Kinyanna Brooks
Mesquite,TX
Summary
Ambitious, career-focused job seeker, anxious to obtain an entry-level Licensed Claims Adjuster position to help launch career while achieving company goals.
Overview
7
7
years of professional experience
1
1
Certification
Work History
Licensed Claims Adjuster
Independant
Dallas, Texas
04.2024 - Current
- Investigated and evaluated insurance claims to determine valid coverage, liability, and damages.
- Interpreted policy language to evaluate claim exposures and develop appropriate resolutions.
- Conducted interviews with claimants, witnesses, medical providers, attorneys., as needed for investigation of the claim.
- Analyzed complex documents including contracts, medical records, legal documents, and other pertinent materials to determine benefit eligibility.
- Drafted detailed reports outlining all findings from investigations into the cause of loss or injury.
- Negotiated settlements on behalf of clients based upon analysis of case facts and financial exposure.
- Assessed damage estimates for repair costs or replacement value of damaged property.
- Reviewed invoices related to medical expenses associated with a claim to ensure accuracy and compliance with policy terms.
- Maintained organized files containing documentation related to each claim file in accordance with company standards.
- Actively communicated with both internal and external stakeholders throughout the life cycle of a claim.
Claims Representative
Magnit
Mesquite, Texas
03.2018 - 10.2024
- Collaborated with other departments to resolve billing disputes or address customer concerns quickly.
- Interpreted legal documents such as contracts or court orders when evaluating claims for payment.
- Provided clear explanations of benefits, eligibility requirements, and applicable laws when communicating with customers.
- Developed strategies to reduce the number of denied or delayed claims within assigned portfolio.
Claims Representative
Ut Southwestern Medical Center
Dallas, Texas
10.2020 - 02.2024
- Conducted research into medical terminology related to healthcare claims processing activities.
- Documented changes in claim statuses using specialized software systems.
- Provided clear explanations of benefits, eligibility requirements, and applicable laws when communicating with customers.
- Reviewed and verified claim information to ensure accuracy of data and compliance with established policies.
- Collaborated with other departments to resolve billing disputes or address customer concerns quickly.
Education
Associate of Applied Science - Health Education
Clarendon College
Clarendon, TX05-2003
Skills
- Claims Investigation
- Policy Interpretation
- Property claims
- Policy investigations
- Property adjusting
- Rules of evidence
- Claims Processing
- Claims file management processes
- Quality Control
- Allocating claims
Certification
- All lines Claims Adjuster License April 2024
Timeline
Licensed Claims Adjuster
Independant
04.2024 - Current
Claims Representative
Ut Southwestern Medical Center
10.2020 - 02.2024
Claims Representative
Magnit
03.2018 - 10.2024
Associate of Applied Science - Health Education
Clarendon College
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