Kelly Brisbin

• Investigated and resolved Medical Payments and Personal Injury Protection (PIP) claims stemming from automobile and Transportation Network Company (TNC) accidents by analyzing liability, coverage, and complex loss circumstances.
• Reviewed medical bills and treatment documentation for accuracy, reasonableness, and strict adherence to policy provisions, regulatory fee schedules, and claim guidelines.
• Partnered with attorneys, medical providers, and internal stakeholders to resolve complex billing disputes and attorney repricing disagreements.
• Utilized Mitchell DecisionPoint to process medical bills under precise claim parameters, identifying data discrepancies and missing documentation to ensure accurate, compliant outcomes
• Manage inbound subrogation lien requests daily from medical providers and health insurance companies, requesting and reviewing applicable policy/legal language and supporting documentation to ensure liens are properly validated and processed.
• Evaluated and responded to time-limit demands and complex legal documents, strategically mitigating litigation risks on high-volume, attorney-represented files.
• Analyzed subrogation waiver requests submitted by legal counsel, applying rigorous independent judgment to protect company interests.

• Reviewed and analyzed complex documentation to ensure accuracy, completeness, and compliance with applicable Army regulations and policies.
• Created daily personnel status reports (PERSTATs) to provide accurate, timely personnel data and updates to higher-level leadership.
• Briefed leadership on personnel status, trends, readiness, discrepancies, and significant issues, providing clear information to support decision-making.
• Interpreted regulatory requirements to support operational effectiveness.
• Managed multiple sensitive cases simultaneously while maintaining accurate records, confidentiality, and strict due dates.
• Prepared detailed case documentation and supporting materials for leadership review and decision-making.
• Applied sound judgment and attention to details when evaluating information and resolving complex administrative matters.

Central Loss Report Representative

• Handled First Notice of Loss (FNOL) for automobile accidents, gathering and documenting detailed loss information to establish accurate claim files.
• Reviewed accident information, policy details, and supporting documentation to ensure claims were accurately documented and routed for appropriate handling.
• Conducted interviews with customers and involved parties to gather relevant facts, identify discrepancies, and determine claim handling needs.
• Applied established policies, procedures, and claim guidelines while exercising sound judgment when evaluating loss information.
• Identified issues, inconsistencies, and missing information; coordinated follow-up to ensure complete and accurate claim documentation.
• Maintained accurate claim notes while managing a high volume of calls in a time-sensitive environment of calls in time-sensitive environment.