Demarco Johnson
Chicago,IL
Summary
Experienced professional with four years of dedicated expertise in workers' compensation. Proven track record in effectively managing claims, ensuring compliance with regulations, and facilitating seamless communication between stakeholders. Skilled in case evaluation, negotiation, and resolution. Seeking a remote work opportunity to leverage my knowledge and contribute to a dynamic team environment while maintaining productivity from a home-based setting.
Overview
5
5
years of professional experience
1
1
Certification
Work History
Claims Adjuster
Gallagher Bassett Services Inc.
Chicago, IL
09.2023 - Current
- Investigated insurance claims, reviewed coverage and liability, prepared reports and recommended payment or denial of claims.
- Researched relevant laws, regulations, legal decisions and precedents to determine appropriate course of action.
- Determined reserves for each claim based on estimated costs of settlement or defense.
- Developed relationships with attorneys, experts and vendors in order to ensure prompt service when necessary.
- Maintained accurate documentation of all claim activity within designated system.
- Utilized computer systems such as Microsoft Office Suite and specialized software programs used by the company.
- Attended continuing education classes in order to stay abreast of changes in industry standards.
- Identified and obtained evidence to ascertain claim value.
- Investigated questionable claims to determine payment authorization.
- Gathered information from various third parties to determine claim acceptability.
- Recommended punitive action on fraudulent claims.
Claims Adjuster
Sedgwick Claims Management
Chicago, IL
07.2019 - 09.2023
- Investigated insurance claims, reviewed coverage and liability, prepared reports and recommended payment or denial of claims.
- Researched relevant laws, regulations, legal decisions and precedents to determine appropriate course of action.
- Interpreted policy language to determine coverage for insureds under various lines of business.
- Conducted interviews with claimants, witnesses and medical professionals to obtain additional information about the claim.
- Analyzed facts of loss including photographs, diagrams and other evidence to identify potential sources of recovery.
- Negotiated settlements with claimants or their representatives in order to resolve disputes quickly and economically.
- Determined reserves for each claim based on estimated costs of settlement or defense.
Education
Bachelor of Arts - Business Communications
DePaul University
Chicago, ILSkills
- Claims Processing
- Workers' compensation claims
- Policy investigations
- Insurance fraud expertise
Certification
- texas all lines adjuster license
Timeline
Claims Adjuster
Gallagher Bassett Services Inc.
09.2023 - Current
Claims Adjuster
Sedgwick Claims Management
07.2019 - 09.2023
Bachelor of Arts - Business Communications
DePaul University