JACQUISE WHITAKER
Antioch,Tn
Summary
Determine to accomplish life changing matters. Strive to grow and expand my knowledge for the future to be the best version of myself.
Overview
12
12
years of professional experience
Work History
License Claims Adjuster
Trexis Insurance
01.2020 - 06.2023
- Communicate personal auto policy language and analyzes liability for the appropriate parties
- Document claims with file notes in decision making process
- Secure detailed recorded statements from all involved parties
- Maintains loss reserves
- Achieves initial contact standards
- Develops and maintains effective working relationships with automotive repair facilities, police authorities and independent appraisal firms
- Setup and monitor rental vehicle usage
- Manages diaries in a timely manner
- Recognize and assign claims to the SIU
- Exceeds file quality standards
- Maintain confidentiality of clients information
- Handles Total Losses to completion
- Exceeds customer’s expectations
- Positive Professional Attitude
- Always willing to help others
- Self-motivated with strong work ethics, with strong communication skills.
Acceptance Insurance
01.2018 - 12.2018
- Demonstrates a high level of investigation, analysis, evaluation and negotiation including interpretation of coverages
- Adherence to proper procedures relating to inspection and evaluation of claims; Such as performing recorded
- Statements
- Evaluate policy coverage, contact insureds, claimants, attorneys, body shops while determining and establishing reserve requirements
- Document computer log with results of review and intentions for handling
- Compile information for decision making with discussion of claims committee where appropriate
- Maintain accurate records and handle administrative responsibilities associated with processing and payment of claims
- Record and update status notes, and document results of contacts per Best Practices
- Respond timely and appropriately to all settlement demands
- Keep internal and external customers advised of file status and other matters as required
- Evaluate claim for potential fraud and work with Special
- Investigations Unit as required
- Assess actual damages associated with claims and conduct negotiations to settle claims
- Determine if subrogation exists and take steps necessary to initiate recovery efforts.
Customer Service Rep
Cigna Healthspring
03.2011 - 10.2017
- High call volume with inbound/outbound calls
- Explained details of Eobs
- Reviewed benefits and claims with providers and customers
- Process Medicare and Medicaid benefits
- Process express scripts prescription drug plans
- Verified claim and coverages
- Grievance resolution specialist
- Verified provider credentials
- Hipaa compliant
Claims/Payment Processor Rep
Aetna
08.2016 - 09.2017
- Verified details of transactions, including funds received and total account balances
- Processed medical claims
- Rectified escalated accounts payable issues from customers and vendors
- Researched and resolved billing and invoice problems
- Review benefits with customers and providers
- Hipaa compliant
Education
High School Diploma -
05.2004
License Claims Adjuster
Skills
- Microsoft Word
- Excel
- Matrix
- Knowledge Check
- Qnxt
- As400
- Accurint
- CCC Tool
- Auto and Property Claims Adjuster
- Team player
- EOB/ SOP Specialist
- Grievance Investigations
- Claims Processing
- Insurance Fraud Expertise
- Strong Interpersonal and Communication Skills
- Data Analysis
- Medical Terminology Specialist
- Highly Motivated
- Quality Control
- Claims investigation
- Medical Coding
Timeline
License Claims Adjuster - Trexis Insurance
01.2020 - 06.2023
- Acceptance Insurance
01.2018 - 12.2018
Claims/Payment Processor Rep - Aetna
08.2016 - 09.2017
Customer Service Rep - Cigna Healthspring
03.2011 - 10.2017
Clarksville High School - High School Diploma,