Summary
Overview
Work History
Education
Skills
Timeline
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Ericca Nesmith

Jonesboro,GA

Summary

Dynamic Claims Adjuster with drive and experience providing a superior level of customer service to clients. Bringing forth the ability to properly investigate a situation and resolve claims quickly in accordance with company and regulatory guidelines. Demonstrating consistent execution of best claim practices and a commitment to industry and company ethics.

Overview

5
5
years of professional experience

Work History

Property Manager and STR Consultant

Moldavite Management Consultants LLC
10.2021 - Current
  • Evaluate short-term and long-term projects, addressing a range of issues and finding resolutions
  • Reviews, performs statistical analysis and interpretation of collected data relating to policies, procedures, organization, managerial and operational practices; Defines and may make recommendations for correcting problems
  • Prepare talent for interviews and speaking engagements; Facilitate as appropriate and coordinate media etiquette training when required
  • Advise new and existing practices on marketing and business development, and continuous quality improvement
  • Manage five short-term rental properties including managing cleaning team.
  • Increased property occupancy rates by effectively marketing available units and conducting thorough tenant screenings.
  • Conducted regular property inspections, identifying areas for improvement and proactively addressing potential safety hazards.
  • Managed budgetary constraints to maximize profitability while maintaining high-quality living environments for residents.

Claims Adjuster - Bodily Injury/Property Damage Adjuster

State Farm
11.2021 - 02.2024
  • Conducting thorough investigations of insurance claims to determine coverage, liability, and damages
  • Reviewing policy documentation, accident reports, witness statements, and other relevant materials to assess the validity of claims
  • Evaluating the extent of damages, injuries, or losses and negotiating settlements within established authority levels
  • Communicating with policyholders, claimants, attorneys, and other parties involved in the claims process to gather necessary information and provide updates on claim status
  • Utilizing industry-standard software and tools to document claim details, update records, investigate and generate reports
  • Collaborating with internal team members, including underwriters, legal counsel, and fraud investigators, to ensure accurate claim assessment and resolution
  • Adhering to company guidelines, policies, and legal requirements while handling claims
  • Keeping up-to-date with industry trends, regulations, and best practices in claims adjusting.
  • Achieved high customer satisfaction ratings by providing clear and timely communication throughout the claims process.

Elite Advocate

UnitedHealth Group
09.2019 - 09.2021
  • Demonstrate superior customer service and professionalism at all times
  • Effectively communicate with care providers, assisting with appointment scheduling and other connections
  • Negotiate fees with healthcare providers and assist members with self-navigating through company website
  • Verify documents and coordinate health care coverage for patients, including eligibility of benefits
  • Gather and process information needed to complete and adjust medical insurance claims
  • Adhere to strict HIPPA guidelines
  • Work to resolve any issues/concerns in order to retain loyal business and increase client satisfaction
  • Display knowledge of benefits, while meeting/exceeding all key performance metrics
  • Submit pre-authorizations and pre-determination requests.

Education

Bachelor of Science - Business Administration

Capella University
Minneapolis, MN
01.2022

Skills

  • Problem Solving
  • Ability to Multitask
  • Teamwork
  • Time Management
  • Professionalism
  • Negotiating
  • Meeting Tight Deadlines
  • Efficiency

Timeline

Claims Adjuster - Bodily Injury/Property Damage Adjuster

State Farm
11.2021 - 02.2024

Property Manager and STR Consultant

Moldavite Management Consultants LLC
10.2021 - Current

Elite Advocate

UnitedHealth Group
09.2019 - 09.2021

Bachelor of Science - Business Administration

Capella University

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Ericca Nesmith