JAYLINN JONES
Lawrenceville,GA
Summary
I am a highly motivated insurance professional with eight years of experience in property assessment, liability determination, and settlement negotiation. Currently, I hold a Property and Casualty license in over thirty states, specializing in the handling of complex litigated and bodily injury and general liability claims. I possess a keen attention to detail, strong observation skills, and extensive knowledge of the insurance industry. My interpersonal and documentation skills are excellent, allowing me to effectively communicate and manage claims. Additionally, I have a comprehensive understanding of claim processes, including medical terminology, medical coding, and claims file management. Throughout my career, I have been commended by my superiors for consistently maintaining accurate and organized case files.
Overview
7
7
years of professional experience
1
1
Certification
Work History
Litigation Claim Adjuster
Crawford and Company
Duluth , GA
10.2022 - Current
- Evaluation and negotiate the resolution of assigned claims in a timely manner, within appropriate authority and in accordance with laws and best practices
- Independently manage a diverse portfolio of high severity claims including coordinating an investigation into liability and exposure and review and interpretation of policy language in an effective and efficient manner
- Manage a caseload of General Liability, Excess and UM/UIM Claims in multiple states.
- Develop legal strategy with counsel and manage General liability, Excess and UIM/UM litigation consistent with litigation guidelines. This includes both, Coverage Counsel and Defense Counsel.
- Attend depositions, mediations, arbitrations, pre-trials, trials, and other legal proceedings.
- Post timely and accurate, loss and expense reserves and reevaluate exposures regularly during the life of a claim
Complex Property Adjuster
Renfroe
Duluth , GA
06.2021 - 10.2022
- Investigated properties, classified damages and created estimates outlining repair costs.
- Maintained knowledge of policies and procedures and insurance coverage benefit levels, eligibility systems and verification processes.
- Handled General Liability Claims for Commercial Vehicle
- Established proof of loss by studying documentation and assembling additional information from outside sources.
- Documented specific claims by completing recorded statement, reports and logs.
- Communicated with personnel and legal counsel on claims involving litigation.
- Investigated potentially fraudulent claims with focus on thoroughness, quality and cost control..
- Drafted statement of loss to summarize damages, payments and underlying policy coverage.
- Review Coverage and draft denial letter for management review.
Catastrophe Claims Adjuster
Renfroe
Duluth , GA
12.2020 - 06.2021
- Assessing daily claims, fire, wind, water, mold, and vandalism
- Scheduling inspections with insureds, attorneys and public adjusters
- Providing policy, and coverage information, with name insured, and attorneys.
- Carefully reviewed claim information to verify accuracy and avert fraudulent claims.
- Investigated claims by reviewing policy contracts to determine claim coverage based on cause and facts of loss.
Bodily Injury Claims Associate
State Farm Insurance Inc
Duluth , GA
12.2016 - 12.2020
- Researched documentation including statements and police reports
- Responsible for management of 250+ claims, collaborating with Special Investigations Unit in reviewing ICD codes on medical bills and verification of diagnosis
- Interpreted and explained policy regulations, exclusions and coverage
- Interviewed or corresponded with claimants, witnesses, police, physicians, or other relevant parties to determine claim settlement, denial, or review
- Reviewed police reports, medical treatment records, medical bills, or physical property damage
- Investigated, processed, and handled multiple disputes regarding liability between first and third parties
- Retained strong medical terminology understanding in effort to better comprehend procedures.
Education
Associate of Science - Business Administration
ATLANTA TECHNICAL COLLEGE
Atlanta, Georgia05.2021
Skills
- Microsoft Office
- Litigation Management
- ICD Coding
- Reserve Analysis
- Analytical Skills
- Leadership
- Deadline Oriented
- Claim Resolution
- Property Adjusting
- Liability Determination
- Fair Claim Practice
- MCS-90 Knowledge
- Legal Documentation and Reporting
- Verbal and Written Communication
- Complex Problem Solving
- Critical Thinking
- Settlement Negotiations
- Coverage Assessment
Certification
- ALASKA, ARIZONA, CONNECTICUT, DELAWARE, FLORIDA GEORGIA, KENTUCKY, LOUISIANA, MISSISSIPPI, NEW HAMPSHIRE, NEW MEXICO, NEW YORK, NORTH CAROLINA, OKLAHOMA, RHODE ISLAND, SOUTH CAROLINA, TEXAS, VERMONT, WASHINGTON DC, WEST VIRGINIA, WYOMING
Timeline
Litigation Claim Adjuster
Crawford and Company
10.2022 - Current
Complex Property Adjuster
Renfroe
06.2021 - 10.2022
Catastrophe Claims Adjuster
Renfroe
12.2020 - 06.2021
Bodily Injury Claims Associate
State Farm Insurance Inc
12.2016 - 12.2020
Associate of Science - Business Administration
ATLANTA TECHNICAL COLLEGE
- ALASKA, ARIZONA, CONNECTICUT, DELAWARE, FLORIDA GEORGIA, KENTUCKY, LOUISIANA, MISSISSIPPI, NEW HAMPSHIRE, NEW MEXICO, NEW YORK, NORTH CAROLINA, OKLAHOMA, RHODE ISLAND, SOUTH CAROLINA, TEXAS, VERMONT, WASHINGTON DC, WEST VIRGINIA, WYOMING
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