Michelle Neal
Mesa
Summary
Dynamic Express Claims Associate at State Farm with a proven track record in claims processing and exceptional customer service. Adept at policy interpretation and documentation review, I consistently improved customer satisfaction and resolved complex claims efficiently. Recognized for my attention to detail and problem-solving abilities, I thrive in high-pressure environments.
Overview
20
20
years of professional experience
Work History
Express Claims Associate
State Farm
09.2023 - Current
- Provided exceptional support during periods of high-volume workloads without compromising quality standards or deadlines.
- Reviewed policy documents carefully to make accurate determinations regarding coverage eligibility for each claim.
- Enhanced customer satisfaction by promptly addressing and resolving claim issues.
- Maintained strong working relationships with policyholders, improving overall communication during the claims process.
- Consistently met or exceeded performance metrics, demonstrating dedication to excellence in the role of Express Claims Associate.
- Ensured compliance with legal requirements, state regulations, and internal guidelines throughout the claims process.
- Coordinated with external partners such as appraisers, adjusters, and attorneys when needed for complex claims resolution.
- Handled escalated customer complaints professionally, ensuring satisfactory outcomes whenever possible through effective communication skills.
- Liaised between policyholders and third-party providers for efficient coordination of services during the claims process.
- Managed high volume of claim files, prioritizing tasks for timely completion.
- Followed up with customers on unresolved issues.
- Verified client information by analyzing existing evidence on file.
- Posted payments to accounts and maintained records.
Case Manager
Epiq Contact Center
07.2023 - 09.2023
- Maintained accurate documentation on all cases, ensuring compliance with regulations and confidentiality requirements.
- Conducted thorough assessments of clients'' situations, identifying issues, goals, and necessary interventions.
- Monitored ongoing cases closely, adjusting case management strategies as needed based on evolving circumstances or new information.
- Educated clients on available programs, benefits, and services, empowering them to make informed decisions about their care needs.
Customer Relations Specialist
Vanguard
03.2023 - 07.2023
- Improved customer satisfaction by addressing concerns promptly and providing effective solutions.
- Conducted regular performance reviews for continuous improvement in customer service delivery.
- Led a team responsible for addressing escalated complaints, resulting in higher resolution rates.
- Analyzed customer feedback and implemented strategies to improve customer experience.
- Maintained accurate records of client interactions, tracking progress towards resolution and identifying trends for process improvements.
- Logged call information and solutions provided into internal database.
- Managed high-volume call center, maintaining professionalism and exceptional quality of support.
Case Manager
Transperfect
11.2022 - 02.2023
- Maintained accurate documentation on all cases, ensuring compliance with regulations and confidentiality requirements.
- Conducted thorough assessments of clients'' situations, identifying issues, goals, and necessary interventions.
- Educated clients on available programs, benefits, and services, empowering them to make informed decisions about their care needs.
- Achieved positive client outcomes by developing and implementing comprehensive case management plans.
- Contributed to team discussions and case conferences actively, sharing insights and expertise with colleagues to optimize client support strategies.
Fraud and Claims Advocate
Wells Fargo
05.2022 - 11.2022
- Identified opportunities for process improvements, leading to reduced errors in claim submissions.
- Advised internal teams on proper documentation procedures, reducing instances of missing or incomplete information that could delay claim resolution times.
- Reduced customer complaints by providing timely and accurate updates on claim status.
- Collaborated with various departments for efficient claims processing, resulting in quicker resolutions for clients.
- Managed sensitive client information with strict confidentiality, adhering to data protection laws and guidelines at all times.
- Provided exceptional customer service to clients during stressful situations, earning positive feedback from satisfied customers.
- Improved claim resolution times by streamlining the claims process and prioritizing high-priority cases.
- Followed up with customers on unresolved issues.
Case Manager Specialist
Transperfect
09.2021 - 05.2022
- Maintained current knowledge of industry best practices and relevant legislation affecting service delivery, ensuring that all client interventions were evidence-based and compliant with applicable guidelines.
- Assisted clients in navigating complex healthcare systems by providing guidance on insurance coverage options, connecting them with appropriate medical providers, and helping them understand available treatment modalities.
- Trained new team members on best practices in case management, contributing to a consistent quality of care across the organization.
- Evaluated program effectiveness through ongoing monitoring and analysis of key performance indicators, driving continuous improvement efforts within the organization.
- Developed strong relationships with community partners, leading to increased availability of resources for clients in need.
Customer Service Cashier
Circle K Convenience Store
08.2018 - 07.2021
- Maintained a clean and organized workspace, promoting a welcoming environment for customers.
- Handled high-pressure situations calmly, maintaining composure during busy periods or difficult interactions.
- Actively listened to customers, handled concerns quickly and escalated major issues to supervisor.
- Processed customer orders and accurately handled payment transactions.
- Resolved customer complaints with professionalism and empathy, resulting in increased customer loyalty.
- Resolved customer complaints and maintained clean and tidy checkout area.
- Counted money in drawers at beginning and end of each shift.
Case Manager Specialist
TransPerfect Connect
07.2016 - 08.2019
- Evaluated program effectiveness through ongoing monitoring and analysis of key performance indicators, driving continuous improvement efforts within the organization.
- Coordinated appropriate referrals to external agencies based on thorough assessment of client needs and goals.
- Managed high caseloads efficiently, prioritizing cases based on urgency and need.
- Conducted detailed assessments of clients'' needs, strengths, and barriers, ensuring appropriate resource allocation.
Customer Service Supervisor
DIRECTV
09.2005 - 05.2016
- Promoted a positive work environment through open communication channels, fostering team collaboration and high morale.
- Collaborated with other departments to address recurring customer concerns, improving overall service quality.
- Coached employees through day-to-day work and complex problems.
- Improved customer satisfaction by addressing and resolving escalated issues promptly and professionally.
- Enhanced team productivity through regular coaching, feedback, and performance evaluations.
- Demonstrated exceptional problem-solving abilities in navigating challenging customer scenarios and finding solutions that met their needs as well as aligned with company policies.
- Managed escalated calls with diplomacy, successfully deescalating situations while ensuring satisfactory resolutions for both parties involved.
- Coached team members to deliver hospitable, professional service while adhering to set service models.
- Responded to customer inquiries and resolved complaints to establish trust and increase satisfaction.
- Actively supported service associates by quickly responding to questions via phone and email and finding appropriate solutions to customer issues.
- Evaluated individual performance metrics to identify areas of improvement, providing targeted coaching to boost results.
- Developed comprehensive training materials for new hires, ensuring consistent knowledge and skill development across the team.
Education
Bachelor of Science - Criminal Justice
University of Phoenix
Tempe, AZ07-2014
Associate of Arts - Animation And Special Effects
Collin’s College
Tempe, AZ06-2002
Skills
- Claims processing
- Microsoft office
- Policy interpretation
- Insurance claims review
- Time management
- Decision-making
- Documentation review
- Coverage determination
- Data analysis
- Coverage assessments
- Accident investigations
- Documentation research
- Accident review
- Customer service
- Attention to detail
- Problem-solving abilities
- Multitasking
- Reliability
- Excellent communication
Pro at Kahoot- Creating
Kahoot is a large part of many different companies for training. I have learned how to adapt to my new roles and interpret Kahoot in the training material to make sure that the new class is understanding their new role.
Timeline
Express Claims Associate
State Farm
09.2023 - Current
Case Manager
Epiq Contact Center
07.2023 - 09.2023
Customer Relations Specialist
Vanguard
03.2023 - 07.2023
Case Manager
Transperfect
11.2022 - 02.2023
Fraud and Claims Advocate
Wells Fargo
05.2022 - 11.2022
Case Manager Specialist
Transperfect
09.2021 - 05.2022
Customer Service Cashier
Circle K Convenience Store
08.2018 - 07.2021
Case Manager Specialist
TransPerfect Connect
07.2016 - 08.2019
Customer Service Supervisor
DIRECTV
09.2005 - 05.2016
Bachelor of Science - Criminal Justice
University of Phoenix
Associate of Arts - Animation And Special Effects
Collin’s College
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