Jessica Douglas
Sonoita,AZ
Summary
Detail-oriented Claims Examiner with 15 years of experience. Strong command of conflict resolution and negotiation combined with excellent reporting and research skills. Thorough understanding of claims process, evaluating catastrophic injuries and litigation against the company and insureds.
Overview
19
19
years of professional experience
Work History
Senior Claims Examiner
GEICO
02.2008 - Current
- Delivered professional customer service to policyholders and potential policyholders by communicating important information and patiently listening to issues.
- Investigated and processed first party, third party and litigation insurance claims for policyholders and claimants.
- Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
- Reviewed police reports, medical treatment records, and physical property damage to determine extent of liability.
- Interviewed claimants and witnesses to gather factual information.
- Directed claims negotiations within allowable limit of up to $3 Million dollars and supported successful litigations for complex issues.
- Handled complaints and grievances using negotiating and problem-solving skills.
- Resolved complex, severe exposure claims.
- Researched incident information to recommend solutions and resolve all claims.
- Reviewed and analyzed suspicious and potentially fraudulent insurance claims.
- Researched statutes, decisions, legal articles, and codes.
- Collaborated with lead attorney and claims home office attorneys to recommend effective strategies for catastrophic injuries, insurance bad faith and litigation cases.
- Assisted counsel in preparing answers, providing documentation, and information for discovery request.
- Revised and finalized letters, briefs, and memos.
- Analyzed evidence gathering and presentation, client counseling and jury selection methods processes for civil litigation.
- Attended court hearings, mediations, arbitrations, depositions and trials.
- Mentored less experienced claims associates and assists with training/coaching.
Customer Service Supervisor
Gap, Inc.
01.2004 - 02.2008
- Implemented daily operating procedures to keep store clean, adequately stocked, and well-organized.
- Hired, managed, developed and trained staff, established and monitored goals, conducted performance reviews and administered salaries for staff.
- Handled customer complaints, resolved issues, and adjusted policies to meet changing needs.
- Supervised more than 50 workers.
Education
No Degree - Business Administration
- Relevant Coursework: Accounting 1&2, Business Law
High School Diploma -
05.2004
- Certified Arbitrator, Intercompany Arbitration Forums - 2010-Present
Skills
- Customer Satisfaction
- Claim Validity Determination
- Liability and Coverage
- Policy Interpretation
- Complex Problem-Solving
- Injury Evaluation
- Litigation Management
- Reserve Management
- HIPAA Procedures
- Negotiation and Mediation Skills
- Detailed Claim File Reports and Presentations
- Exhibit and Motion Preparation
Timeline
Senior Claims Examiner - GEICO
02.2008 - Current
Customer Service Supervisor - Gap, Inc.
01.2004 - 02.2008
Pima Community College - No Degree, Business Administration
Santa Fe High School - High School Diploma,
Licenses & Certifications - ,
Similar Profiles
Hope RodriguezHope Rodriguez
Claims Adjuster at GEICOClaims Adjuster at GEICO
Anthony JohnsonAnthony Johnson
Auto Claims Adjuster- LDP at GEICOAuto Claims Adjuster- LDP at GEICO
Joletha GoodmanJoletha Goodman
Business Developer at GEICOBusiness Developer at GEICO
Humberto MenjivarHumberto Menjivar
Bilingual Commercial Trucking Sales Representative at GEICOBilingual Commercial Trucking Sales Representative at GEICO
Stephanie CianciottoStephanie Cianciotto
ACCOUNTANT at Self EmployedACCOUNTANT at Self Employed