Dora Brown
Ruskin,Florida
Summary
Insurance Adjuster skilled in investigating and analyzing liability concerning personal, casualty or property loss. Proven history of leveraging excellent negotiation skills to facilitate settlements. Excellent communication skills demonstrated through serval years of experience interviewing specialists, witnesses and claimants to compile information.
Overview
10
10
years of professional experience
Work History
Workers' Compensation Specialist
ALOIS Temp Agency (Sedgwick)
07.2023 - 12.2023
- Calling and confirming appointments via phone and email
- Assuring the WC, NF and Lien case is active for Medical Treatment
- Determined liability, compensability and benefits due on each claim.
- Monitored claim progress and issued appropriate notices to maintain continued progress on claim processing and eliminate liability to company.
- Investigate claims by interviewing claimant, employer, witnesses, and physicians.
- Determine compensability and total value of claim
- Maintain reserves
Claims Adjuster
Riley Adjustment Bureau
02.2021 - 07.2023
- Examined claims forms and other records to determine insurance coverage.
- Verified insurance claims and determined fair amount for settlement.
- Reviewed police reports, medical treatment records, and physical property damage to determine extent of liability.
- Conducted comprehensive interviews of witnesses and claimants to gather facts and information.
- Documented all investigation activity and presented reports to management.
- Evaluated insurance policies and analyzed damages to determine coverage.
- Negotiated with policyholders and claimants to reach mutually satisfactory resolutions.
- Maintained suspicious claims database and prepared reports for supervisors.
- Negotiated favorable settlements with claimants, attorneys, and other insurance carriers to minimize financial risk for the company.
- Conducted thorough investigations of complex insurance claims, gathering evidence and analyzing relevant documentation.
Auto Claims Adjuster
Progressive
07.2019 - 07.2021
- Enhanced customer satisfaction by efficiently managing auto claims and providing prompt resolutions.
- Ensured regulatory compliance in all aspects of the auto claims process by staying up-to-date on industry laws and regulations.
- Issued payouts to claimants.
- Managed a high volume caseload without sacrificing quality or timeliness in delivering resolutions to clients'' auto accident-related issues.
- Reviewed police reports, photographs and other documentation to gain complete understanding of accident.
- Successfully negotiated settlements with claimants and insurers.
Customer Service Representative
Progressive
07.2018 - 07.2019
- Review coverages on home and auto insurance policy
- Process payments
- Developed strong product knowledge to provide informed recommendations based on individual customer needs.
Workers' Compensation Case Manager
Aetna
05.2014 - 05.2018
- Reviewed new files to determine current status of injury claim and to develop plan of action.
- Reviewed police reports, medical treatment records, and physical property damage to determine extent of liability.
- Conducted comprehensive interviews of witnesses and claimants to gather facts and information.
- Identified suspicious losses and contacted manager for investigative assistance.
- Determine coverage, compensability, potential for subrogation recovery, Federal DBA/longshore, and second injury funds.
- Establishes reserves and authorizes payments within reserving authority limits.
Education
Bachelor of Business Administration
University of Phoenix
01.2023
Certificate NPN# W650389 - All Lines Claims Adjuster Florida
Central Insurance School
01.2019
High School Diploma -
Middleton High School
Tampa, FL05.2006
Skills
- Decision Making
- Critical Thinking
- Negotiation
- Microsoft Office
- Xactimate
- Pyramid
- Juris
- Problem-Solving
- Multitasking
- Time Management
Timeline
Workers' Compensation Specialist
ALOIS Temp Agency (Sedgwick)
07.2023 - 12.2023
Claims Adjuster
Riley Adjustment Bureau
02.2021 - 07.2023
Auto Claims Adjuster
Progressive
07.2019 - 07.2021
Customer Service Representative
Progressive
07.2018 - 07.2019
Workers' Compensation Case Manager
Aetna
05.2014 - 05.2018
Bachelor of Business Administration
University of Phoenix
Certificate NPN# W650389 - All Lines Claims Adjuster Florida
Central Insurance School
High School Diploma -
Middleton High School