Deanna Manley
Senior Claims Adjuster
Fort Lauderdale,FL
Overview
21
21
years of professional experience
5
5
years of post-secondary education
Work History
Senior Claims Adjuster
AmTrust Financial Services
01.2015 - 08.2024
- Thoroughly investigating workers' compensation claims by contacting injured workers, medical providers, and employer representatives
- Reviewing and analyzing medical bills to confirm charges and treatment are workers' comp injury-related and in accordance with the treatment plan
- Answer questions regarding the status of pending claims from claimants, policyholders and medical providers
- Consulting with attorneys regarding litigation management, settlement strategy and claim resolution
- Interviewed claimants and witnesses to gather factual information
- Optimized workload management, prioritizing time-sensitive cases to ensure timely resolutions for clients
- Provided exceptional customer service during stressful situations, demonstrating empathy, patience, and professionalism throughout the entire claims process
- Achieved high accuracy rates in claims evaluation by consistently applying knowledge of policy coverage, liability assessment, and damage valuation
- Enhanced customer satisfaction by promptly addressing and resolving complex claim issues through thorough investigation and analysis
- Reduced claim processing time by implementing streamlined procedures and efficient documentation practices.
Workers Compensation Claims Adjuster
Lumbermen's Underwriting Alliance
07.2011 - 12.2015
- Maintained contact with claimants and attorneys to determine treatment status
- Delivered exceptional customer service to policyholders by communicating important information and patiently listening to issues
- Reviewed new files to determine current status of injury claim and to develop plan of action
- Conducted comprehensive interviews of witnesses and claimants to gather facts and information
- Organized, planned and documented materials for workers comp claims
- Analyzed information gathered by investigation and reported findings and recommendations
- Reviewed questionable claims by conducting agent and claimant interviews to correct omissions and errors
- Read over insurance policies to ascertain levels of coverage and determine whether claims would receive approvals or denials
- Identified insurance coverage limitations with thorough examinations of claims documentation and related records
- Reviewed police reports, medical treatment records, and physical property damage to determine extent of liability.
Medical Office Manager
Hanger Clinic: Prosthetics and Orthodics
11.2007 - 06.2011
- Assessed processes and procedures, complying with OSHA, and HIPAA regulations
- Managed daily administrative tasks to ensure smooth operations within the medical office environment
- Maintained strict confidentiality of sensitive patient information, adhering to HIPAA guidelines and safeguarding against potential data breaches
- Created and managed electronic patient records, encompassing data entry and administrative functions related to insurance, billing, and accounts receivable
- Assisted physicians with clinical documentation to ensure complete and accurate records for each patient visit
- Addressed and remedied all patient or team member issues
- Communicated effectively with staff members, physicians, and patients, employing active listening and interpersonal skills
- Enhanced patient care by establishing strong relationships with medical professionals, including physicians, nurses, and technicians
- Maintained up-to-date knowledge of healthcare regulations and policies, ensuring the practice remained in compliance at all times
- Increased revenue by optimizing billing processes and ensuring timely collection of payments from both patients and insurance companies
- Coordinated regular staff meetings to address challenges, discuss solutions, and share best practices within the team
- Provided proper scheduling of patients, ensuring timely, and effective allocation of resources and calendars
- Ensured a safe, comfortable environment for patients by promptly addressing any concerns or issues that arose during their visits
- Assisted with regulatory issues such as compliance
- Developed close working relationships with front office and back office staff
- Created and implemented organizational policies and procedures.
Office Manager
Proficient Air Conditioning
06.2003 - 10.2007
- Handled sensitive information with discretion, maintaining confidentiality of company documents and personnel records
- Provided exceptional customer service when addressing client inquiries or concerns via phone calls or email correspondence
- Maintained computer and physical filing systems
- Updated reports, managed accounts, and generated reports for company database
- Maintained accurate financial records by reconciling accounts payable/receivable transactions regularly to ensure balanced budgets
- Developed and maintained successful relationships with vendors, suppliers and contractors
- Oversaw office inventory activities by ordering and requisitions and stocking and shipment receiving
- Managed office operations while scheduling appointments for department managers
- Coordinated office events and meetings, ensuring timely execution and optimal scheduling for all participants
- Established workflow processes, monitored daily productivity, and implemented modifications to improve overall performance of personnel
- Delivered performance reviews, recommending additional training or advancements
- Maintained professional demeanor by staying calm when addressing unhappy or angry customers
- Improved staffing during busy periods by creating employee schedules and monitoring call-outs.
Summary
Experienced Sr. Workers' Comp Claims Adjuster Equipped with strong problem-solving abilities, willingness to learn, and excellent communication skills. Poised to contribute to team success and achieve positive results. Ready to tackle new challenges and advance organizational objectives with dedication and enthusiasm.
Education
High School Diploma -
Coconut Creek High
Coconut Creek, FL 08.1999 - 06.2003
No Degree - Business Administration
Broward College
Fort Lauderdale, FL 08.2003 - 08.2004
Skills
- Strategic Decision-Making
- Analytical Problem Solving
- Effective communication abilities
- Claims files management processes
- Excellent writing skills
- Strong interpersonal skills
- Conflict resolution techniques
- Claims Processing
- Workers' compensation claims
- Policy investigations
- Litigation resolution
- Settlement management
- Claims Investigation
- Highly motivated
- Database Management
- Claims negotiation
- Claims file documentation
- Claims investigations
- Allocating claims
- Risk Management
- Insurance regulations
- Claims file management processes
- Best Practices Implementation
- Advanced oral and written communication skills
- Workers' Compensation claims guidelines
- Caseload Management
Certification
- CIE - Certified Insurance Examiner
- 0620- All Lines Adjuster License - Nov. 2015
Accomplishments
- Maintained a consistent closing ratio of 136%.
- Maintained a superior quality rating of 92% in file handling from 2017 to present, exceeding the 80% department goal.
- Achieved and maintained "Employee of the Year" from 2017 through present
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Timeline
Senior Claims Adjuster
AmTrust Financial Services
01.2015 - 08.2024
Workers Compensation Claims Adjuster
Lumbermen's Underwriting Alliance
07.2011 - 12.2015
Medical Office Manager
Hanger Clinic: Prosthetics and Orthodics
11.2007 - 06.2011
No Degree - Business Administration
Broward College
08.2003 - 08.2004
Office Manager
Proficient Air Conditioning
06.2003 - 10.2007
High School Diploma -
Coconut Creek High
08.1999 - 06.2003
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