Summary
Overview
Work History
Education
Skills
Languages
Timeline
Generic

Eunice Payano

Tampa,FL

Summary

Detailed Adjuster with over 5 years of experience in corporate insurance claims. Strong command of claimant information intake processes, litigation and treatment management, and fraudulent investigation protocols. Impactful skills preparing operational reports, presenting information to audiences and approving claim payouts.

Overview

8
8
years of professional experience

Work History

Casualty Claims Specialist

Liberty Mutual
08.2022 - Current
  • Delivered exceptional customer service to policyholders by communicating important information and patiently listening to issues.
  • Examined claims forms and other records to determine insurance coverage.
  • Read over insurance policies to ascertain levels of coverage and determine whether claims would receive approvals or denials.
  • Conducted day-to-day administrative tasks to maintain information files and process paperwork.
  • Reviewed police reports, medical treatment records, and physical property damage to determine extent of liability.
  • Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
  • Reviewed and analyzed suspicious and potentially fraudulent insurance claims.
  • Conducted comprehensive interviews of witnesses and claimants to gather facts and information.
  • Directed claims negotiations within allowable limits and supported successful litigations for advanced issues.
  • Negotiated settlement agreements to resolve disputes.

Workers' Compensation Claims Specialist

Liberty Mutual
12.2018 - 08.2022
  • Provided a high degree of customer service to clients, including face to face interactions during claims reviews, stewardship meetings and similar account-specific sessions.
  • Promptly investigated all assigned claims with minimal supervision, including those of a more complex nature.
  • Determined coverage, compensability, potential for subrogation recovery, and second injury fund (when applicable).
  • Negotiated claims settlements within granted authority.
  • Established and implemented appropriate action plans for case resolution including medical and disability management, litigation management, negotiation and disposition.
  • Worked collaboratively with telephonic and field nurse professionals to develop and execute return to work strategies
  • Communicated effectively, verbally and in writing with internal and external parties on a wide variety of claims and account issues.
  • Authorized treatment based on the practiced protocols established by statute or company policy.

Strategic Account Executive

Dynamic Network Group, LLC
01.2018 - 12.2018
  • Negotiated agreements to develop and execute profitability strategies for key accounts.
  • Generated sales activity to build functional pipeline of qualified opportunities.
  • Supported continuous improvement of group strategies, program development and organizational effectiveness to drive revenue.
  • Determined direction for strategic accounts by researching competitive landscape, market insights and communication across stakeholders.
  • Traveled (within the state) to visit stakeholders, prospects and existing clients, generating additional business opportunities.
  • Built credibility and trust to influence client's buying decisions.
  • Suggested solutions and innovative ideas to meet client needs.
  • Established client and market priorities to execute strategic course of action.

Workers' Compensation Claims Specialist

Chubb Group Of Insurance Companies
10.2015 - 10.2017
  • Analyzed and managed complex or technically difficult claims by investigating and gathering information to determine the exposure on the claim; managed claims through well-developed action plans to an appropriate and timely resolution.
  • Calculated and assigned timely and appropriate reserves to claims; managed reserve adequacy throughout the life of the claim .
  • Prepared necessary state filings within statutory limits.
  • Managed the litigation process; ensured timely and cost-effective claims resolution.
  • Used appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients.
  • Reported claims to the excess carrier; responded to requests of directions in a professional and timely manner.
  • Managed claim recoveries, including be not limited to subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets.
  • Communicated claim activity and processing with the claimant and the client and maintained professional client relationships.

Education

Bachelor of Science - Business Management

University of Central Florida
Orlando, FL
05.2012

Associate of Arts - Business Administration

Valencia College
Orlando, FL
05.2010

Skills

  • Organizational Skills
  • Case Management
  • Settlement Determinations
  • Litigation Review
  • Investigation Documentation
  • Damage Itemization
  • Bodily Injury Settlements Proficiency
  • Customer Relationship Management
  • Negotiation and Mediation Skills
  • Liability Determinations

Languages

Spanish
Native or Bilingual

Timeline

Casualty Claims Specialist

Liberty Mutual
08.2022 - Current

Workers' Compensation Claims Specialist

Liberty Mutual
12.2018 - 08.2022

Strategic Account Executive

Dynamic Network Group, LLC
01.2018 - 12.2018

Workers' Compensation Claims Specialist

Chubb Group Of Insurance Companies
10.2015 - 10.2017

Bachelor of Science - Business Management

University of Central Florida

Associate of Arts - Business Administration

Valencia College

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Eunice Payano