Andrea D. Owens

Skilled Claims Specialist with comprehensive experience in handling, investigating, and settling insurance claims. Strengths lie in proficient communication abilities, keen analytical thinking, and effective problem-solving skills. Previous work has resulted in streamlined operations and improved customer satisfaction rates through successful negotiation and settlement of complex claims.

Adjuster License in Property & Casualty

• Risk & Claim Specialist, TMD Staffing, Houston, TX, Current, Responsible for managing, investigating, evaluating, and negotiating resolutions of claims for and against the company., Determining legal liability or statutory eligibility of claims, exercising financial control on claims, and determining monetary claim value., Responsible for reducing accidents and losses, thereby improving the safety and efficiency of all employees., Conducts safety meetings, audits, and inspections to ensure compliance, evaluate performance, identify corrective action, and implement follow up assessments., Collaborates with management to develop an Emergency Action Plan and serve as primary contact for project site injury and incident notification, investigation, and case management., Maintains a written log of safety inspection activities, reports, and correspondence., Creates and modifies policies to comply with safety legislation and industry practices., Determine potential risk/loss exposures., Reporting of claims and/or exposures., Process, review, investigate, negotiate, and/or resolve claims., Determine acceptance and/or denial of claims.
• Risk Manager Coordinator, F.A. Wilhelm Construction, Indianapolis, IN, 01/01/20, 12/31/22, Ensuring proper contract insurance requirements are established and met by all subcontractors and vendors by job., Responsible for administering other regulatory and compliance programs for risk management and loss control., Manages worker compensation insurance claims., Overseeing all aspects of corporate insurance programs including general liability, property, and worker's compensation., Responsible for the renewal and application process of various insurance policies., Timely collecting and synthesizing relevant asset and financial data from SMEs., Facilitating external presentations and coordinating renewal information with insurance brokers., Responsible for claims processing, accounting, and budgetary tasks of the organization., Acts as the primary point of contact for multiple insurance lines., Conducts audits of policy and compliance to standards.
• Workers Comp Investigative Case Manager, Travelers, Indianapolis, IN, 01/01/16, 12/31/20, Conducted coverage and jurisdiction analysis and communication with insured based on application of policy information., Leveraged expertise to determine causal relatedness of medical conditions and interpreted workers’ compensation policies., Handled litigated claims, developed litigation plan with staff or panel counsel., Maintained claim files, effective diary system, and document claim file activities., Devised resolution strategies to negotiate and settle claims., Processed proper EDI forms for state requirements and ensured compliance with HIPPA and OSHA regulations., Studied claims through prompt contact with appropriate parties., Trained new employees to ensure proper learning regarding claims handling.

• Analytical and accomplished professional with experience in managing and investigating claims, identifying red flags, fraud, offering safety tips to prevent accidents/ injuries along with litigation handling.
• Expert at analyzing operational risk and developing mitigation plans that help optimize risk solutions.
• Develop and manage relationships with internal and external partners to achieve mutual success.
• Proven record of providing revisions to strategies and execute plans based on business initiatives; collaborate and align risk adjustments to work plans with quality team and external vendors.