders' compliance, recommended sentences and request sentencing conditions.

●Inform offenders or inmates of requirements of conditional release, such as office visits, restitution payments, or educational and employment stipulations.

●Write reports describing offenders' progress.

●Arrange for medical, mental health, or substance abuse treatment services according to individual needs or court orders.

●Supervise people on community-based sentences, such as electronically monitored home detention, and provide field supervision of probationers by conducting curfew checks or visits to home, work, or school.

●Gather information about offenders' backgrounds by talking to offenders, their families and friends, and other collateral contacts.

●Investigate alleged probation violations, using interviews, surveillance, and search and seizure.

●Participate in decisions about whether cases should go before courts.

●Identify and approve work placements for offenders with community service sentences.

Lillibridge Property Management 04/2015 – 09/2015

Commercial Property Management Administrator

●Plan, schedule, and coordinate general maintenance, major repairs, and remodeling or construction projects for commercial properties.

●Direct collection of monthly assessments, rental fees, and deposits and payment of insurance premiums, mortgage, taxes, and incurred operating expenses.

●Act as liaisons between on-site managers or tenants and owners.

●Maintain records of sales, rental or usage activity, special permits issued, maintenance and operating costs, or property availability.

●Solicit and analyze bids from contractors for repairs, renovations, and maintenance.

●Prepare and administer contracts for provision of property services, such as cleaning, maintenance, and security services.

●Investigate complaints, disturbances and violations and resolve problems, following management rules and regulations.

●Maintain contact with insurance carriers, fire and police departments, and other agencies to ensure protection and compliance with codes and regulations.

Specialty Risk of America, IL, IN 01/2013 – 10/2014

Commercial Claims Manager

●Recruit, train and supervise claims personnel.

●Investigate, evaluate, and settle claims, applying technical knowledge and human relations skills to effect fair and prompt disposal of cases and to contribute to a reduced loss ratio.

●Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies.

●Resolve complex, severe exposure claims, using high service oriented file handling.

●Pay and process claims within designated authority level.

●Examine claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments.

●Verify and analyze data used in settling claims to ensure that claims are valid and that settlements are made according to company practices and procedures.

●Enter claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation.

●Confer with legal counsel on claims requiring litigation.

●Conduct recorded statements of claimants, doctors, medical specialists, or employers to get additional information for proper assessment of damages.

●Maintain claim files, such as records of settled claims and an inventory of claims requiring detailed analysis.

●Present cases and participate in their discussion at claim committee meetings.

●Supervise claims adjusters to ensure that adjusters have followed proper methods.

●Conduct detailed bill reviews to implement sound litigation management and expense control.

●Communicate with reinsurance brokers to obtain information necessary for processing claims.

●Prepare reports to be submitted to company's executive committee.

Illinois Casualty Company, Central & Southern IL, South Metro Chicago,

Eastern IN, Southern MN, MO, IA 04/2010-01/2013

Field Claim Representative

●Responsible for fraud education and training of all field and in-house adjusters.

●Investigate, evaluate, and settle property, casualty and Dram Shop claims.

●Engage in the defense of litigated files and participate in arbitrations, mediations and courtroom testimony.

●Collect and maintain evidence in compliance with company standards and chain of custody criteria.

●Assist in the investigation and prosecution of suspected fraud cases with the NICB and local law enforcement.

●Prepare reservation of rights letters, claim committee reports and requests for authority per company and statutory requirements.

●Conduct background, financial and criminal record searches through ISO, Lexus Nexus and Westlaw.

●Complete and maintain coverage exposure reports and continually update reserve reviews.

●Respond to Department of Insurance Complaints when applicable.

Horace Mann Insurance, Springfield, IL 02/2010-04/2010 Customer Service Representative

●Confer with customers to provide information about products or services, provide premium quotes, and address complaints.

●Check to ensure that appropriate changes were made to resolve customers' problems.

●Keep records of customer interactions or transactions, recording details of inquiries, complaints, or comments, as well as actions taken.

●Resolve customers' service or billing complaints by involving the billing and/or underwriting department as needed.

●Complete insurance applications, prepare change of address records, and request policy terminations.

●Refer unresolved customer grievances to designated departments for further investigation.

●Contact customers to respond to inquiries or to notify them of claim investigation results or any planned adjustments.

●Review insurance policy terms to determine whether a particular loss is covered by insurance.

●Recommend improvements in coverages, procedures, or billing methods to prevent future problems.

State Farm Insurance, Collinsville, Springfield, Bloomington, IL

Hazelwood, MO 08/1991 – 11/2009

Senior Claim Specialist – Special Investigative Unit

Claim Specialist – Bodily Injury Unit

Medical Payment Specialist

Claim Representative – Auto Property Damage Unit

●Investigate personal lines and commercial property and casualty claims for the presence of fraud.

●Collect and maintain evidence in support of fraud investigations upholding stringent chain of custody standards.

●Conduct financial, criminal and background searches utilizing public and private databases.

●Responsible for training up to 6 claim handling units on fraud detection, fair claim practices, court room testimony, evidence collection, statement taking and proper evaluation of damages.

●Instruct law enforcement and fire personnel on the fundamentals of insurance fraud, including identification of arson for profit, staged thefts, slip and fall claims, and misrepresentations in the application and reporting process.

●Present to community and civic organizations about the impact of insurance fraud.

●Prepare and present fraud awareness programs to in excess of 100 agents and staff in compliance with Department of Insurance continuing education requirements.

●Participate in the recruitment and utilization of vendors and attorneys, including the oversight of work, billing and Legal Services protocol.

●Assist in the investigation of potential fraud claims with the NICB, local law enforcement, Office of the Inspector General, Office of State Fire Marshal, National Depository Insurance Corporation, BATF and FBI.

●Prepare investigative reports, recommendation memos, denial letters and responses to Department of Insurance complaints.

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