Joy Tuttle
Anchorage,AK
Summary
Detail-oriented claims adjuster offering 17.5 years in a career focusing on workers' compensation claims. Comprehensive knowledge of claims. Skilled in investigating and determining compensability. Proven history of leveraging excellent negotiation skills to facilitate settlements. Excellent communication skills interviewing employers, claimants, witnesses and specialists to compile information. Organized and dependable with a history of meeting company goals, excellent time management, meeting required deadlines. Skilled in working under pressure, problem solving and adapting to new situations and challenges. Successful at managing multiple priorities with a positive attitude.
Overview
17
17
years of professional experience
Work History
Claims Adjuster
Travelers Insurance
02.2008 - 06.2025
- Handle case load of 125 plus.
- Negotiate settlement agreements to resolve disputes.
- Review and analyze documents and medical records to determine and establish Indemnity, medical and litigation reserves on claims.
- Conduct comprehensive interviews of employers, claimants and witnesses to gather facts and information.
- Substantiate legitimate claims and denial of unjustified claims.
- Review new files to determine current status of injury claim and to develop plan of action.
- Review and analyze suspicious and potentially fraudulent insurance claims.
- Maintain contact with claimants and attorneys to determine treatment status.
- Train other claims staff members on proper handling and evaluation of injury claims.
- Analyze information gathered by investigations to report findings and recommendations.
- Partner with legal counsel on litigation cases.
- Organize, plan, and document materials for workers' compensation claims.
- Compare data from surveillance footage to data on medical reports.
- Collect information from customers to complete claims and legal files.
- Direct and coordinate various investigations conducted by field investigation team.
- Verify accuracy of records to maintain accuracy of records database.
- Investigate legal issues pertaining to claims.
- Direct contact with provider offices regarding claimants' medical treatment.
- Partner with both telephonic and field medical case management to coordinate medical plan of action on claims.
- Collaborated with legal teams to resolve complex claims disputes effectively.
- Evaluated claims to determine liability and coverage in accordance with company policies.
- Conducted thorough investigations using industry-standard tools and technology.
- Developed and implemented streamlined processes to enhance claims resolution efficiency.
- Mentored junior adjusters, fostering professional growth and knowledge sharing within the team.
- Ensured compliance with regulatory requirements while maintaining high accuracy in claims processing.
- 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.
- Verified insurance claims and determined fair amount for settlement.
- 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.
- 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, medical treatment records, and physical property damage to determine extent of liability.
- Conducted comprehensive interviews of witnesses and claimants to gather facts and information.
- Identified potential fraud indicators early in the investigation process, protecting company assets from potential losses due to fraudulent activity.
Education
Certificate of Completion - Dental Assisting
University of Alaska Anchorage
Anchorage, Alaska05.2005
Skills
- Workers' Compensation Claims procedures and processing
- Team collaboration
- Advanced oral and written communication skills
- Decision-making
- Litigation Resolution and negotiation
- Skilled interviewing techniques
- Record management
- Strong Communication and Interpersonal Skills (empathy and patience)
- Medical Terminology
- Judgment and Decision-Making
- Minimize Exposure
- Familiar with Fraud Statutes
- Complex Problem-Solving
- Verify Data
- Critical Thinking
- Claims Investigations
- Time Management
- Database Management
- Highly motivated
- Settlement negotiation
* Legal compliance
Timeline
Claims Adjuster
Travelers Insurance
02.2008 - 06.2025
Certificate of Completion - Dental Assisting
University of Alaska Anchorage
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