CHARLIE MORRIS III

*Investigate and process bodily injury, property damage, and first party collision and comprehensive damage claims for government-based and commercial insureds.

*Analyze medical bills and records by decoding ICD codes/procedure codes to complete detailed authority requests and evaluation reports.

*Utilize ISO searches to analyze claim history.

*Collect and update claim file with mandatory Medicare information to ensure compliance with federal regulations.

*Handles total losses with private automobiles, commercial trucks, and equipment.

*Investigates and handles general liability claims.

*Resolves customer inquiries regarding claim status, payments, and denials in a timely manner.

*Investigated, evaluated, and negotiated complex automobile accident claims while reviewing for signs of fraud and compliance with policy language.

*Handled first party medical payments coverage and processed medical bills to the providers; required review of UB-92 and HCFA-1500 claim forms in addition to obtaining medical authorizations to request medical records.

*Handled death benefit, towing, rental, and uninsured/underinsured claims.

*Worked with the National Insurance Crime Bureau and law enforcement on cases involving fraud.

*Experienced at successfully handling a large inventory of complex claims with a strict adherence to state laws and most files had attorney involvement.

*Once rated as the level III claim representative in the West Virginia total loss unit and served as a team resource.

*Successfully recognized and defended many fraudulent claims via proper referral to the Special Investigations Unit.

*Utilized recorded statements, scene investigations, and analysis of laws of the highway to properly assess liability and negligence.

*Selected by management to serve as the office subrogation specialist against auto manufacturers for claims paid as the result of defects; required using cause and origin experts and collecting evidence.

*Collaborated with manager and defense counsel to develop successful strategies to resolve or defend lawsuits.

*Managed an assigned territory where I was required to attend mediations and trials.

*Canvassed accident scenes, interviewed witnesses, and completed scene investigations.

*Consulted with customers and provided detailed instructions on how to set up and utilize their phone products

*Recommended optional services to residential and business customers for optimal benefits and customer satisfaction

*Fielded customer complaints and resolved or escalated to the proper department