Emma Coleman

• Educated policyholders on coverage details to clarify expectations and responsibilities.
• Evaluated claims for accuracy and completeness for prompt resolution of disputes.
• Prepared detailed reports by compiling findings from investigations and analysis of claims.
• Monitored changes in insurance laws for updates that impact claims handling.
• Negotiated settlements with policyholders to reach agreeable resolutions.
• Examined claims forms and other records to determine insurance coverage.
• Verified insurance claims and determined fair amount for settlement.

• Increased recovery rates by implementing efficient subrogation strategies and negotiation tactics.
• Negotiated settlements with responsible parties, obtaining favorable terms for the company while minimizing legal costs.
• Streamlined processes for identifying potential subrogation opportunities, improving case outcomes.
• Provided exceptional customer service when interacting with claimants or other stakeholders throughout the claims process.

• Leveraged strong analytical skills to assess vehicle damages accurately and determine appropriate settlement amounts based on market values.

• Maximized recoveries from at-fault parties through diligent subrogation efforts, contributing to the company''s financial success.

• Provided exceptional customer service, addressing policyholder concerns and answering questions regarding claim status.

• Implemented cost-saving strategies during negotiations with repair facilities, reducing overall expenses for the company.

• Improved claims handling efficiency by maintaining organized records of all open and closed claims.

• Upheld the integrity of the claims process by consistently adhering to ethical guidelines and maintaining confidentiality when dealing with sensitive client information.

• Reduced processing time for claims by streamlining the evaluation process and ensuring accurate documentation.

• Collaborated with appraisers to negotiate settlements, resulting in fair compensation for policyholders.

• Served as a liaison between policyholders, repair facilities, and other stakeholders to expedite claim resolution while maintaining open lines of communication.

Managed Workers Compensation cases, including complex and long term indemnity claims, ensuring accurate compensability decisions and reserve adequacy.

Conducted 3 point contact investigation, with claimants, employers and medical providers to gather critical information and ensurance PHI regulation compliances were met.

Evaluated claims for settlement purposes, while identifying subrogation opportunities and negotiating settlements to achieve favorable outcomes.

Responded to Requests for Authorization, and Utilization Review referrals, ensuring appropriate medical treatment and timely resolutions.

Maintained detailed documentation in claim systems, prepared carrier reports and monitored reserves adequacy throughout the lifecycle of the claim

Developed Action Plans to resolve claims effectively and efficiently, by coordinating return to work efforts and facilitated wage statement calculations and benefit payments.

Communicated regularly with account managers, brokers, and policyholders to provide updates and ensure seamless claim handling.

• Drafted comprehensive investigative reports to summarize findings and support case conclusions.
• Coordinated with legal teams to prepare for trials and provide necessary evidence.
• Collected, analyzed and interpreted information, documentation, and physical evidence associated with investigations.
• Conducted thorough interviews to gather critical information from witnesses and suspects.
• Ensured compliance with legal regulations during investigations, minimizing risk for litigation or procedural errors.
• Improved case resolution rates by conducting thorough investigations and utilizing effective interviewing techniques.

• Conducted interviews with witnesses and clients.

• Prepared case reports from allegations, transcripts of interviews and physical evidence.

• Assisted in the development of investigative strategies, resulting in more efficient case resolutions.