Kartrenna Moore
Red Oak,TX
Summary
To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills. Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals. Observant Property Adjuster with 7 years of comprehensive experience investigating claims and determining correct amount of compensation for each case. Expertise in evaluating evidence such as photos and recordings to determine extent of damage. Proficient in calculating depreciation factors and replacement costs. Motivated Independent claims adjuster specializing in personal, property and casualty loss and damages. Negotiates peaceful resolutions of all claims with emphasis on fairness and thoroughness. Trustworthy and dependable.
Overview
7
7
years of professional experience
Work History
INDEPENDENT PROPERTY DAMAGE ADJUSTER Remote
EBERL CLAIM SERVICE /STATE FARM
10.2016 - 08.2023
- Assisted and educated the insured on the claims process and explained how the claim will be paid.
- Obtained necessary personal and financial information needed for claim and payments
- Verified insurance benefits of the insured and fully documented the claim process in the system
- Investigated residential and property damage claims by gathering relevant data to determine the extent of the company liability
- Examined policy, coverage, and endorsements Issued payments up to 30,000 on claims to the insured
- Collaborated with insurance agents, contractors, insured and answered incoming customer calls. Worked escalated claims and Department of Insurance complaints
- Reviewed and investigated property damage and facts on claims from catastrophic losses.
- Review supplements and final invoices received from contractors and negotiate to move the claim through the claims process
- Resolved calls which may result in inquiry or escalations from insured, agents, and contractors
- Demonstrated proper documentation of the claims file, effectively and efficiently worked towards having a resolution to the claim.
- Prepared sketch of floor plan and roofline and entered data into Xactimate to develop line-by-line item costs of damages.
- Scoped and photographed properties for defects and damage.
- Carefully reviewed claim information to verify accuracy and avert fraudulent claims.
- Delivered exceptional customer service to policyholders by communicating important information and patiently listening to issues.
- Examined claims forms and other records to determine insurance coverage.
- Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
- Reviewed and analyzed suspicious and potentially fraudulent insurance claims.
- Clarified coverage of losses to policyholders and provided assistance in itemizing damages and finding alternative living arrangements.
- Documented information gathered in field and uploaded data to company database for efficient processing using Xactimate.
- Collected property information from customers to complete claims.
- Handled calls from customers and other stakeholders about processes.
HOME HEALTHCARE FINANCIAL MANAGER
Complete Home Healthcare
11.2021 - 09.2022
- Prepared of accurate medical claims based on contracted agreements for services with government Payers.
- Reviewed and identified claims pricing discrepancies based on updates/changes to fee schedules. Created and submits secondary electronic Billing of Amerigroup patients copays, which includes entering the necessary information into Availity portal or billing via paper at time of initial billing. Monitored billing requirements pursuant to contracts with third party payers or government programs. Answered insurance/billing questions from branch staff and help educate. Reviewed information from electronic medical record in patient account to ensure preparation and submission of clean claims. Performed routine revenue review of claims billed within the current month. Answered incoming calls. Created claim batches and process them via electronic submission. Manually process any claims that are not eligible for electronic billing.
- Identified any claims that need attention, make corrections, and resubmit. Ensured coding to the highest level of specificity and for maximum reimbursement by third party payers. Daily review and follow up of unbilled delivery tickets in billing review and ready to bill Effectively utilize time and resources to meet service to internal and external customers. Ensured compliance with federal, state, and local governments, third party contracts, and company policies. Clearly communicate any billing related issues to all appropriate parties including Intake, collection.
- Monitored the unbilled-pending invoices queues and communicate to the branch on missing or needed documents or information. Maintained current knowledge of departmental and organizational policy performance goals. Provided exceptional Customer service to internal and external customers. Ensured compliance with federal, state, and local governments, third party contracts, and company policies. Clearly communicated any billing related issues to all appropriate parties including Intake, collection.
- Monitored the unbilled-pending invoices queues and communicate to the branch on missing or needed documents or information. Maintained current knowledge of departmental and organizational policies.
Education
Master of Arts - Counseling
Prairie View A&M University
Prairie View, TXMaster of Arts - Instructional Technology
America Intercontinental University
Remote BACHELOR OF SCIENCE - Criminal Justice
Paul Quinn College
Dallas, TX08.2003
Skills
- TECHNICAL PROFICIENCY MS EXCEL MS WORD MS POWERPOINT MS PUBLISHER MS ACCESS OUTLOOK
- Team Training
- Networking skills
- Prioritizing workflows
- Systems and software programs
- Account management
- Staff Management
- Company policy adherence
- Presentation skills
- Standardized Testing
- Anti-bullying techniques
- Social skills
- Common core
- Teacher Support
- Lesson Planning
- Classroom management
- Behavioral modeling
- Elementary education
- Student counseling
- Smart Classroom
- Group and individual instruction
- Student records management
- IEP specialist
- Critical Thinking
- Active Listening
- Technical Knowledge
- Insurance Understanding
- Insurance Industry Experience
- Property Adjusting
- Claims Understanding
- Claim Validity Determination
- Property Claims
- Investigate Property Damage
- Case Management
- Investigative Interviews
- Xactimate Specialist
- Customer Service Expertise
- Determine Coverage
- Interview Claimants
- Verify Data
- Hail and Wind Damage Assessment
- Customer Satisfaction
- Claims Investigations
- Repair Pricing
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Quote
There is a powerful driving force inside every human being that, once unleashed, can make any vision, dream, or desire a reality.
Tony Robbins
Timeline
HOME HEALTHCARE FINANCIAL MANAGER
Complete Home Healthcare
11.2021 - 09.2022
INDEPENDENT PROPERTY DAMAGE ADJUSTER Remote
EBERL CLAIM SERVICE /STATE FARM
10.2016 - 08.2023
Master of Arts - Counseling
Prairie View A&M University
Master of Arts - Instructional Technology
America Intercontinental University
BACHELOR OF SCIENCE - Criminal Justice
Paul Quinn College
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