Andrea Todd
Kansas City,MO
Summary
Result-driven, resourceful, and conscientious Insurance Management Professional having 20+ years of experience. Seeking a new professional career with a reputable company where I can utilize my knowledge, experience and interpersonal skills to ensure customer satisfaction.
Overview
26
26
years of professional experience
1
1
Certification
Work History
Specialist II Primary Servicing
SitusAMC
04.2022 - Current
- Approve system generated reporting and related client deliverables for compliance, adherence, accuracy as determined by supporting information
- Manage communication with various internal and external clients regarding various questions to the proper servicing of the client's CRE loans
- Ensure adherence to internal policies, quality standards, and management direction while meeting contractual deliverables to clients
- Design and build spreadsheet templates and/or financial models, including the coding of interrelated excel formulas, data tables and macros, to analyze the loan metrics, cash flows, amortization tables and similar debt or collateral analysis, and, find and correct logic errors contained within
- Assist in compiling various internal reports and assist the asset managers and the portfolio management team with reporting to the client.
Catastrophe Claims Adjuster
EA Renfroe/State Farm
02.2022 - 05.2022
- Investigated and analyzed claims involving property damage due to catastrophes, such as floods, hurricanes, tornadoes and earthquakes.
- Reviewed policy language to determine coverage for each claim and applied relevant laws or regulations when applicable.
- Interpreted insurance policies in order to accurately assess liability and identify potential areas of fraud or misrepresentation.
- Monitored progress on open cases in order to ensure timely resolution of all matters.
- Negotiated settlements with claimants in order to resolve disputes quickly and effectively.
- Ensured compliance with state laws governing catastrophe insurance policies.
Property Claims Adjuster
Alacrity Solutions/Liberty Mutual
Carrolton, Texas
07.2021 - 11.2021
- Investigated property damage claims to determine coverage and liability.
- Evaluated policy provisions, applicable laws, and other relevant information to determine claim payments or denials.
- Assessed the value of damaged items based on market trends and depreciation factors.
- Communicated with customers via phone or email to update them on their claims status or answer questions they may have had.
- Provided guidance to claimants regarding the claims process and documentation needed for payment processing.
- Negotiated settlements with claimants to resolve disputes.
Property Claims Adjuster
Pilot Catastrophe Services/ Allstate Insurance
Mobile, Alabama
10.2019 - 06.2021
- Carefully examined claims forms and supporting records to determine insurance coverage
- Interviewed agents and claimants to correct errors or omissions and investigate questionable claims
- Appraised insurance policies and analyzed damages to determine coverage
- Organized summaries of damages, payments, and policy coverage
- Investigated claims involving potential and suspected fraudulent activities.
- Evaluated policy provisions, applicable laws, and other relevant information to determine claim payments or denials.
- Communicated with customers via phone or email to update them on their claims status or answer questions they may have had.
Senior Insurance Claims Adjuster
GEHA
Kansas City, Missouri
08.1998 - 06.2019
- Demonstrated exceptional customer service skills and appropriate diagnostic sales techniques to team members
- Ensured strict confidentiality of patient finances, records, and health statuses
- Escalated policy changes and company conditions that weighed on customer satisfaction
- Delivered designated duties effectively within tight deadlines and fast-paced atmosphere
- Developed distinct written communications, reports, and documents to ensure smooth operations
- Calculated adjustments, premiums, and refunds
- Examined 200+ patient cases per week and verified insurance coverage information
- Gained and employed grounded knowledge of basic medical terminology to better understand services and procedures
- Coordinated with contracting department to resolve payer issues
- Acted as claims process subject matter expert, answering internal and external questions and inquiries
- Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt
- Assured timely verification of insurance benefits prior to patient procedures or appointments
- Streamlined administrative support processes
- Established positive and trusting relationships with injured clients, administering efficient customer service and processing claims quickly
- Investigated Stop Loss Protection.
Medical Information Specialist
St Luke's Healthcare System
Kansas City, Missouri
01.2013 - 04.2019
- Gathered and reviewed medical records to ensure accuracy of patient information.
- Maintained, updated, and organized all patient files in accordance with HIPAA regulations.
- Answered incoming calls from patients seeking advice or requesting medical information.
- Verified medical codes for diagnosis, treatments, procedures and supplies using ICD-10 coding system.
- Compiled and processed data for billing purposes utilizing billing software programs.
- Submitted electronic claims to various insurance carriers.
- Answered incoming calls regarding billing inquiries from patients and and or providers in a professional manner.
- Performed daily reconciliation of accounts receivable with payment postings on the computer system.
Education
All Lines Adjuster License -
National Institute of Adjusting
Some College (No Degree) - Healthcare Management
Metropolitan Community College - Kansas City
Kansas City, MOSkills
- Policy Interpretation
- Excellent time management skills
- Claims Processing
- Claims Investigation
- Worker's Compensation Knowledge
- Data Entry
- HIPAA Compliance
- ICD-10
- Critical Thinking
- Medical Billing
Certification
- USAA Certification
- Xactimate
- Citrix
- State Farm Property and Auto Certification
- VT 3625810
- MI 19658111
- NC 19658111
- WV 19658111
- FL W708967
- GA 3382607
- IN 3615029
- ID 819890
- UT 820102
- OR 19658111
- OK 3001044836
- WA 1090580
- SC 19658111
- MT 3001100190
- AL 3001063184
- MN 40715977
- LA 881062
- KY DOI-1111711
- MS 10716265
- AR 19658111
- TX 2573859
Special Skills Training
- Property Claims
- Auto Claims
- Medical Office Experience
- HIPAA Compliance
- Problem Resolution
- Patients Scheduling
- Insurance Verification
- Medical Billing
References
References upon request
Timeline
Specialist II Primary Servicing
SitusAMC
04.2022 - Current
Catastrophe Claims Adjuster
EA Renfroe/State Farm
02.2022 - 05.2022
Property Claims Adjuster
Alacrity Solutions/Liberty Mutual
07.2021 - 11.2021
Property Claims Adjuster
Pilot Catastrophe Services/ Allstate Insurance
10.2019 - 06.2021
Medical Information Specialist
St Luke's Healthcare System
01.2013 - 04.2019
Senior Insurance Claims Adjuster
GEHA
08.1998 - 06.2019
All Lines Adjuster License -
National Institute of Adjusting
Some College (No Degree) - Healthcare Management
Metropolitan Community College - Kansas City