Whitney Estes Email and Phone Number

• Manages, investigates and resolves claims and assist in providing service to policyholders. Performs field investigation on assigned cases and make recommendations on additional work as indicated. Communicates with policyholders, witnesses, and claimants in order to gather information regarding claims and refers tasks to auxiliary resources as necessary. Responds to various written and telephone inquiries including status reports. Ensures adequacy of reserves. Confirms or denies coverage and liability and advises policyholders and claimants as to proper course of action. Makes effective use of loss management techniques (Direct Dealing; ICP; V3 checks; open end release; first call settlements). Negotiates settlements with attorneys, claimants, and/or co-defendants. Arranges for expert inspections involving third party or potential fraud actions as needed. Identifies and recommends referral of potentially fraudulent claims to the SIU. Proficient in both multiple claims operating systems and able to work off multiple platforms.

• This position I was responsible for managing a team of 6 quality assurance representatives located locally in Albany NY office as well as representative remotely in an office in Neshannock, PA. I lead the team in the completion of quality file reviews and evaluations to meet protocol and state/jurisdictional regulations. Reinforced focus on continuous improvement of claims process and workflows. Based on evaluation and trend analysis, determined any technical / customer service training needs and provided high level feedback to management teams

• Conducted claim file reviews and evaluated end to end claims process including coverage/policy interpretation, liability/negotiation and adherence to all claims protocols and state/jurisdictional regulations. Monitored live or recorded conversations with Policyholders and Claimants. Evaluated content of calls against predefined best practices including customer service, communication skills, evaluation process, etc. Coached and provided feedback to Claims Customer Service Representatives with a focus on technical claims handling and customer service. Identified trends during the QA process requiring corrective action within a unit or across the office and reports findings to Team Manager and Claims Manager on a regular basis Developed and followed up on action plans and worked with Team Managers to execute plans. Ensured calibration of QA results and action plans across the office. Based on evaluation and trend analysis, determined any technical/customer service training needs. Trained on a one on one basis with customer service representatives to ensure alignment across offices. Participated in evaluation of training issues and made recommendations. Focused on continuous process improvement of claims processes and workflows.