Jameela Maddox
Country Club Hills,IL
Summary
Professional as a Claims Representative, Regulatory Filing Technician, and Policy Service Representative. Maintains a strong knowledge of the insurance industry, including filing forms and regulations. Excellent communication and organizational skills, and proficiency in operating computer software. Across the board, maintain the necessary skills and ability to effectively handle insurance claims.
Overview
26
26
years of professional experience
1
1
Certification
Work History
Claims Representative
Lawyer's Professional Liability
Chicago, IL
06.2014 - 09.2016
- Company Overview: Professional Services initial solutions Team
- Performs a combination of duties in accordance with departmental guidelines:
- Interpret basic policy coverages and determine if coverages apply to claims submitted, escalating issues as needed
- Establish reserves and authorize payment within the scope of authority, settling claims in the most cost-effective and timely manner
- Provide a prompt issuance of disbursements while effectively managing loss costs and claim expenses
- Conduct investigations and assessment of claims: contact with insureds, claimants, witnesses, and experts
- Determine and escalate serious claim developments to management efficiently and effectively
- Coalitions with attorneys, account representatives, agents, underwriters, doctors, and insureds to develop a focused strategy for timely and cost-effective resolution of claims
- Acknowledges the need for negotiate, participates in planning strategy, and negotiate within the scope of authority
- Identify claims with third-party recovery potential and coordinate with the subrogation/salvage unit
- Analyzes claims activity and prepared for the reports for management review
- Accountable for input of data that accurately reflects claim circumstances and other information important to our business outcomes
- Conserves current on state/territory issues, regulations, and trends
- Professional Services initial solutions Team
Regulatory Filing Technician
CNA Insurance
Chicago, IL
05.2011 - 05.2014
- Develop and maintain all documentation required for state filing requirements
- Assure accurate regulatory filing with state departments, and support all staff in regulatory filing activities
- Decide if the facts of the claim require state-specific reports
- Apprehend pipeline for state filing requirements
- Procedure state and federal (NPDB) reports4
- Accountable for updating and maintaining state filing reports /yearly reconciliation
- Process filings via industry industrialization tools and manage the transfer of funds in support of these filings
- Receive and distribute bulletins and notices regarding state & NPDB reporting requirements
- Take part in a way that collaborates with internal and external partners
- Fortify knowledge of State Department Insurance filing requirements
Senior Policy Representative
CNA Insurance
Chicago, IL
05.2005 - 12.2011
- Review incoming business transactions and related information for completeness, accuracy, and quality
- Work with underwriter and other areas to resolve any discrepancies and process insurance policies in a timely manner
- Quote, rate, and maintenance for multiple lines of business: Auto, General Liability, and Work Comp
- Perform manual rating functions
- Train less experienced staff and act as a resource for questions
Claims Representative
Mass Mutual Insurance
Matteson, IL
01.2002 - 12.2003
- Processed Medical claims for several business partners
- Strengthened contact with senior executives regarding disbursements
- Provided specialized customer services regarding individual policyholder
Job Coach
Park Lawn Center
Alsip, IL
09.1990 - 08.2003
- Identify interests:Help job seekers find jobs that match their interests
- Understand the business community:Explain how people with disabilities can add value to the workplace
- Find workplace supports:Identify resources that can help job seekers get employed
- Connect interests and capabilities:Match individual skills and interests with potential jobs
- Coordinate with employers:Negotiate customized job responsibilities and secure employment
- Provide job training: Tailor one-on-one training to the individual
- Help with adjustment:Support the individual as they adjust to their new role
- Advocate: Advocate for the individual throughout their employment
- Teach workplace behavior: Teach workplace attitudes and help individuals develop relationships with coworkers
Education
Bachelors Degree - Bachelor of Sciences and Arts
Governors State University
05.2006
Associate's - Radiology
Malcolm X College
06.1979
Skills
- General knowledge of the insurance industry, the business unit and products
- Strong working knowledge of filing forms, regulations, and positions
- Ability to work independently as well as in a team environment
- Strong writing and verbal communication skills
- Strong organizational skills including the ability to prioritize and coordinate multiple projects
- Solid computer skills including Microsoft Office Suite and other business-related software systems
- Organizational skills
- Medical office experience
- Typing
- Time management
- Data entry
- Administrative experience
- EMR systems
- Insurance Verification
- Medical Terminology
- Developmental Disabilities Experience
- HIPAA
- Medical Records
Certification
- Paralegal Certificate
- Paraprofessional Educator Aide
Workauthorization
Authorized to work in the US for any employer
Pronouns
She/Her
Timeline
Claims Representative
Lawyer's Professional Liability
06.2014 - 09.2016
Regulatory Filing Technician
CNA Insurance
05.2011 - 05.2014
Senior Policy Representative
CNA Insurance
05.2005 - 12.2011
Claims Representative
Mass Mutual Insurance
01.2002 - 12.2003
Job Coach
Park Lawn Center
09.1990 - 08.2003
Bachelors Degree - Bachelor of Sciences and Arts
Governors State University
Associate's - Radiology
Malcolm X College
Similar Profiles
Brandon A. DavisonBrandon A. Davison
Healthcare Professional Insurance Senior Underwriter at CARE Professional Liability Association, LLCHealthcare Professional Insurance Senior Underwriter at CARE Professional Liability Association, LLC
Kushal MaluKushal Malu
Intern at Lawyer's Office & District CourtIntern at Lawyer's Office & District Court
Nusrat Jahan TonniNusrat Jahan Tonni
Volunteer at Lawyer's OfficeVolunteer at Lawyer's Office
Jaimyra SweetJaimyra Sweet
Patient Care Assistant at Help At Home HomecarePatient Care Assistant at Help At Home Homecare
Willie HayesWillie Hayes
Laborer at TNC Remodeling IncLaborer at TNC Remodeling Inc