Johnetta Dixon
Semmes,AL
Summary
Seasoned Insurance Claims Adjuster with history of investigating and resolving claims. Possess strong skills in negotiating settlements, interpreting insurance policies, and managing large caseloads effectively. Demonstrated ability to resolve complex cases with professionalism, resulting in satisfied clients and minimized losses for the company.
Overview
12
12
years of professional experience
1
1
Certification
Work History
Insurance Claims Adjuster
Pilot Catastrophe- Remote Work
03.2019 - 08.2024
- Investigate property damage or personal injury
- Gather information from sources, such as police reports
- Investigate questionable claims
- Assist attorneys and other specialists when defending the company against contestation
- Reviewed and evaluated insurance claims for coverage, accuracy, completeness and compliance with company standards.
- Investigated the circumstances of insurance claims to determine liability.
- Analyzed policy language to determine applicable coverage and benefit levels.
- Collaborated with other departments to ensure timely resolution of customer complaints.
- Researched complex cases and developed appropriate solutions in a timely manner.
- Interpreted medical records and legal documents related to insurance claims.
- Negotiated settlements within prescribed authority limits.
- Developed strategies for resolving difficult or contentious claims cases.
- Advised customers on the status of their claim payments or denials.
- Maintained accurate records of all claim activities in accordance with company guidelines.
- Ensured that all claims were settled promptly and equitably according to established procedures.
- Provided expert advice regarding technical aspects of claims processing.
- Conducted site visits as needed to investigate potential fraudulent activity.
- Participated in meetings with attorneys, claimants, witnesses, experts., as required by the case.
- Assisted in the development of new policies and procedures related to claim adjudication.
- Communicated effectively with all internal departments concerning pending matters pertaining to assigned files.
- Prepared detailed reports summarizing findings from investigations into questionable claims activities.
- Drafted statement of loss to summarize damages, payments and underlying policy coverage.
- Gathered information from various third parties to determine claim acceptability.
- Negotiated and settled claims according to information presented through reports, research, and data verification.
Data Entry Specialist
DST Health Solutions- Remote Work
Birmingham, AL
02.2013 - 10.2015
- Verified that information in the computer system was up-to-date and accurate.
- Organized billing and invoice data, and prepared accounts receivable and expected revenue reports for controllers.
- Developed and created a more effective filing system to accelerate paperwork processing.
- Technical Support and inbound/outbound calls.
- Inputted data into computer system to ensure accuracy and completeness of records.
- Performed data entry tasks including keying in numerical or alphanumerical information from source documents into databases.
- Validated customer information, such as addresses and contact numbers.
Patient Escort
UAB Hospital
Birmingham, AL
07.2013 - 08.2014
- Transported patients and guests to the destination that has been assigned.
- Conducted blood pick-ups and deliveries.
- Assisted nursing staff during transfers with patients.
- Assisted patients to their destinations, such as waiting rooms or medical examination rooms.
- Greeted and welcomed patients in a friendly manner.
Education
Associate of Arts - Elementary Education
Faulkner State Community College
Bay Minette, AL, US01.2008
Property and Casualty Adjuster License - AL, MI, TX, WA, FL, LA, OR, SC
Skills
- Strong interpersonal skills
- Excellent communication skills
- Time Management
- Self Motivation
- Decision Making
- Ability to Work Under Pressure
- Customer Service
- Claims Investigation
- Policy Interpretation
- Claims Processing
- Property adjusting
- Property claims
Certification
Property and Casualty Adjuster License, AL, MI, TX, WA, FL, LA, OR, SC
Timeline
Insurance Claims Adjuster
Pilot Catastrophe- Remote Work
03.2019 - 08.2024
Patient Escort
UAB Hospital
07.2013 - 08.2014
Data Entry Specialist
DST Health Solutions- Remote Work
02.2013 - 10.2015
Associate of Arts - Elementary Education
Faulkner State Community College