JODI COE
Williamston,MI
Summary
Multi-line Claims Supervisor dedicated to quality investigation, adjustment and supervision of diverse cases. Blends strategic planning and leadership strengths to establish top-performing claims departments. Trains and mentors staff, optimizing compliance with policies, procedures and applicable laws.
Overview
18
18
years of professional experience
1
1
Certification
Work History
Claims Supervisor
CompOne Administrators
Novi, MI
06.2019 - Current
- Investigation, negotiation, settle or deny complex PIP and general liability claims in sectors such as: roadway defect, commercial and personal property damage, personal injury, slip and falls and complex bodily injury involving catastrophic injuries/fatalities.
- Provide continued support to managers, conducted performance reviews and made recommendations on disciplinary actions and promotions.
- Monitoring team performance, call handling time, adherence to daily schedules, claim guidelines and procedures. Resolved claims that are complex in nature, have disputed liability, fraud or SIU indicators.
- Applies expert training and assistance to staff and clients with an understanding of insurance regulations, statutes, processes and maintained organizational relationships with internal and external business partners.
- Proficient in General Liability and Personal Injury Protection claims, reviewing medical terminology, medical records, completing evaluations of general damage elements and negotiating claim settlements.
- Resolution of complex claims involving disputed liability, fraud, subrogation and partnered with assigned claim representatives and service providers to achieve the best outcome.
- Efficiently managing all aspects of litigated claims, including an advanced knowledge of the Michigan No-Fault statute and Governmental Tort Liability Act.
- Mentor junior staff, fostering professional growth and improving overall team performance.
- Maintained up-to-date knowledge of industry trends and regulations, ensuring adherence to all relevant guidelines.
- Oversaw regular audits of processed claims to identify patterns of error or potential fraud indicators.
- Increased team productivity by implementing efficient workflows and setting clear expectations for staff members.
- Streamlined operations for increased efficiency through regular process reviews and implementing necessary changes.
Senior Claims Representative
Frankenmuth Insurance
Frankenmuth, MI
02.2017 - 06.2019
- Reviewed and analyzed suspicious and potentially fraudulent insurance claims
- Compared data from surveillance footage to data on medical reports
- Evaluated all evidence with the ultimate goal of creating positive outcomes for client's claims
- Successfully eliminated claimant, premium and provider fraud
- Reviewed and paid all necessary and related medical billings
- Building and maintaining relationships with insureds, claimants, and vendors
- Coordinating and facilitating all aspects of PIP claims.
- Conducted thorough investigations of disputed claims, gathering evidence to support decision-making processes.
- Negotiated claim settlements with claimants and attorneys to resolve claims efficiently and fairly.
Senior Claims Representative
Michigan Farm Bureau Insurance
Lansing, MI
05.2011 - 02.2017
- Litigation and Catastrophic PIP claims specialist.
- Working effectively with claimants and vendors (physicians, nurse case managers, attorneys, surveillance teams, and contractors) in all aspects of the Personal Injury Protection claims process
- Investigating and analyzing claims for coverage, relatedness, and potential fraud
- Negotiating claim status and attending litigation proceedings, including depositions, settlement conferences, case evaluations, and trial
- Evaluating and processing medical bills and correspondence in relation to injuries sustained in motor vehicle accidents
- Coordinating and implementing changes in the user interface, as part of the OnBase Task Force
- Partnering with SIU and outside attorneys in the investigation of Southeast Michigan attorney and medical provider rings to assist in lowering insurance fraud.
- Settled complex claims fairly by applying critical thinking, negotiation skills, and detailed knowledge of insurance policies.
- Identified fraudulent claims through diligent investigation and collaboration with law enforcement agencies when necessary.
- Developed strong working relationships with external partners such as adjusters, legal counsel, and medical professionals to facilitate efficient claim resolution processes.
- Delivered comprehensive training sessions for new hires on claims handling procedures, policy interpretation basics, negotiation techniques, and other core competencies related to the role of a Claims Specialist.
Corporate Account Manager
Superior Investigative Services
01.2014 - 12.2014
- Directed and coordinated marketing activities and policies to promote products and services
- Preserved brand integrity by monitoring the consistency and quality of marketing content
- Coordinated and participated in promotional activities and trade shows
- Directed product development using in-depth knowledge of vendor landscape and industry insight
- Presented information at professional forums, conferences and associations.
Catastrophic Claims Specialist
Auto-Owners Insurance Company
Lansing, MI
09.2006 - 05.2011
- Working effectively with claimants and vendors (physicians, nurse case managers, attorneys, surveillance teams, and contractors) in all aspects of the Personal Injury Protection claims process
- Investigating and analyzing claims for coverage, relatedness, and potential fraud
- Negotiating claim status and attending litigation proceedings, including depositions, settlement conferences, case evaluations, and trial
- Evaluating and processing medical bills and correspondence in relation to injuries sustained in motor vehicle accidents
- Maintained accurate records by diligently updating claim files and ensuring all required documentation was submitted in a timely manner.
- Delivered comprehensive training sessions for new hires on claims handling procedures, policy interpretation basics, negotiation techniques, and other core competencies related to the role of a Claims Specialist.
- Reduced claim processing errors by conducting thorough investigations and accurately interpreting policy details.
Education
No Degree - Biochemistry
Michigan State University - Lyman Briggs College
East Lansing, MIBachelor of Science - Business Administration Finance
Central Michigan University
Mt Pleasant, MI01.2004
Skills
- Property and Casualty Claims Processing
- Insurance policy knowledge
- Skilled multi-tasker
- Highly motivated
- Advanced oral and written communication skills
- Claims Management Expertise
- Legal Compliance
- Team motivation
- Claims investigation and research
- Team Management
- Fraud prevention
- Insurance Negotiation
- Advanced knowledge of No-Fault Statutes & GTLA
- MS Office
Certification
- Chartered Property and Casualty Underwriting
- Associate in Claims
- Associate in Insurance Services
- Associate in Management
- Certified Workers Compensation Professional
Timeline
Claims Supervisor
CompOne Administrators
06.2019 - Current
Senior Claims Representative
Frankenmuth Insurance
02.2017 - 06.2019
Corporate Account Manager
Superior Investigative Services
01.2014 - 12.2014
Senior Claims Representative
Michigan Farm Bureau Insurance
05.2011 - 02.2017
Catastrophic Claims Specialist
Auto-Owners Insurance Company
09.2006 - 05.2011
No Degree - Biochemistry
Michigan State University - Lyman Briggs College
Bachelor of Science - Business Administration Finance
Central Michigan University