Edna Chatman
Gulf Shores,AL
Summary
Looking to obtain a position within a well-established organization where skills and experience can be used for mutual success. History of providing residents and insured with assistance in activities of daily living.
SUMMARY OF QUALIFICATIONS Experience Managing over 10+ years. Ability to work in a fast-paced environment. Basic Computer Skills Environment Administrative Experience Productive interpersonal and time organized and meticulous management skills. Ability to work independently. Cash handling experience more than three years Customer service-oriented collections experience
Overview
20
20
years of professional experience
Work History
Inside Property Claim Adjuster
Pilot Catastrophe
Mobile , AL
04.2023 - 11.2024
- Cat Claims, Daily claims, CVE claims, supplement, claim processor, Contents claims, Coordinated Claims
- Building trust with insured and managing their claim with confidence of knowing the coverages provided within their policy
- Coordinated resources, scheduled, and prioritized work assignment
- Reviewed photographs and other claim documents
- NEXT-GEN
- Conducted a detailed investigation of claims
- Inspected property damage, conducted an analysis of the claimant's policy limits, assessed the cost or value of an insured item
- Reviewed photographs that insured, and contractor sent in on other claims document
- Negotiated with other professionals, such as contractors, on behalf of the policyholder, to come to an agreement to restore the policyholder to pre-loss condition
- Negotiated with the claimant to settle the claim, calculated benefit payments and approved payment of claims within a certain monetary limit, made payments to the insured
- Ensured accurate and timely benefit payment and services, proactively managed claim costs and expenses
- Continuously analyzed case facts and monitored activities to identify fraud or abuse, and/or third-party liability throughout the course of the claim
- Coordinated resources, scheduled, and prioritized work assignments
Health Care Claims Processor
Crawford and Company
Atlanta, GA
06.2022 - 03.2023
- Investigated, evaluated, and settled Health care insurance claims
- Determined whether the insured's policy covers the claimed loss according to their healthcare policy.
- Decided an appropriate amount the Healthcare company should pay out.
- Ensured that claims were not fraudulent.
- Contacted claimant's employers or doctors for additional information if the claim was questionable.
- Negotiated settlements and authorized payments.
- Used communication skills to gather needed information from individuals, including medical Healthcare experts, claimants, and witnesses.
- Documented the claim file according to the Healthcare documentation workflow.
- Strong applied skills that where needed to make a coverage determination and subsequent damage evaluation once coverage is accepted.
- Investigate Healthcare insurance claims to decide the settlement amount for an insured.
- Established positive and trusting relationships with injured clients, administering efficient customer service and processing claims quickly.
- Responded to customer inquiries, providing detailed explanations of insurance policies and claims processes.
Inside Property Claim Adjuster
Pilot Catastrophe Auto
Mobile, AL
05.2021 - 01.2022
- All state program CCC
- Process auto claims under first damage, supplement, and total loss
- Examine damaged vehicles to decide extent of structural, body, mechanical, electrical, or interior damage
- Estimate parts and labor to repair damage, using standard automotive labor and parts cost manuals and knowledge of automotive repair
- Review repair cost estimates with automobile repair shop to secure agreement on cost of repairs
- Decide salvage value on total-loss vehicle
- Interview or correspond with claimants, witnesses, police, physicians, or other relevant parties to determine claim settlement, denial, or review
- Review police reports, medical treatment records, medical bills, or physical property damage to determine the extent of liability
- Negotiate claim settlements and recommend litigation when settlement claim cannot be negotiated
Remote Property Claim Adjuster
Mid-America
Mobile, AL
10.2020 - 05.2021
- Built trust with insured and handled their claim with confidence of knowing the coverages provided within their policy
- Handled claims from start to finish which entailed dealing with vendor, agency, contractor, etc
- Obtained and negotiated repairs and pricing on both initial and supplements claims with insured to obtained efficient claim handling policyholders and claimants
- Reviewed and negotiated settlement of Subro requests from third party carriers
- Calculated benefits payment, approved payment of claims, and issued settlements, to close claims within a timely matter
- Settled and issued payments, compiled estimates, created loss, settled, and handled all claims process from the quality first contacts until final closure
- Documented all conversations with insured, contractor, agents, etc
- And maintained quality document of the claim
- Reviewed photographs through Image Right for Mid-America that insured, and contractor send in on other claims document
- Scoped and photographed property for defects and damages
Car Sales Representative
Mobile Chevrolet
Mobile, AL
06.2019 - 03.2020
- Closed sales by overcoming objection; asking for sales; negotiating price; completing sales or purchase contracts
- Explained provisions and offered warranties, services, and financing
Car Sales Representative
Matt Bowers Nissan
Daphne, AL
08.2018 - 07.2019
- Closed sales by overcoming objections; asking for sales; negotiating price; completing sales or purchase contracts
- Explained provisions and offered warranties, services, and financing
Inside Property Claim Adjuster
Pilot Catastrophe
Mobile, AL
01.2017 - 01.2019
- Cat Claims, Daily claims, CVE claims, supplement, claim processor, Contents claims, Coordinated Claims
- Building trust with insured and managing their claim with confidence of knowing the coverages provided within their policy
- Coordinated resources, scheduled, and prioritized work assignment
- Reviewed photographs and other claim documents
- NEXT-GEN
- Conducted a detailed investigation of claims
- Inspected property damage, conducted an analysis of the claimant's policy limits, assessed the cost or value of an insured item
- Reviewed photographs that insured, and contractor sent in on other claims document
- Negotiated with other professionals, such as contractors, on behalf of the policyholder, to come to an agreement to restore the policyholder to pre-loss condition
- Negotiated with the claimant to settle the claim, calculated benefit payments and approved payment of claims within a certain monetary limit, made payments to the insured
- Ensured accurate and timely benefit payment and services, proactively managed claim costs and expenses
- Continuously analyzed case facts and monitored activities to identify fraud or abuse, and/or third-party liability throughout the course of the claim
- Coordinated resources, scheduled, and prioritized work assignments
Deli Manager
End of the Road Chevron
Theodore, AL
01.2012 - 06.2017
- Responsible for Inventory and Purchasing
- Managed payroll and scheduling for all employees
- Successfully suggested sales campaigns for better market exposure
- Responsible for training and staffing and provided customer service daily
- Made deposits
- Accounts Payable and computed Profit/Loss statements
Education
Diploma -
Theodore High School
Theodore, AL01.1985
Skills
- Medical Terminology
- Guidewire
- Next Gen
- Technical Claim Handling Skills
- Analytical Claim Handling Skills
- Scoping damage Properties
- Estimating Properties Correctly
- Diagnostic Procedures
- Patient Assessment
- Electronic Medical Records
References
Available Upon Request
Timeline
Inside Property Claim Adjuster
Pilot Catastrophe
04.2023 - 11.2024
Health Care Claims Processor
Crawford and Company
06.2022 - 03.2023
Inside Property Claim Adjuster
Pilot Catastrophe Auto
05.2021 - 01.2022
Remote Property Claim Adjuster
Mid-America
10.2020 - 05.2021
Car Sales Representative
Mobile Chevrolet
06.2019 - 03.2020
Car Sales Representative
Matt Bowers Nissan
08.2018 - 07.2019
Inside Property Claim Adjuster
Pilot Catastrophe
01.2017 - 01.2019
Deli Manager
End of the Road Chevron
01.2012 - 06.2017
Diploma -
Theodore High School
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