Jeromesia Trahan
Experienced Liability Claims Adjuster
Houston,TX
Summary
I've ascertained over 10 years of claims experience in the industry, aligned with a comprehensive understanding of claims practices legal concepts and knowledge of litigation procedures, my intimate understanding of claims and uncompromising core values of file management claims procedures have allow me to remain committed to bring value through loyalty to any organization. I am highly intelligent, highly motivated, self-sufficient, flexible, and adaptable. I, self-aligned, governed and motivated with little need of supervision or direction. I am looking to re- enter the workplace where I can advance in a dynamic environment and further ,y expertise in Commercial General Liability field enhancing my commercial certification. The goal is to align myself with a team that not only recognizes the value I bring to the company but one who is also committed to the investment made in me with continued career training and education.
Overview
1
1
Certification
Work History
Claims Case Coordinator
US Legal Support - Litigation Resource Services
Houston , TX
- Developed and implemented case plans to meet the needs of clients.
- Reviewed client records and documents for accuracy and completeness.
- Provided guidance and counseling services to clients in crisis situations.
- Coordinated communication between multiple stakeholders, including families, doctors, social workers, teachers.
- Assessed client needs and developed individualized treatment plans accordingly.
- Maintained accurate documentation of all case activity in accordance with agency policy and regulations.
- Facilitated group meetings to discuss issues related to the cases being managed.
- Assisted clients in navigating complex legal systems by providing resources and referrals.
- Monitored compliance of court orders pertaining to each case.
- Acted as an advocate for clients during meetings with other professionals or agencies.
- Ensured confidentiality of all sensitive information associated with cases being managed.
- Stayed up to date on relevant processes and compliance standards for optimal oversight.
- Handled administrative procedures to meet objectives set by boards of directors or senior management.
- Determined organizational policies regarding program eligibility, requirements and benefits.
- Provided direct service and support by handling referrals for advocacy issues or resolving complaints.
- Met clerical needs by making phone calls, replying to emails and data entry.
- Completed patient follow-up services, data collection and clinical monitoring and liaised with primary health care providers to deliver coordinated care to patients.
- Accurately documented each activity for each patient in specified databases.
Liability Claims Adjuster
GEICO, Government Employees Insurance
Houston, TX
- Investigated liability claims to determine the extent of insurance company's responsibility for payment.
- Conducted interviews with claimants, witnesses, and medical providers to obtain information concerning claim circumstances.
- Researched applicable legal precedents and consulted with attorneys when necessary.
- Analyzed medical reports and other documents to assess damages and prepare settlement recommendations.
- Negotiated settlements with claimants or their representatives in order to resolve disputes.
- Drafted reports that documented investigation results, findings, and conclusions regarding liability claims.
- Assessed potential subrogation opportunities for recovering payments from third parties who were liable for losses incurred by insureds.
- Maintained detailed records of all activity related to assigned cases in accordance with established procedures.
- Reviewed policies issued by the company to ensure compliance with state regulations governing liability coverage.
- Monitored court proceedings involving pending litigation against the company and reported relevant developments.
- Ensured timely processing of claims through regular follow-up on outstanding issues.
- Developed effective working relationships with clients, service providers, attorneys, and other professionals involved in claim resolution process.
- Provided technical guidance and support to less experienced adjusters regarding complex liability claims investigations.
- Evaluated potential exposure levels associated with each case prior to initiating any settlement negotiations.
- Performed administrative duties such as preparing correspondence, reviewing invoices, tracking expenses., as required.
- Reviewed, evaluated and adjusted claims to promote fair and prompt settlement.
- Negotiated and settled claims according to information presented through reports, research and data verification.
- Completed required investigations on referred files within established timeframes.
- Identified and collected evidence and determined value to specific claim to properly assess conditions.
- Reviewed data to verify validity of claims and determine case management actions.
- Investigated questionable claims to determine payment authorization.
- Obtained necessary information to complete proper evaluation of injury claims.
- Gathered information from various third parties to determine claim acceptability.
- Conducted witness interviews to assist claim information gathering process.
- Analyzed and audited open claims to calculate additional payments owed.
- Communicated with personnel and legal counsel on claims involving litigation.
- Explained premiums owed to policyholders, agents and underwriters.
- Delivered exceptional customer service to clients by communicating information and actively listening to concerns.
- Input claim information and payments into company database.
- Reviewed policies to determine appropriate levels of coverage and assist with approval or denial decisions.
- Analyzed information gathered by investigations and reported findings and recommendations.
- Reviewed police reports, medical treatment records, medical bills and physical property damage to determine extent of liability.
- Explained loss coverage, assisted policyholders with itemizing damages and coordinated alternative living arrangements.
- Gathered and documented evidence to support court proceedings.
- Verified liability extent with reviews of police reports, medical treatment histories and other records.
- Conducted secondary evaluations of original investigations documentation and reports to facilitate smooth resolutions.
Education
Senior Claims Law Associate (SCLA) - CCLA-Casualty & Law-Principles-Fraud Investigation
American Educational Institute
Online- U.S.Skills
- Cross-Functional Collaboration
- Proficient in multi claims and estimating software
- Data Analysis by Research and Facts Collecting
- Written and Verbal Communication
- Customer Communication & Interpersonal Abilities
- Advocacy Experience & Client Needs Assessments
- Critical Thinking & Decision-Making
- Claims Evaluation & Coverage Assessment
- Liability Determination & Complex Problem Solving
- Policy Investigations & Policy Analysis
- Damage Assessment & Settlement Negotiation
- Claim Form Analysis Report and Records Review
- Coverage Determination & Benefit Explanation
- Fraudulent Claims & Complex Claims Investigation
**Administrative Leadership In Coaching & Mentoring**
> Quality Control & Management of Exposure Lines
> Legal Documentation and Reporting
> File/Claim Management for Allocation
> Litigation, Mitigation & Arbitration Support
> Regulatory Compliance
> Rules of Evidence & Collection Regulations; Sourcing__Compiling__Preserving
- Insurance claims cases
- Claims management
- Case Report Development
- Denied claims identification
- Claims Auditing
- Claims evaluations
Additional Information
- As an advanced claims and Insurance Professional, my desire in the industry is to lend and advance my knowledge of and experience in claims handling and liability investigation of Subrogation with Third Party Liability through training.
- Gain additional education & exposure with Commercial Liability Litigation
- My ideal employer will have an innovative approach to cultivating a positive and culturally diverse workforce with integrity, loyalty, and commitment to all.
**Thanks for your time & consideration**
Certification
- Licensed TX Adjuster - ALL LINES - 2014
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Quote
"In the pursuit of progress, one must be present, prepared, persistent & patient!"
JTrahan
Timeline
Claims Case Coordinator
US Legal Support - Litigation Resource Services
Liability Claims Adjuster
GEICO, Government Employees Insurance
Senior Claims Law Associate (SCLA) - CCLA-Casualty & Law-Principles-Fraud Investigation
American Educational Institute
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