Danielle Washington
Tampa,FL
Summary
Motivated claims and insurance professional specializing in personal, property, casualty and health loss damages. Negotiates peaceful resolutions of all claims with emphasis on fairness and thoroughness. Trustworthy and dependable, analytical, problem solver.
Experienced sales advisor with 10 years of experience customizing insurance programs, explaining features and advantages and developing successful marketing strategies, advanced customer service skills and customer relationship management.
Exceptional at multitasking, organizational and time management.
Highly adaptable at developing profitable and quality-focused processes. Experienced in management and team leadership skills, a methodical and detail-oriented team player as well. Ability to prioritize projects and multitask effectively to achieve project goals. Overall offering a strong work ethic.
Overview
11
11
years of professional experience
1
1
Certification
Work History
Desk Examiner
IMS Claim Services
09.2022 - 12.2022
- Examined claims forms and other records to determine insurance coverage.
- Initiated first contact with insured to obtain claim details
- Reviewed field inspections to determine if coverage exists
- Verified insurance claims and determined fair amount for settlement.
- Documented all investigation activity and presented reports to management.
- Reported to management on customer problems, field conditions, safety issues and policy problems.
- Negotiated with PA's and attorney's for settlement agreements to resolve disputes.
- Partnered with legal counsel on litigation cases.
Senior Claims Analyst
Rhino
01.2022 - 09.2022
- Investigated properties to determine extent of damage and estimate repair costs.
- Reviewed and analyzed suspicious and potentially fraudulent insurance claims.
- Followed up with insured individuals regarding premium and deductibles payments.
- Synthesized data into comprehensive quarterly written reports for management.
- Substantiated legitimate claims and denied unjustified claims.
- Negotiated settlement agreements to resolve disputes.
COVID-19 Response Frontline Case Investigator
Kansa Department Of Health & Enviorment
11.2020 - 03.2022
- Data Entry
- Correspond via telephone with the use of scripted information
- Follow up calls on cases interviewed
- Protect recorded case health Information (HIPPA)
- Investigate and review cases using EpiTrax & Salesforce
- Communicated with documented COVID-19 patients and other exposed persons via phone call, text, e-mail and other platforms.
- Investigated and identified confirmed and suspected coronavirus cases, also documenting potentially affected contacts.
- Collected and recorded information in electronic medical records.
- Offered basic guidance regarding testing and medical consultation for those exposed to people with COVID-19.
- Contacted people exposed to individuals with COVID-19, assessed symptoms and referred for testing.
Desk Examiner
CXIS
02.2021 - 02.2022
- Examine daily and catastrophe claims
- Collaborated with the claims department and industry anti-fraud organizations to resolve claims.
- Investigated properties to determine the extent of damage and estimate repair costs.
- Followed up on potentially fraudulent claims initiated by claims representatives.
- Evaluated accuracy and quality of data entered into the agency management system.
- Established positive and trusting relationships with injured clients, administering efficient customer service and processing claims quickly.
- Modeled exceptional customer service skills and appropriate diagnostic sales techniques to team members.
- Analyzed information gathered by investigations to report findings and recommendations.
- Reported policy changes and company conditions affecting customer satisfaction.
- Conducted thorough property investigations to identify and classify damages for customer claims.
- Directed claims negotiations within allowable limit of $65,000 and supported successful litigations for advanced issues.
Claims Analyst
Wipro
04.2020 - 04.2021
- Exceeded in processing more than 100 claims daily
- Resolved resubmitted claims that needed to be reprocessed
- Analyze & investigate claim information, data entry, process EDI edits
- UB04, HCPCS, ICD-10 CPT
- Executed claims processing, while generating increased revenue.
- Investigated high volume of insurance claims to determine validity and coverage eligibility.
- Reviewed and analyzed suspicious and potentially fraudulent insurance claims.
- Processed 100- 120 claims per daily production
- Researched claims and incident information to deliver solutions and resolve problems.
Accounting Specialist & Claims Processor
American Integrity
03.2016 - 03.2020
- Reviewed accounts daily for billing transactions
- Trained incoming team members on billing procedures and duties
- Daily claim handler and catastrophe claim handler, analyze and investigate claims
- Communicate with policyholders, vendors, attorneys, public adjusters and all other parties involved.
- review reports, AOB's
- Analyze cash unallocated balance, apply payments, reverse payments
- Oversee credit balance and lockbox
- Organized budget documentation and tracked expenses to maintain tight business controls.
- Applied mathematical abilities to calculate and check figures in accounting systems.
- Reconciled account information and reported figures in general ledger by comparing to bank account statement each month.
- Investigated daily variances and corrected errors to resolve discrepancies.
- Audited and analyzed payroll information and produced payroll returns to reduce outsourcing costs.
- Analyzed financial information and made proactive adjustments.
Customer Service specialist
Affinity Insurance
08.2015 - 03.2016
- Maintained client’s policy records
- Bind auto and home policies
- Maintained client financial records
- Used consultative techniques to understand customer needs and make strategic referrals to business partners.
- Achieved high satisfaction rating through proactive one-call resolutions of customer issues.
- Provided primary customer support to internal and external customers.
- Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
- Addressed customer complaints and mitigated dissatisfaction by employing timely and on-point solutions.
- Maintained and managed customer files and databases.
- Collected customer feedback and made process changes to exceed customer satisfaction goals.
- Recorded product or service failure complaints and notified appropriate departments.
- Developed customer service improvement initiatives to decrease customer wait times.
Office manager
Freeway Insurance Svc
06.2013 - 08.2015
- Trained and onboarded new employees
- Implemented ways to improve office sales
- Collaborated with other local businesses to market insurance products
- Perform daily office deposits & submit a daily balance sheet
Independent Insurance Adjuster
IMS, CCA
Desk Examiner
CCA
01.2023 - 07.2023
- Interviewed claimants and witnesses to gather factual information.
- Examined photographs and statements.
- Researched claims and incident information to deliver solutions and resolve problems.
- Evaluated insurance policies and analyzed damages to determine coverage.
- Negotiated with policyholders and claimants to reach mutually satisfactory resolutions.
- Delivered exceptional customer service to policyholders by communicating important information and patiently listening to issues.
Desk Adjuster
CCA
01.2023 - 01.2024
- Managed high-volume caseloads to ensure rapid resolution for clients and maintained customer satisfaction levels.
- Reduced errors in claims handling by conducting thorough investigations and consistently verifying information accuracy.
- Expedited claim settlements with skilled negotiation tactics that led to fair resolutions for all parties involved.
- Developed strong relationships with policyholders by providing exceptional customer service throughout the claims process.
Education
Master of Science -
The University of West Florida
Pensacola, FL12.2023
Bachelor of Science -
University of South Florida
08.2021
Associate of Art - Liberal Arts
Hillsborough Community College
12.2019
Skills
- Critical thinker
- Analyzing/ analysis
- Time management
- Leadership
- Team work
- Problem solving
- Organizational
- Effective communications
- Adaptability
- Emotional Intelligence
- Creativity
- Marketing communications
Additional Information
- Awards: , Global Citizen Award (USF) 08/2021
Certification
- Licensed 620 all lines adjuster
- Licensed agent 20-44
- NFIP Certification
Timeline
Desk Examiner
CCA
01.2023 - 07.2023
Desk Adjuster
CCA
01.2023 - 01.2024
Desk Examiner
IMS Claim Services
09.2022 - 12.2022
Senior Claims Analyst
Rhino
01.2022 - 09.2022
Desk Examiner
CXIS
02.2021 - 02.2022
COVID-19 Response Frontline Case Investigator
Kansa Department Of Health & Enviorment
11.2020 - 03.2022
Claims Analyst
Wipro
04.2020 - 04.2021
Accounting Specialist & Claims Processor
American Integrity
03.2016 - 03.2020
Customer Service specialist
Affinity Insurance
08.2015 - 03.2016
Office manager
Freeway Insurance Svc
06.2013 - 08.2015
Independent Insurance Adjuster
IMS, CCA
Master of Science -
The University of West Florida
Bachelor of Science -
University of South Florida
Associate of Art - Liberal Arts
Hillsborough Community College