Arianysis Todd
Orlando
Summary
Results-oriented professional with a proven track record in education and leadership, specializing in claims handling, particularly in medical and auto claims. Expertise in managing and resolving a wide range of insurance claims, with strong skills in claims investigation and settlement processes. Committed to enhancing customer satisfaction while ensuring compliance with policy guidelines and regulations. Achievements include improving operational efficiency by streamlining claims procedures.
Overview
4
4
years of professional experience
Work History
FTW-Claims Generalist
Progressive
01.2025 - Current
- Managed time and resources to facilitate sound claim decisions.
- Prioritized tasks effectively to align with business and customer needs.
- Investigated auto policies to assess coverage for loss or damage.
- Established efficient sequences for timely contact with all relevant parties.
- Collected and documented information from customers, agents, and witnesses through interviews.
- Ensured coverage and liability decisions aligned with accident reports.
- Identified potential fraud cases and initiated investigations.
- Managed claims inventory, including paperwork, communications, and payment issuance.
NMU-Medical Payment's Rep
Progressive
07.2023 - 01.2025
- Utilized bill software to accurately re-price medical billings with health Insurance payments and adjustments.
- Identified and promptly addressed wage exposures on medical claims for insureds with wage loss coverage according to state specifics.
- Reviewed and interpreted policy language to properly clear any coverage verification questions.
- Interpreted medical records to ensure submitted medical bills were motor vehicle accident related.
- Investigated coverage, fraud, injury causation, and subrogation issues on all claims assigned.
- Interpreted and applied policy and state laws to make accurate coverage decisions.
- Recognizes the need for fraud/Special Investigations Unit (SIU) involvement and worked with SIU to assist in fraud investigations.
- Opened subrogation when appropriate according to state specifics.
- Developed and executed action plans around coverage, fraud, injury causation, and subrogation issues.
- Efficiently maintained diaries and action items.
- Reviewed and handled incoming mail and electronic correspondence.
- Contacted insureds, attorneys, and medical providers to follow up on current file status.
- Participated and contributed in Teams meetings by creating and leading DEI activities.
Central Loss Reporting Unit Representative
Progressive
Orlando
11.2021 - 07.2023
- Communicated coverage information to customers, setting clear expectations for the claims process.
- Utilized empathy to de-escalate challenging situations, aiding customers with effective problem-solving.
- Managed time efficiently to ensure accurate reporting and timely completion of daily tasks.
- Documented calls meticulously for file owners and stakeholders using strong communication skills.
- Collaborated with team members to uphold company standards and implement best practices in customer assistance.
- Received consistent positive feedback from customers, file owners, and supervisors for outstanding service.
- Led team in developing a monthly newsletter to enhance internal communication.
Education
B.S - Secondary English Education
UNIVERSITY OF SOUTH FLORIDA
Orlando, FL01.2013
Associate of Arts - Liberal Arts
Hillsborough Community College
Tampa, FL05-2009
Skills
- Customer service and relations
- Medical billing
- Time management
- Problem-solving
- Team collaboration
- Verbal and written communication
- Office suite proficiency
- Independent work
- Bilingual (Spanish)
- Budget administration
- Workflow planning
- Project development
- Mentoring
- Education experience
Career Overview
A driven professional with a strong work ethic and dedication to consistently excel in meeting company objectives. I bring a robust background in education and leadership before my start with Progressive, along with a deep understanding of the claims handling process, including medical claims. I have been successful in all of my positions in and outside of Progressive and my goal is to continue to grow within Progressive and utilize all of my skills to meet company objectives.
Languages
Spanish
Native/ Bilingual
Timeline
FTW-Claims Generalist
Progressive
01.2025 - Current
NMU-Medical Payment's Rep
Progressive
07.2023 - 01.2025
Central Loss Reporting Unit Representative
Progressive
11.2021 - 07.2023
B.S - Secondary English Education
UNIVERSITY OF SOUTH FLORIDA
Associate of Arts - Liberal Arts
Hillsborough Community College