Jasmine Branch
Seagoville,TX
Summary
Experienced Insurance Specialist with 10+ years of expertise in claims and compliance management. Skilled in cultivating strong client and vendor relationships, analyzing data, and negotiating settlements. Consistently ensures timely filing of state-required forms and provides mentorship to colleagues. Recognized for delivering excellent customer service, excelling in SME New Hire training, and providing effective coaching.
Overview
7
7
years of professional experience
1
1
Certification
Work History
SENIOR CLAIMS EXAMINER
BROADSPIRE
06.2024 - Current
- Assess the compensability of worker's compensation claims by conducting thorough and timely investigations; Ensure all compliance forms are completed and filed according to state-mandated guidelines
- Analyze claim data to establish appropriate reserves, considering the most likely outcomes; This approach prevents incremental reserve increases (stair-stepping) and provides a more accurate financial forecast for each claim
- Collaborate with internal team members, defense attorneys vendors, and stakeholders to ensure claims are serviced according to the specific requirements of the file
- Lead compliance reviews and round table meetings with clients and management team to discuss large loss files; Provide constructive feedback to clients to enhance their claim reporting and management
processes - Ensure claims are addressed timely and follow-ups are completed as scheduled by maintaining a diary system and calendar
- Stay current with changes to applicable regulatory standards and company procedures
CLAIMS EXAMINER III
SEDGWICK
07.2023 - 06.2024
- Consistently managed over 130 litigated loss time worker's compensation claims and medical only claims for designated clients with business across midwestern states from inception to close
- Conducted comprehensive interviews of witnesses and claimants to gather facts, determine compensability, and set claim reserves based on the most probable claim outcome
- Communicated with stakeholders, including regulatory bodies and internal teams, to provide clear information and resolve compliance issues
- Made informed decisions by applying critical thinking skills in assessing documentation, evaluating risks, and implementing action plans that maintain compliance
- Assisted with internal and external audits to confirm compliance with applicable laws and regulations
- Directed claims negotiations independently and with the assistance of defense; Ensured settlement documents were filed and payments were rendered timely and within state guidelines
CLAIMS SPECIALIST II
LIBERTY MUTUAL INSURANCE
11.2020 - 07.2023
- Managed litigated and non-litigated worker's compensation files by conducting claim investigations to confirm coverage, determine liability, and evaluate compensability and damages
- Assessed policy coverage and communicated coverage concerns to insured; Established and adjusted reserves as necessary during the life of the claim
- Ensured all state filings were documented and filed according to mandates; Engaged staff attorney, subrogation, and other internal departments as needed
- Strictly followed jurisdictional requirements for timely filing of required forms and payment of benefits to reduce the incurrence of fines and penalties
- Conducted mentor and coaching sessions with new hires to ensure proper education of compliance processes and the ability to transfer knowledge and skills to their new role
- Maintained TX adjusters license by adhering to state guidelines, attending trainings, and timely completion of continuing education courses
CLAIM PROCESSOR
LIBERTY MUTUAL INSURANCE
02.2020 - 11.2020
- Assisted Auto Liability Adjusters with litigated case files by obtaining the most accurate and current information regarding first and third-party bodily injury
- Managed incoming settlement demands, drop letters, LORs, and compliance documents by placing them in appropriate folders
- Made timely notifications to adjusters regarding all legal notices and compliance documents via email and claim diaries to eliminate delayed responses and errors
- Reviewed adjuster's claim evaluations and scheduled attorney contacts based on continuous monitoring of those evaluations and calendar updates
- Mentored and trained new processors on standard work expectations, offered support and made recommendations for efficiency and desktop management
- Developed an employee engagement team responsible for team celebrations and contests with the primary goal to drive diversity and inclusion and keep employees motivated
SR SPECIALIST - POLICY SERVICING
LIBERTY MUTUAL INSURANCE
09.2019 - 10.2020
- Rewrote personal line policies for eligible customers in an attempt to provide a better insurance premium or to initiate state transfers, product changes, and reinstatements
- Exercised independent judgment when deciding to rewrite policies for existing customers by conducting a thorough review of the customer tenure and policy history
- Utilized time effectively to ensure department service levels were met while still exceeding the needs of the customer
- Reviewed and organized incoming data from a variety of sources by placing documents into the correct file categories to ensure proper processing
- Led team huddles to review team stats, metrics, areas of opportunity, and discussed general team concerns in the absence of the team manager
- Utilized knowledge of insurance principles, policies, and customers insurance history to determine value of business
CORE - CUSTOMER SERVICE REP
Liberty Mutual Insurance
04.2018 - 09.2019
- Developed and maintained positive customer relations and coordinated with team members to properly handle requests and questions.
- Answered incoming calls from new and existing customers with coverage, billing, licensing and state compliance questions
- Educated customers on coverage and policy language on every type of personal line policy; Trained to service personal line policies in all 50 states
- Offered new lines of service to customers based on review of their profile and by listening to the needs of the customer
- Selected to coach and mentor peers and new hires to help with continuous improvement of metrics both individually and for the site as a whole
- Top performer by continuously exceeding all CORE metrics for average handle time, eNPS, iLTR and leads
Education
A.A.S. - Applied Science
PANOLA COLLEGE
Carthage, TX12.2017
Skills
- Compliance Monitoring
- Risk Management
- Process & Control Evaluation
- Project Management
- Analytical & Critical Thinking
- Attention to Detail
- Time Management
- Verbal & Written Communication
- Cross-Functional Collaboration
- Regulatory Analysis
- Policy Adherence
Certification
- Property & Casualty License | TX Dept. of Insurance
- All Lines Adjuster License | TX Dept. of Insurance
- Health & Life Insurance License | TX Dept. of Insurance
Timeline
SENIOR CLAIMS EXAMINER
BROADSPIRE
06.2024 - Current
CLAIMS EXAMINER III
SEDGWICK
07.2023 - 06.2024
CLAIMS SPECIALIST II
LIBERTY MUTUAL INSURANCE
11.2020 - 07.2023
CLAIM PROCESSOR
LIBERTY MUTUAL INSURANCE
02.2020 - 11.2020
SR SPECIALIST - POLICY SERVICING
LIBERTY MUTUAL INSURANCE
09.2019 - 10.2020
CORE - CUSTOMER SERVICE REP
Liberty Mutual Insurance
04.2018 - 09.2019
- Property & Casualty License | TX Dept. of Insurance
- All Lines Adjuster License | TX Dept. of Insurance
- Health & Life Insurance License | TX Dept. of Insurance
A.A.S. - Applied Science
PANOLA COLLEGE
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