Ivana Pranjic
Oak Lawn,IL
Summary
Experienced in processing first and third party liability claims, theft and fire losses, monitoring of salvage recoveries, and vandalism losses claims in high-volume environments. Successful at managing complete claims process with minimal direction. Conversational skills in English, Bosnian, and Serbo-Croation.
Excellent critical thinking and organizational abilities.
Military Veteran. Authorized to work in US for any employer.
Overview
8
8
years of professional experience
1
1
Certification
Work History
Claims Representative III
Clearcover Insurance
Chicago, IL
11.2021 - 02.2024
- Processed a high volume of claims efficiently while maintaining quality standards.
- Provided quality customer service to assigned, insured and claimants throughout claims process to deliver timely service to customers.
- Maintained detailed records of all communication with customers, claimants, providers, and internal departments.
- Reviewed and verified claim information to ensure accuracy of data and compliance with established policies.
- Provided clear explanations of benefits, eligibility requirements, and applicable laws when communicating with customers.
- Documented changes in claim statuses using specialized software systems.
- Adhered to strict guidelines pertaining to confidentiality while handling sensitive personal information.
- Verified details with policyholders and requested additional information.
- Investigated facts, confirmed coverage and liability, negotiated settlements, and determined payments for claims.
- Ensured timely submission of required documentation from claimants prior to approval of payment.
- Identified potential fraud indicators during the review process and reported suspicious activity accordingly.
- Assisted claimants, providers and clients with problems or questions regarding claims.
- Modified and updated existing policies and claims to reflect change in beneficiary, amount of coverage or type of insurance.
- Coordinated and planned investigations of claims to confirm compensability and coverage.
- Assisted new policyholders with processing claims.
- Collaborated with fellow team members to manage large volume of claims.
- Drafted statements of loss to summarize payments, underlying policy coverages and damages.
Auto Property Damage Adjuster
First Chicago Insurance Company
Bedford Park, IL
12.2018 - 11.2021
- Created or updated records with new files or information.
- Analyzed data and prepared summary reports for management review.
- Conducted research into applicable laws governing property damage cases.
- Investigated claims to determine validity and extent of damage.
- Evaluated policy coverage for each claim to ensure compliance with insurance regulations.
- Provided training sessions for new adjusters on best practices concerning handling of property damage claims.
- Maintained detailed records of payments made to claimants and vendors involved in the process.
- Interpreted complex policy language as it relates to liability issues associated with property damage claims.
- Reviewed pertinent documents including police reports, contracts, deeds.
- Interviewed claimants, witnesses, and experts to gather information about the incident.
- Reviewed policies to determine appropriate levels of coverage and assist with approval or denial decisions.
- Delivered exceptional customer service to clients by communicating information and actively listening to concerns.
- Input claim information and payments into company database.
- Investigated potentially fraudulent claims with focus on thoroughness, quality and cost control.
- Checked into questionable claims, interviewing agents and claimants to resolve errors and omissions.
- Analyzed information gathered by investigations and reported findings and recommendations.
- Reduced loss ratios through fair and prompt processing of claims.
- Drafted statement of loss to summarize damages, payments and underlying policy coverage.
Claims Representative
Founders Insurance Company
Des Plaines, IL
11.2017 - 11.2018
- Processed a high volume of claims efficiently while maintaining quality standards.
- Provided quality customer service to assigned, insured and claimants throughout claims process to deliver timely service to customers.
- Handled customer inquiries regarding insurance policy coverage details and payment status updates.
- Maintained detailed records of all communication with customers, claimants, providers, and internal departments.
- Reviewed and verified claim information to ensure accuracy of data and compliance with established policies.
- Documented changes in claim statuses using specialized software systems.
- Adhered to strict guidelines pertaining to confidentiality while handling sensitive personal information.
- Verified details with policyholders and requested additional information.
- Delivered quality customer service to assigned, insured and claimants throughout entire claims lifecycle to promote service times.
- Investigated facts, confirmed coverage and liability, negotiated settlements, and determined payments for claims.
- Ensured timely submission of required documentation from claimants prior to approval of payment.
- Managed asset recoveries for claims, including salvage, and subrogation.
- Identified potential fraud indicators during the review process and reported suspicious activity accordingly.
- Attended continuing education seminars related to insurance industry best practices and new legislation.
- Developed strategies to reduce the number of denied or delayed claims within assigned portfolio.
- Negotiated settlements for uncomplicated claims in accordance with actual company liability.
- Checked documentation for appropriate coding, catching errors and making revisions.
- Processed claims for payment or forwarded to appropriate personnel for further investigation
- Assisted claimants, providers and clients with problems or questions regarding claims.
- Examined claims, records and procedures to grant approval of coverage.
- Assisted new and current policyholders with processing claims.
- Examined automobile policies with third-party liability, accident benefits and collision benefits.
- Drafted statements of loss to summarize payments, underlying policy coverages and damages.
Fast Track Claims Representative
American Freedom Insurance
Mount Prospect, IL
02.2016 - 10.2017
- Processed a high volume of claims efficiently while maintaining quality standards.
- Provided quality customer service to assigned, insured and claimants throughout claims process to deliver timely service to customers.
- Handled customer inquiries regarding insurance policy coverage details and payment status updates.
- Maintained detailed records of all communication with customers, claimants, providers, and internal departments.
- Reviewed and verified claim information to ensure accuracy of data and compliance with established policies.
- Provided clear explanations of benefits, eligibility requirements, and applicable laws when communicating with customers.
- Documented changes in claim statuses using specialized software systems.
- Adhered to strict guidelines pertaining to confidentiality while handling sensitive personal information.
- Verified details with policyholders and requested additional information.
- Delivered quality customer service to assigned, insured and claimants throughout entire claims lifecycle to promote service times.
- Investigated facts, confirmed coverage and liability, negotiated settlements, and determined payments for claims.
- Identified potential fraud indicators during the review process and reported suspicious activity accordingly.
- Checked documentation for appropriate coding, catching errors and making revisions.
- Processed claims for payment or forwarded to appropriate personnel for further investigation
- Assisted claimants, providers and clients with problems or questions regarding claims.
- Examined claims, records and procedures to grant approval of coverage.
- Used insurance rate standards to calculate premiums, refunds, commissions and adjustments.
- Collected payments, processed receipts and informed policyholders of outstanding balances.
- Coordinated and planned investigations of claims to confirm compensability and coverage.
- Assisted new and current policyholders with processing claims.
- Prepared and reviewed insurance-claim forms and related documents for completeness.
- Handled modification and updating of policies.
Education
Certificate - Public Police Services - Criminal Justice
Wilbur Wright College
Chicago, IL06-2007
Skills
- File Management
- Conflict Resolution
- Team Collaboration
- Insurance Claims Review
- Accident Review
- Decision-Making
- Coverage Determination
- Time Management
- Claims Investigation
- Policy Knowledge
- Settlement Negotiation
- Accident Investigations
- Settlement Determinations
- Microsoft Office
Certification
- Licensed in AR, KY, OK, TX, VA, LA, AL
Timeline
Claims Representative III
Clearcover Insurance
11.2021 - 02.2024
Auto Property Damage Adjuster
First Chicago Insurance Company
12.2018 - 11.2021
Claims Representative
Founders Insurance Company
11.2017 - 11.2018
Fast Track Claims Representative
American Freedom Insurance
02.2016 - 10.2017
Certificate - Public Police Services - Criminal Justice
Wilbur Wright College
- Licensed in AR, KY, OK, TX, VA, LA, AL
Similar Profiles
Tina WilletTina Willet
Customer Advocate II at Clearcover InsuranceCustomer Advocate II at Clearcover Insurance
Lisa OslerLisa Osler
Customer Experience Supervisor at Clearcover Insurance CompanyCustomer Experience Supervisor at Clearcover Insurance Company
Eric EdsonEric Edson
Senior Data Scientist at ClearcoverSenior Data Scientist at Clearcover