ACESON MORRELL
Summary
Property Field Adjuster with a strong foundation in claims management and settlement negotiation. Recognized for high customer satisfaction through efficient claims processing, regulatory compliance navigation, and accurate damage evaluations using Xactimate.
Overview
14
14
years of professional experience
1
1
Certification
Work History
Catastrophe Property Field Adjuster
State Farm
11.2024 - Current
- Handled claims for homeowners, businesses, and large losses from weather-related events.
Acted as primary liaison for insureds throughout claims management.
Clarified coverage provisions to aid policy comprehension.
Evaluated damages to facilitate precise claim estimations. - Investigated policyholders' claims to determine coverage and liability under the insurance policy.
- Traveled to customer sites to evaluate fallen trees, leaking roofs and other issues to create accurate cost estimations.
- Coordinated emergency repairs and contractor services to expedite claims resolution for insureds.
- Monitored contractor repair progress to ensure compliance with insurance requirements.
- Negotiated settlements with claimants, ensuring alignment with company policies and maximizing client satisfaction.
Virtual Property Adjuster
Allstate
11.2022 - 09.2024
- Communicate empathetically with customers and help them through their claim process in a fast, fair, and easy manner
- Gathered information for property estimates in Xactimate, facilitating accurate claim evaluations.
- Managed entire claims process from initiation to resolution.
- Specialized in processing claims related to wind, hail, and water damage.
- Negotiate claim settlements with customers in accordance with business unit standard methodologies
- Handle escalated claims files that have complex contents or additional living expense damages
- Reviewed and applied state laws and regulations to ensure compliant claim handling, minimizing legal risks.
- Reviewed, evaluated and adjusted claims to promote fair and prompt settlement.
- Resolved claims for insureds by providing relevant policy details and excellent customer service.
- Established reserves for each claim based on analysis of the facts and applicable law.
- Interface with customers and vendors virtually over the Virtual Assist system - This means vendors will inspect loss sites while on a video call with the adjuster
- Inspected homes without an adjuster and submitted photos, measurements, and drawings for documentation.
- In our virtual environment, adjusters are required to participate and be on camera during online meetings and trainings
- Drafted statements of loss to clearly summarize damages, payments, and underlying policy coverage for efficient claims processing.
- Analyzed and determined fault in auto accidents based on evidence and applicable laws.
Virtual Property Adjuster/FNOL
USAA
02.2020 - 01.2022
- Investigated, evaluated, negotiated, and adjusted low to moderately complex wind/hail, water damage, and personal property claims to confirm coverage, determine legal liability, and equitably settle in compliance with state regulatory requirements
- Handle escalated claims files that have complex contents or additional living expense damages
- Settle moderately complex and occasionally complex property damage on countrywide condominium claims
- Explained coverage of loss and assisted policyholders with itemization of damages, coordination of emergency repairs, and arrangement of additional living accommodations
- Delivered claims service through internal channels (phone/fax/email/mail) to members and third-party customers, ensuring timely communication and resolution
- Review the policy and decide how coverage applies and provide the customer with a detailed explanation of both the estimate and the policy
- Write appraisals for dwelling repairs of routine claims based on information collected from customers and contractors and issue payment to policyholders where possible
- Acquires and applies basic knowledge of Property & Casualty insurance industry products, services, and processes to include P&C insurance policy contracts and coverages and the USAA claim handling process and procedures
- Contributes to business goals, performance metrics, and effectively uses tools & technology
- Supported workload surges and Catastrophe operations by working significant overtime during designated catastrophic events.
- Adapted to various work environments including independent, team-based, in-person, and virtual settings
Audit Rep Senior Claims adjuster (Special Needs Research Adviser)
United Healthcare Group
Telecommute
04.2017 - 03.2020
- Review, analyze and research complex health care claims to identify discrepancies, verify pricing, confirm prior authorizations, and process them for payment
- Research and process claims according to the processing guidelines and benefits, Knowledge and use of ICD-9, ICD-10, and CPT coding
- Determined if claim submission was completed correctly, verified data, and entered system for adjudication and reviewed payments history to determine final payment amount, if any
- Investigated non-standard requests and problems, reviewed medical records for missing documentation, and coordinated requests for necessary documents.
- Researcher for issue with review claims, systems, and policies to determine accurate provider contract set up, facilitates contract corrections
- Electronic medical records research set up case with all relevant documents, medical records, and benefit documents
- Provided holistic family support to families of children with special needs and mental health/substance use, ensuring end-to-end resolution of benefit issues within caseloads.
- Plans, prioritizes, organizes, and completes work to meet established objectives
- Applies knowledge/skills to a range of moderately complex activities
- Demonstrates great depth of knowledge/skills in own function
Clinical Administrative Coordinator
United Healthcare Group
Atlanta
12.2016 - 05.2017
- Coordinated appropriate care levels under RN or MD supervision, ensuring alignment with patient needs.
- Coordinated health services to facilitate patient care, contributing to overall service delivery.
- Provided clinical and medical management services, including case management, health assessments, interventions, and discharge planning.
- Prioritizes and organizes own work to meet agreed upon deadlines
- Works with others as part of a team- Moderate work experience within own function
- Completed tasks in situations lacking established procedures.
- Knowledge of queuing theories and workforce forecasting and scheduling WFM
CAO Patient Intake Coordinator, Case Specialist
Fresenius Medical Care Center
Kennesaw
07.2015 - 01.2017
- Coordinated admissions process from initial request to final authorization while maintaining patient confidentiality
- Ensures all intake data for admissions requests are collected, completed, and communicated according to the established standard operating procedures and in compliance with all regulatory requirements
- Initiate contact to gather required clinical and demographic data from patient and sources
- Interviews patient, patient's representative, or referral source to obtain the necessary personal and financial data to determine eligibility for admission
- Obtains the necessary information - demographic, financial and clinical and other pertinent data - from the referral agency to initiate the process
- Completes the preliminary paperwork and standard admissions forms to ensure efficient processing of admissions
- Facilitated efficient admissions process by answering phones and assisting callers professionally, escalating issues to supervisor when necessary
- Coordinates with the Patient Placement Coordinators to establish appropriate placement of patients according to vacancies rates and capacity of relevant clinics
- Review referrals and verify all physician information
- Determine need for case management intervention
- Provide expertise or general claims support by reviewing, researching, investigating, negotiating, processing, and adjusting claims
- Works closely with applicable billing groups to request and obtain insurance verification in a timely manner
- Communicates with individual clinics to ensure medical record approval and prompt scheduling of patients and forwards necessary documents and records to the appropriate receiving facilities
- Maintained and updated database with current data, pertinent information, and status of admissions referrals, recording details of enquiries, complaints, and issues.
- Utilized ICD-9, ICD-10, and CPT codes for accurate medical billing and documentation.
- Coordinate or provide appropriate levels of care under the direct supervision of an RN or MD
- Providing clinical and medical management services, including case management, health assessments, interventions, and discharge planning.
Operations Representative/ Tech Support
Comcast
Alpharetta
12.2014 - 08.2015
- Prioritized and dispatched service and installation requests to ensure timely response and customer satisfaction
- Rescheduled and assigned jobs to technicians, optimizing workflow and improving service delivery
- Monitored daily progress of technicians and adjusted routes to accommodate customer additions, rescheduling, and cancellations while providing support to the Technicians
- Effectively communicated with field personnel regarding any customer-impacting concerns, minimizing the need for future contacts
- Updated customer accounts with requested upgrades or downgrades, enhancing client experience and system accuracy
- Utilize appropriate knowledge resources to drive resolution of applicable problems/issues (e.g., websites, CRM tools, knowledge bases, product manuals, SharePoint)
- Understanding of supporting incident management processes.
Tech Support
AT&T
Boca Raton
05.2012 - 01.2015
- Resolved challenging customer issues including device-related troubleshooting, billing, service inquiries in a call center environment
- Utilizes appropriate knowledge resources to drive resolution of applicable problems/issues (e.g., websites, CRM tools, knowledge bases, product manuals, SharePoint)
- Collaborated with providers to resolve billing and claims issues while educating them on prevention strategies
- Coordinated customer billing, payments, and collections processes to ensure timely and accurate record keeping
- Analyzes daily call contact reports to determine accuracy, follow-up, timeframes
- Operates PC to input and retrieve subscriber account data and make notations as needed in the appropriate workforce management tool
- Recorded completion codes to provide accurate service history
- Input data into databases for tracking and reporting purposes
- Gained knowledge of supporting incident management processes in a customer service environment.
Education
Health Management Information Online Courses -
Capella University
01-2023
South Carolina State University
Orangeburg, SC01-2008
Denmark Technical College
Denmark, SC01-2008
Skills
- Xactimate estimating
- Xactimate estimation
- Claims management
- Fraud detection
- Damage evaluation
- Damage assessment
- Property valuation
- Insurance regulations
- Coverage analysis
- Policy interpretation
- Report writing
- Technical knowledge
- Critical thinking
- Analytical thinking
- Problem solving
- Decision making
- Time management
- Settlement negotiation
- Customer service
- Conflict resolution
- Active listening
Certification
- All Lines Adjuster Licenses
Timeline
Catastrophe Property Field Adjuster
State Farm
11.2024 - Current
Virtual Property Adjuster
Allstate
11.2022 - 09.2024
Virtual Property Adjuster/FNOL
USAA
02.2020 - 01.2022
Audit Rep Senior Claims adjuster (Special Needs Research Adviser)
United Healthcare Group
04.2017 - 03.2020
Clinical Administrative Coordinator
United Healthcare Group
12.2016 - 05.2017
CAO Patient Intake Coordinator, Case Specialist
Fresenius Medical Care Center
07.2015 - 01.2017
Operations Representative/ Tech Support
Comcast
12.2014 - 08.2015
Tech Support
AT&T
05.2012 - 01.2015
Health Management Information Online Courses -
Capella University
South Carolina State University
Denmark Technical College