Ashley Traylor
Cypress,TX
Summary
Tactful Claims Specialist with expertise in settlement preparation, claims processing and appeal filing. Diplomatic and personable professional accustomed to handling sensitive, confidential information and investigating complex liability claims. Committed to maintaining customer satisfaction and contributing to company success.
Overview
14
14
years of professional experience
1
1
Certification
Work History
Claims Consultant
Brady, Chapman, Holland & Associates
12.2023 - Current
- Review, analyze, and process, when applicable, the first notice of loss on behalf of our client to the insurance carrier(s), including communicating the claim number and adjuster contact information to the client
- Monitor all open claims activity, assisting as needed to ensure the client's needs are being met and the claim is brought to conclusion in a timely manner
- Prepares Best Claims Handling reports and attends and assists with regularly scheduled client presentation meetings
- Prepares and distributes internal Large Loss Alerts for all catastrophic events and claims that result in a fatality and or losses with reserves > $100,000
- Maintain BCH systems, including document management, according to BCH policies and procedures
- Understand, utilize, and manage WorkSmart | ImageRight tasks according to BCH procedures.
ESU PD Adjuster (Contract)
Trexis Insurance
08.2023 - 11.2023
- Analyzed and processed claims through well-developed action plans to ensure efficient and timely resolution by investigating and gathering information to determine the exposure on the claim
- Estimated cost of medical treatment, or compensation for injured parties involved in accidents
- Interpreted medical reports, reviewed medical billing, evaluated claim value, and managed claims process to ensure efficient resolution
- Negotiated settlement of claims within designated authority.
Independent Insurance Adjuster
Renfroe
10.2022 - 08.2023
- Examined claims forms and other records to determine insurance coverage
- Verified insurance claims and determined fair amount for settlement
- Evaluated insurance policies and analyzed damages to determine coverage
- Answered customer questions regarding deductibles
- Reviewed police reports, medical treatment records and physical property damage to determine extent of liability
- Documented all investigation activity and presented reports to management.
Vertical Delivery Recruiter (Finance & Accounting)
Kforce Inc
04.2022 - 04.2023
- Analyzed client requirements against candidate qualifications and submitted candidates to be reviewed by senior national delivery specialist or national delivery market manager for quality review, VMS client representatives and/or K-force internally
- Established initial contact with prospective candidates and conducted preliminary interviews as required
- Conducted resume review and assessment based upon SLOMA (Skills, Location, Opportunity, Money and Availability) criteria to determine candidate suitability/viability
- Segmented, organized and prioritized candidates according to the degree of alignment with position requirements
- Determined the right to work in the U.S
- And if visa is required, send to K-force 3rd Party and ITS
- Determined candidate compensation expectation to maximize probability
- Packaged candidates in accordance with corporate standards and focused on the pipelining of candidates to field recruiters
- Submitted prospect's credentials for re-formatting to a corporate standard or to the respective client and/or field representative and obtain feedback/confirmation of prospects candidacy.
University Relations Recruiter II
Lumen Technologies
08.2021 - 03.2022
- Traveled to meet face-to-face with candidates at school events and job fairs
- Screened, ranked, and recommended candidates for open positions
- Maintained relationships with universities, student organizations, and recruitment networks
- Developed internship programs and evaluated the performance of new employees
- Responded to candidate inquiries about the overall University Relations program.
Claims Adjuster
Progressive Insurance
10.2016 - 12.2020
- Interviewed policyholders, witnesses and third parties to gather information and details regarding injury events
- Evaluated coverage, liability and damages and investigated suspicious claims
- Interpreted policy details and recommended most favorable course of action
- Interviewed relevant parties to determine claim denial or settlement
- Negotiated terms and handled settlements and adjustments with attorneys, claimants and co-defenders
- Referred extreme cases to Special Investigation Unit (SIU) for further review
- Obtained credit information from banking services
- Examined forms to determine insurance coverage
- Prepared reports of findings in investigations.
District Parole Officer II
Texas Department of Criminal Justice
07.2010 - 10.2016
- Coordinated and worked closely with law enforcement, social service agencies and mental health providers
- Served as court liaison by attending court hearings and presenting reports and recommendations
- Collaborated with institutional staff, area law enforcement, mental health boards, county attorneys and treatment providers
- Performed routine home inspections and drug tests for offenders on parole
- Reported violations of parole conditions to appropriate authorities and maintained record of case activity
- Arranged substance abuse rehabilitation for offenders.
Education
Master of Arts - MA - Sociology
Prairie View A&M University
01.2013
Bachelor of Arts - BA - Mass Communication/Media Studies
Prairie View A&M University
01.2006
Skills
- Insurance Claims
- Claims Resolution
- Claims Management
- Claims analysis
- Investigation techniques
- Policy Interpretation
- Claims Investigation
- Claims Processing
- Documentation Review
- Coverage assessments
- Accident Investigations
- Critical Thinking
- Customer service and support
- Team Collaboration
- Active Listening
- Decision-Making
- Relationship Building
- Insurance policy coverage knowledge
- Claims adjustment
- Report and Records Review
- Settlement Negotiations
Certification
- Adjuster All lines
- TWIA Claims Examiner Certification
- TWIA Field Adjuster Certification
Timeline
Claims Consultant
Brady, Chapman, Holland & Associates
12.2023 - Current
ESU PD Adjuster (Contract)
Trexis Insurance
08.2023 - 11.2023
Independent Insurance Adjuster
Renfroe
10.2022 - 08.2023
Vertical Delivery Recruiter (Finance & Accounting)
Kforce Inc
04.2022 - 04.2023
University Relations Recruiter II
Lumen Technologies
08.2021 - 03.2022
Claims Adjuster
Progressive Insurance
10.2016 - 12.2020
District Parole Officer II
Texas Department of Criminal Justice
07.2010 - 10.2016
Master of Arts - MA - Sociology
Prairie View A&M University
Bachelor of Arts - BA - Mass Communication/Media Studies
Prairie View A&M University
- Adjuster All lines
- TWIA Claims Examiner Certification
- TWIA Field Adjuster Certification
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