Angelic Robinson
Gordon,GA
Summary
Seasoned Examiner with thirty years of experience of managing claim settlements for loss to vehicles and property. Strengths include handling documents, managing time and planning and scheduling claims processing. Consistently meets service and quality requirements while working from remote locations with minimal supervision.
Overview
31
31
years of professional experience
Work History
Examiner
GEICO
Macon, GA
06.2012 - Current
- Reviewed and analyzed claims to ensure accuracy of information, completeness of medical records, and compliance with policy terms.
- Compiled evidence from various sources such as medical records, employment histories, and legal documents.
- Determined if claims were valid according to established rules and regulations.
- Conducted interviews with claimants, employers, physicians and other healthcare providers to obtain additional information relevant to the claim.
- Negotiated settlements with attorneys representing claimants in order to reach a fair resolution of the claim.
- Advised claimants on their rights under the policy provisions and applicable laws.
- Gathered evidence such as witness statements, medical records, police reports and accident reconstructions.
- Investigated, analyzed and evaluated complex insurance claims to determine coverage and liability.
- Attended court hearings to provide testimony regarding specific cases or issues related to litigation.
- Interpreted legal documents such as contracts, policies and pleadings in order to assess potential liability exposures.
- Maintained detailed documentation of all activities related to assigned cases including correspondence, research notes, investigative reports and settlement agreements.
- Reviewed relevant case law in order to evaluate potential courses of action for resolving disputes.
- Provided expert advice on various aspects of litigation management including risk assessment, budgeting and strategy development.
- Developed strategies for defending clients against lawsuits alleging negligence or breach of contract.
- Researched statutes, regulations and other legal materials in order to identify potential defenses against claims.
- Collaborated with attorneys representing insureds in order to develop effective defense strategies.
- Monitored developments during trial proceedings in order to ensure that client interests are protected at all times.
- Conducted interviews with witnesses involved in civil actions in order to obtain information pertinent to the case.
- Analyzed financial data associated with litigated matters in order to accurately estimate reserves for future payments.
- Assisted attorneys with preparation for mediations and arbitrations by providing necessary evidence and arguments.
- Reviewed invoices submitted by outside counsel for accuracy prior to authorizing payment from trust accounts.
- Reviewed, evaluated and adjusted claims to promote fair and prompt settlement.
- Negotiated and settled claims according to information presented through reports, research and data verification.
- Completed required investigations on referred files within established timeframes.
- Identified and obtained evidence to ascertain claim value.
- Reviewed data to verify validity of claims and determine case management actions.
- Identified and collected evidence and determined value to specific claim to properly assess conditions.
- Investigated questionable claims to determine payment authorization.
- Obtained necessary information to complete proper evaluation of injury claims.
- Communicated with personnel and legal counsel on claims involving litigation.
- Reduced loss ratios through fair and prompt processing of claims.
PIP Adjuster
GEICO
Macon, GA
01.1997 - Current
- Analyzed policy provisions, legal documents and medical records.
- Assessed potential losses for insureds in accordance with applicable laws and regulations.
- Evaluated subrogation opportunities to identify recoverable funds.
- Maintained detailed records of all claim activities in a timely manner.
- Researched relevant case law to support coverage decisions.
- Established reserves for each claim based on analysis of the facts and applicable law.
- Ensured compliance with regulatory requirements relating to claims handling.
- Participated in training sessions related to new policies or procedures.
- Documented date, parties involved and specific details about incidents.
- Resolved medical payment and PIP claims for insureds by providing relevant policy details and excellent customer service.
Claim Service Representative
GEICO
Macon, GA
01.1994 - Current
- Resolved customer inquiries and complaints in a professional manner.
- Maintained accurate records of claim processing activities.
- Analyzed and evaluated data related to insurance policies, contracts, and claims.
- Ensured compliance with applicable regulations regarding claim handling.
- Assisted customers in completing necessary paperwork for filing claims.
- Performed research on claim issues as needed to resolve discrepancies.
- Provided timely updates to customers about the status of their claims.
- Verified accuracy of information submitted by policyholders when filing claims.
- Collaborated with internal teams such as underwriting, billing, and accounts receivable departments.
- Coached junior staff members on best practices for handling difficult cases.
- Provided guidance to policyholders on how to file a successful claim.
- Maintained knowledge of policies and procedures and insurance coverage benefit levels, eligibility systems and verification processes.
- Resolved claims by approving or denying documentation, calculating benefits due and determining compensation settlement.
- Documented specific claims by completing and recording forms, reports and logs.
- Planned and conducted investigations of claims to confirm coverage and compensability.
- Determined covered insurance losses by studying provisions of policies or certificates.
Telephone Adjuster II
GEICO
Macon, GA
01.2002 - 01.2012
- Investigated inconsistencies in documentation or reports obtained from third parties.
- worked to resolve claims before attorneys became involved
- secured recorded statements for liability investigations
- Investigated insurance claims to determine liability and damages.
- Negotiated settlements with claimants, attorneys and other parties.
- Drafted correspondence related to claim investigations and settlements.
- Evaluated subrogation opportunities to identify recoverable funds.
- Established reserves for each claim based on analysis of the facts and applicable law.
Telephone Adjuster 1
GEICO
Macon, GA
01.2000 - 01.2012
- Identified potential fraud by analyzing data for any irregularities or discrepancies.
- Evaluated eligibility for benefits based on analysis of case facts and application of applicable laws.
- Determined if claims were valid according to established rules and regulations.
Direct Mail Handler/Leinholder Services
GEICO
Macon, GA
01.1993 - 01.1994
- input data to provider customers with free rate quotes
- took calls from lienholder companies to confirm information on vehicles and policies
- filed policy documents into customer folders
Education
High School Diploma -
Wilkinson County High School
Irwinton, GA06.1991
Skills
- Group Facilitation
- Claims Handling
- Evaluation of Liability Exposure
- Policy Interpretation Knowledge
- Mitigation Skills
- Claims Investigations
- Confidential Records Management
- Damage Assessment
- Records Evaluation
- Documentation Review
- Document Review
- Records Maintenance
- File Management
- Problem-Solving Abilities
- Researching Skills
- Professional Correspondence
- Customer Service
- Typing 40 WPM
- Court Processes
Timeline
Examiner
GEICO
06.2012 - Current
Telephone Adjuster II
GEICO
01.2002 - 01.2012
Telephone Adjuster 1
GEICO
01.2000 - 01.2012
PIP Adjuster
GEICO
01.1997 - Current
Claim Service Representative
GEICO
01.1994 - Current
Direct Mail Handler/Leinholder Services
GEICO
01.1993 - 01.1994
High School Diploma -
Wilkinson County High School