Elle Franklin
Tucson
Summary
Licensed, results-driven claims adjuster, excelling in claims investigation and negotiation. Demonstrated analytical skills and effective communication, achieving high customer satisfaction through empathetic service, and exceptional problem-solving skills.
Overview
5
5
years of professional experience
1
1
Certification
Work History
Claims Adjuster
AllState
TUCSON
04.2024 - 04.2025
- Prepared detailed reports on investigation findings and claim status for internal use.
- Analyzed information gathered by investigations and reported findings and recommendations.
- Delivered exceptional customer service to clients by communicating information and actively listening to concerns.
- Investigated insurance claims, reviewed coverage and liability, prepared reports and recommended payment or denial of claims.
- Conducted interviews with claimants, witnesses and medical professionals to obtain additional information about the claim.
- Researched relevant laws, regulations, legal decisions and precedents to determine appropriate course of action.
- Attended continuing education classes in order to stay abreast of changes in industry standards.
- Worked collaboratively with team members across multiple departments; identified areas where processes could be improved.
- Organized files into logical categories; maintained complete records according to established procedures.
- Maintained accurate documentation of all claim activity within designated system.
- Analyzed facts of loss including photographs, diagrams and other evidence to identify potential sources of recovery.
- Drafted statement of loss to summarize damages, payments and underlying policy coverage.
- Identified and obtained evidence to ascertain claim value.
- Interpreted insurance policy language to apply appropriate coverage.
- Communicated effectively with policyholders, providing updates and explaining claim processes.
- Investigated questionable claims to determine payment authorization.
- Analyzed and determined fault in auto accidents based on evidence and applicable laws.
- Utilized computer systems such as Microsoft Office Suite and specialized software programs used by the company.
Claims Specialist
GEICO
01.2022 - 10.2023
- Manages an inventory of claims to evaluate compensability/liability.
- Establishes action plan based on case facts, best practices, protocols, regulatory issues and available resources.
- Plans and conducts investigations of claims to confirm coverage and to determine liability, compensability and damages.
- Assesses policy coverage for submitted claims and notifies the insured of any issues; determines and establishes reserve requirements, adjusting reserves, as necessary, during the processing of the claim, refers claims to the subrogation group or Special Investigations Unit as appropriate.
- Assess actual damages associated with claims and conducts negotiations, within assigned authority limits, to settle claims.
- Performs other duties as assigned.
Retention Representative
VXI Global Solutions, LLC
02.2020 - 07.2021
- Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
- Answered customer telephone calls promptly to avoid on-hold wait times.
- Handled customer inquiries and suggestions courteously and professionally.
- Clarified customer issues and determined root cause of problems to resolve product or service complaints.
- Answered constant flow of customer calls with minimal wait times.
- Offered advice and assistance to customers, paying attention to special needs or wants.
- Participated in team meetings and training sessions to stay informed about product updates and changes.
- Processed customer service orders promptly to increase customer satisfaction.
- Actively listened to customers, handled concerns quickly and escalated major issues to supervisor.
- Responded to customer requests for products, services, and company information.
Education
BUSINESS, MANAGEMENT, MARKETING, AND RELATED SUPPORT SERVICES
Pima Community College
Tucson, AZSkills
- Customer Service
- Data Entry
- Negotiation
- Microsoft Office
- Microsoft Excel
- Windows
- Claims Management
- Analytical Skills
- Claims investigation
- Report preparation
- Liability assessment
- Claims negotiation
- Data documentation
- Effective communication
- Critical thinking
- Problem solving
- Attention to detail
- Time management
- Verbal and written communication
- Interviewing techniques
- Empathy and patience
- Automobile claims specialist
- California claims adjuster license
- Database management
- Decision-making
- Active listening
- Claims file documentation
- Multitasking and organization
Certification
- CA claims adjuster license
References
References available upon request.
Timeline
Claims Adjuster
AllState
04.2024 - 04.2025
Claims Specialist
GEICO
01.2022 - 10.2023
Retention Representative
VXI Global Solutions, LLC
02.2020 - 07.2021
BUSINESS, MANAGEMENT, MARKETING, AND RELATED SUPPORT SERVICES
Pima Community College
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