Jennifer Fowler
Insurance
New Braunfels,TX
Summary
Claims Examiner with deep knowledge of auto claims industry. Solid abilities in developing objectives and strategies to settle auto claims. Excellent skills compiling, coding, categorizing and auditing information to process claims.
Overview
13
13
years of professional experience
2
2
Certification
Work History
Claims Adjuster
Progressive Insurance
11.2019 - 08.2024
- Negotiated favorable settlements with claimants, attorneys, and other insurance carriers to minimize financial risk for the company.
- Examined claims forms and other records to determine insurance coverage.
- Maintained compliance with state regulatory requirements through meticulous documentation and adherence to company policies.
- Conducted thorough investigations of complex insurance claims, gathering evidence and analyzing relevant documentation.
- Achieved cost savings through successful subrogation efforts, recovering funds from responsible parties in various claims scenarios.
- Prepared summaries of payments, and policy coverages.
- Contributed to a positive work environment through active participation in team meetings and collaborating on cross-functional projects.
- Provided exceptional customer service during emotionally difficult situations for policyholders following accidents or natural disasters.
- Achieved high customer satisfaction ratings by providing clear and timely communication throughout the claims process.
- Reviewed police reports and physical property damage to determine extent of liability.
- Answered customer questions regarding deductibles.
- Evaluated coverage accurately by interpreting complex insurance policies and applying them to specific claim scenarios.
- Conducted comprehensive interviews of witnesses and claimants to gather facts and information.
- Improved claim resolution times by efficiently managing a caseload of 50+ claims per month.
- Identified potential fraud indicators early in the investigation process, protecting company assets from potential losses due to fraudulent activity.
- Facilitated smooth transitions for policyholders during the claim process by liaising between various departments, ensuring all parties were informed and engaged.
- Negotiated with policyholders and claimants to reach mutually satisfactory resolutions.
- Mentored junior adjusters on best practices and industry regulations, contributing to their professional growth and development.
- Provided exceptional customer service, addressing concerns, and answering questions promptly.
- Delivered exceptional customer service to policyholders by communicating important information and patiently listening to issues.
- Researched claims and incident information to deliver solutions and resolve problems.
- Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
- Determined liability outlined in coverage and assessed documentation such from police and healthcare providers to understand damages incurred.
- Read over insurance policies to ascertain levels of coverage and determine whether claims would receive approvals or denials.
- Analyzed information gathered by investigation and reported findings and recommendations.
- Interviewed and reviewed questionable claims by conducting agent and claimant interviews to correct omissions and errors.
- Maintained claims data in Claims Pro systems.
- Conducted day-to-day administrative tasks to maintain information files and process paperwork.
- Identified suspicious losses and contacted manager for investigative assistance.
Policy Service Specialist
Progressive Insurance
01.2019 - 11.2019
- Maximized customer retention levels by offering personalized assistance on selecting appropriate additional coverages.
- Managed confidential client information securely maintaining compliance with industry regulations and company policies.
- Mentored junior team members to foster a supportive work environment and promote professional growth within the department.
- Delivered excellent customer experiences while resolving complex issues related to billing discrepancies or coverage disputes.
- Improved customer satisfaction with timely and accurate policy updates, modifications, and renewals.
- Maintained strong relationships with customers by addressing inquiries promptly and providing exceptional service at all times.
- Checked documentation for accuracy and validity on updated systems.
- Posted payments to accounts and maintained records.
- Collected premiums and issued accurate receipts.
Ancillary-Property-HOA-Code Compliance Specialist
Assurant Specialty Property
08.2011 - 10.2018
- Implemented robust record-keeping systems that ensured accurate documentation was maintained according to regulatory requirements at all times.
- Served as a point of contact for employees seeking guidance on compliance matters, instilling confidence in the organization''s commitment to regulatory adherence.
- Assisted in the preparation of regular reports for senior management, detailing compliance activities and progress towards established goals.
- Reduced instances of non-compliance through meticulous monitoring of internal controls and periodic audits.
- Provided expert guidance to colleagues on matters related to regulatory compliance, solidifying company-wide understanding of requirements.
- Conducted thorough risk assessments to identify potential areas of non-compliance and recommended corrective actions.
- Served as subject matter expert by advising staff and customers and working directly with external agencies throughout audits or to remedy compliance issues.
- Performed quality reviews to uncover workflow and communication issues.
- Supported team by pitching in to complete special projects.
- Collaborated with other departments to integrate compliance considerations into daily business operations seamlessly.
- Created and maintained compliant work environment.
- Evaluated and monitored supplier and partner relationships to support compliance.
- Warned violators of infractions or penalties.
- Advised clients on compliance fraud and investigations, as well as potential remedies and required actions.
- Assessed fees related to registration of property-related documents.
Education
Medical Billing & Coding
Virginia College of Austin
Austin, TX05.2010
High School Diploma -
Leander High School
Leander, TX10.1997
Certification
- Certified Insurance Coding Specialist
- Claims Adjuster License
Skills
- Advanced oral and written communication skills
- Advanced computer skills -Proficient with CLAIMS PRO, ACCURINT, ISO, CSAA, DCS, POLICY PRO, ARMS, HERTZ
- Data Analysis
- Medical Coding - Healthcare Common Procedures Coding System (HCPCS)
- Settlement Negotiations
Timeline
Claims Adjuster
Progressive Insurance
11.2019 - 08.2024
Policy Service Specialist
Progressive Insurance
01.2019 - 11.2019
Ancillary-Property-HOA-Code Compliance Specialist
Assurant Specialty Property
08.2011 - 10.2018
Medical Billing & Coding
Virginia College of Austin
High School Diploma -
Leander High School