Claims Representative

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Carmelle A. Philippe 5 Nelson Place, Norwich CT 06360 C: 860-334-8723 H: 860-889-1830 [email protected] Professional Profile I am an experienced licensed professional with an outstanding academic record an d excellent customer service skills seeking a challenging and rewarding career. * Excellent internal and external communication skills. * Knowledge of insurance & claim concepts. * Effectively prioritize and multitask. * Possess State of Connecticut Medication Administration Certification. * Licensed Connecticut Property & Casualty claims adjuster and Producer. * Processed and audited medical bills prior to authorizing payment to medical pr oviders. * Solid negotiation and customer service skills. * Outstanding organizational and time management skills. * Proficient in the use of computer programs. * Excel in a fast paced and challenging work environment. * I possess a four year degree plus have the ability to handle multiple prioriti es in a fast paced environment. * I successfully completed customer service training and possess exceptional com munication, negotiation & organizational skills. Professional Accomplishments Insurance Sales * Provided excellent customer service to prospects and policyholders. * Executed professional selling process. * Acquired Producers Property, Casualty & Life licenses. * Utilized highly effective communication, negotiation and persuasive skills whe n prospecting. * Created marketing plans for new and existing business clients. * Applied underwriting guidelines during quoting and throughout sales process. Claims Representative * Handled all out of state automobile injury claims. * Successfully completed communications, customer service courses and medical ma nagement review workshop series. * Investigated, evaluated, negotiated and resolved claims. * Conducted thorough coverage, liability, injury and medical investigations. * Interpreted medical reports and audited medical bills. * Set and maintained appropriate claim & expense reserves. * Complied with specific state regulations. * Acquired Property and Casualty Claims Adjuster's License * Extensive and formal training in GL, BI and PD Claims Adjuster * Handled No Fault, Bodily Injury and 1st/3rd Party Auto Property Damage claims. * Assisted Underwriting Department in collecting proper premiums from policyhold ers by detecting coverage problems and obtaining pertinent policy information. * Handled arbitrations, suits and reverse subrogation. * Responded to inquiries from New York State Insurance Department, American Arbi tration Association and conciliation Unit (ADR). Residential Instructor * Assist members with participation in residential, recovery oriented activities , recreational, social and community events. * Aid members in performing daily living skills and meeting daily living needs s uch as shopping, laundry, housekeeping, transportation, etc. * Document interactions in the Programs Communication Log. * Provide emotional support to clients. * Provide crisis intervention supports per direction of case manager. * Monitor client's emotional, physical and mental health and report relevant inf ormation to the Case Manager. Employment Specialist (Job Coach)

* Work with individuals with intellectual, physical and emotional disabilities i n a supported employment program, employment center and modules area. * Duties include but not limited to skill training, meeting quality control expe ctations of management and/or behavior management. * Supervision of program participants, paperwork(weekly/monthly) Work History Employment Specialist CW Resources Inc. 2010-Present Residential Instructor NERS Inc. Claims Representative The Hartford Insurance Group 2007-2009 Insurance Sales Rep. Liberty Mutual Insurance 2005-2006 Claims Specialist II 2002-2003 Sr. Claims Adjuster 2000-2002 Claims Adjuster 1998-1999

2009-2010

Maryland Automobile Insurance Fund New York City Transit-MTA American Transit Insurance Company

Education B.S. in Business Management, GPA 3.8 The College of Staten Island, Staten Island, NY 1996 A.A.S. in Business Administration, GPA 3.6 Kingsborough Community College, Brooklyn, NY 1995 Relevant academic honor- Dean's List References are available upon request.

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