Customer Service Team Leader
Resume:
Crystal Lloyd
Ocean Springs, MS *****
****************@******.***
Experienced professional with over 10 years of experience in the medical and insurance industry. Has a demonstrated track record of success working with diverse client populations in one-on-one or group settings. Innate ability to establish rapport quickly, build trust, interact with and relate to individuals on all levels. Superior leadership skills proven in the facilitation of staff development and group trainings. Educational knowledge and technical skills have impacted my ability to successfully achieve results. Seeking to increase these strengths within a professional position that will enhance these career- oriented skills.
Authorized to work in the US for any employer
Work Experience
Commercial Claim Representative
Liberty Mutual Insurance
January 2023 to Present
• Determine applicable coverage based on SSI
• Review for potential risk, make recommendation based on the risk
• Negotiate settlement offers
• 50 state coverage policy review based on venue
• Team leader in KPI’s measured and viewed as a resource for team- mates with policy / liability questions
• Responsible for maintaining an extensive knowledge of policy language and coverages
• Responsible for reviewing and following up with carriers for reserve and closing amounts for claims and update the agency Claims
Reporting System
Material Damage Adjuster
NATIONAL GENERAL INSURANCE
December 2021 to January 2023
• Handles investigation regarding all aspects of advanced auto claims
(coverage, liability and damages) with the exercise discretion and independence within increased level of authority
• Applies advanced understanding of insurance policies written by the company, the industry, and organizational relationships within the company and department
• Determines subrogation or fraud potential and how to handle
• Identifies customer needs and works to meet those needs using appropriate customer service skills
• Recognizes and identifies body parts of a vehicle and understanding other potential property damage
• For claims involving injuries (if handled), learns how to review, evaluate, and negotiate basic to moderate injury claims
• Applies increased experience in the Adjuster II level or a rotation into a specialty position (Coverage, Investigation Specialist, Total Loss,
Initial Handler, Extended Handler, etc.)
Advanced Emergency Medical Technician
WILLIAMSON MEDICAL CENTER
September 2017 to June 2022
• Responsible for applying medical knowledge, terminology and interpersonal skills to stabilize and maintain patient’s well-being through compassionate care methods
• Responsible for responding to emergency calls in a rural community which involved extended transport times and immediate care for critical patients
• Responsible for responding to 911 calls for emergency medical assistance, ranging from bandaging a wound to life-saving cardiopulmonary resuscitation (CPR)
• Responsible for following guidelines that was learned in training and was received from on-the-job physicians
• Responsible for performing on the spot assessment of the patient’s condition and determined a proper course of treatment
• Responsible for using backboards and restraints to immobilize patients and secure them in the ambulance for transport
• Responsible for helping transfer patients to the emergency department of a healthcare facility and report their observations and first aid treatment to the taking-over hospital staff
• Responsible for creating a patient care report, documenting the medical care given to the patient at the scene and en-route to the hospital
• Responsible for replacing used supplies and checking or cleaning the equipment after use
• Responsible for demonstrating a willingness to adjust responsibilities to and accommodate a fast-paced work environment, maintain excellent customer service, and create teamwork with co-workers Auto Claim Representative
STATE FARM INSURANCE
May 2007 to January 2016
• Responsible for analyzing claims to determine the extent of Company’s liability
• Responsible for executing approval or denial decisions and negotiate settlements with Claimants that are in accordance with policy provisions
• Responsible for collaborating with Insurance Agents and interview Claimants to correct errors, rectify any omissions and investigate questionable issues
• Responsible for maintaining file ownership with an inventory of approximately 40 claims with revolving calendars
• Successfully settling approximately 2,500 claims per year
• Responsible for transmitting, faxing or mailing claim reports to carriers the same day notified of the loss
• Responsible for answering telephones in a professional manner while taking client and third-party claims and answered individual questions
• Responsible for contacting carriers to follow up on status of personal property claims and provided assistance with expediting claim settlements
• Responsible for responding promptly when personal property clients inquired on the status of their claims
• Responsible for following agency procedures for personal property claim processing and settlement
• Responsible for providing management with reports on personal property claims activity
• Responsible for reviewing and following up with carriers for reserve and closing amounts for claims and update the agency Claims
Reporting System
• Responsible for maintaining and recording loss history, including payment and closure of claims in the client’s records and in the
Claims Reporting System
• Responsible for building working relationships with carriers’ claims representatives and managers
• Responsible for documenting in the Claims Management System all conversations with clients and/or carriers pertaining to coverages and exposures and related documentation Medical Claims Processor
STATEFARM INSURANCE
• Responsible for supporting claims processors in processing hundreds of first party medical insurance claims
• Responsible for analyzing and determining the completion and validity of claims
• Responsible for assisting policyholders in a busy call-center environment
• Responsible for utilizing extensive claims knowledge including medical claim handling procedures and state statutes (TN, KY and
OH)
• Selected as a Team Leader to handle the highest level of Actual Call Delivery (ACD) calls
• Responsible for participating in fundamental claims training sessions to develop a stronger understanding of insurance policy structures and potential associated legal issues
• Responsible for ensuring that all reported losses were properly investigated, evaluated, coverages verified, and the claim file properly documented
• Responsible for promptly entering information in the claims software and saw that all information was kept up to date as the claim progresses, including adequate reserves
• Responsible for proactively seeking appropriate documentation and working with insureds and/or claimants to arrive at a prompt settlement of the claim and issue payment. This included explaining policy language and coverages shown on the declarations page
• Responsible for determining potential for subrogation of claims and/or salvage of property
• Responsible for maintaining an extensive knowledge of policy language and coverages Education
Bachelor of Science in Business Administration
BETHEL UNIVERSITY - McKenzie, TN
December 2011
Emergency Medical Technician IV
Motlow State Community College - McMinnville, TN
May 2001
Woodbury Grammar School
Skills
• Facilitated Auto Claims and Corrective Repair Glass Training
• Proficient in Microsoft Office, PowerPoint, Excel
• Proficient in eMedical Platform System
• CPR Certification
• Advanced Emergency Medical Technician (AEMT)
• Insurance Adjuster Licensee, Multi-State
• Negotiation
• Analysis skills
• Customer service
• Interviewing
Certifications and Licenses
First Aid Certification
AEMT Certification
CPR Certification
Property & Casualty License
Licensed in Florida
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