Kalen Owens
Teague/Mexia
Summary
Analytical Claims Examiner with more than 5 years of experience known for high productivity and efficient task completion. Possess specialized skills in claim investigation, policy interpretation, and dispute resolution. Excel at communication, problem-solving, and decision-making to facilitate fair and timely claim settlements.
Overview
8
8
years of professional experience
1
1
Certification
Work History
Claims Examiner
Alacrity Solutions
02.2023 - Current
- Analyzed customer complaints, identified root causes of problems, and developed corrective action plans.
- Assessed accuracy of claim payments by comparing submitted bills to benefit allowance guidelines.
- Evaluated requests for pre-certification and authorization services, determining appropriate reimbursement levels based on contractual agreements between providers and payers.
- Interpreted policy language contained within contracts between providers and payers.
- Managed workloads efficiently by prioritizing tasks based on urgency or importance.
- Paid and processed claims within designated authority level.
- Reviewed, evaluated and adjusted claims to promote fair and prompt settlement.
Claims Examiner
Homeowners of America
08.2022 - 02.2023
- Review first notice of loss and make initial contact with the insured within 24 hours after the report is received from the independent adjuster
- Distribute payment to insured and any parties involved in the claim.
- Handled supplement requirements as needed.
- Conduct prompt, thorough and fair investigations by obtaining relevant facts to determine coverage
- Document all file handling with precision
- Determine coverage and policy limits for multiple policy types, i.e., DP-3, HO-3, HO-6 and more
- Effectively negotiate settlements of claims of varying complexity and perils.
- Draft denial, partial denial, settlement letters and more
Property Adjuster
Sedgwick CMS
11.2021 - 08.2022
- Ensured communication with the insured within 24 hours.
- Conducted prompt and thorough investigations to determine coverage.
- Document all file handling with precision.
- Determine coverage and policy limits for multiple policy types.
- Successfully negotiated settlements for complex claims and diverse risks.
- Create estimates using Symbility for personal property.
- Process supplements as needed.
- Draft denial, partial denial and supplemental letters.
- Meet time requirements of the policy and fair claims handling practices.
Desk Adjuster
Southwest Adjusters
01.2020 - 11.2021
- Evaluate overall claim handling processes with the insured, including additional living expenses and content losses.
- Handled investigation of daily CAT claims.
- Determined coverage and policy limits.
- Ensured adherence to state, legal, and statutory guidelines for claims processing.
- Properly notated the claim file as necessary.
Claims Specialist
Goldfein Claims Management
02.2018 - 01.2020
- Approved estimates for the cost of repairs or replacement of damaged or destroyed property.
- Developed the information necessary to make advance, partial and final payments where appropriate.
- Maintained Letters of Representation with public adjusters and attorneys.
- Established and maintained accurate loss cost estimates and reserves for each claim reporting.
- Completed assignments in a fast-paced environment while achieving individual and team metrics.
Auto Desk Adjuster
Four Seventy Claims
03.2017 - 02.2018
- Investigate single and multi-vehicle auto accidents using recorded statements, photos and/or police reports.
- Negotiate claim settlements with customers and third-party carriers.
- Maintained assigned claims and diaries while also assisting team members.
- Evaluate and negotiate settlements for claimants.
- Thoroughly documented all file handling activity.
- Communicate compassionately with customers and help them through the claim process in a fast, fair, and easy manner.
Education
Associate of Applied Science - Cybersecurity
Navarro College
Corsicana, TXSkills
- Proficient in Microsoft Office 365
- Proficient in Adobe
- Image Right
- NextGen
- Guidewire
- Symbility
- Xactimate
- Liability and coverage
- Coverage analysis
- Investigative skills
- Detail orientation
- Claims adjustment
- Communication Skills
- Insurance policy knowledge
- Multitasking Abilities
- Time management abilities
- Policy analysis
Certification
- Texas All Lines Adjuster
- Florida
- Louisiana
- South Carolina
- North Carolina
- Arizona
- Kentucky
- Michigan
- Minnesota
- New Mexico
- Alabama
Timeline
Claims Examiner
Alacrity Solutions
02.2023 - Current
Claims Examiner
Homeowners of America
08.2022 - 02.2023
Property Adjuster
Sedgwick CMS
11.2021 - 08.2022
Desk Adjuster
Southwest Adjusters
01.2020 - 11.2021
Claims Specialist
Goldfein Claims Management
02.2018 - 01.2020
Auto Desk Adjuster
Four Seventy Claims
03.2017 - 02.2018
Associate of Applied Science - Cybersecurity
Navarro College
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