LAMONICA WHITE
Irving,TX
Summary
Solution-driven, detailed-oriented, and highly analytical claims professional equipped with dynamic leadership in identifying new high-potential opportunities due to changes in business and economic conditions. Versatile office skills to include but not limited to proficiency in Microsoft Office programs. Exceptional leader, planner, and problem solver who readily adapts to change and works independently as well as in group settings and exceeds expectations. Ability to handle multiple priorities and meet various deadlines without compromising quality or quantity of work.
Licensed Claims Adjuster focused on Auto/Property Damage & Total Loss.
Positive attitude and exceptional problem solving skills.
Energetic and enthusiastic insurance adjuster motivated to succeed in fast-paced and deadline-driven professional environment. Comprehensive knowledge of claims adjusting with special knowledge of Auto/Property & Total Loss. Licensed Claims Adjuster focused on construction inspections and workers' compensation claims. Positive attitude and exceptional problem solving skills.
Overview
11
11
years of professional experience
1
1
Certification
Work History
Claims Adjuster
Sea Harbor Insurance
Irving, TX
02.2023 - Current
- Investigated insurance claims, reviewed coverage and liability, prepared reports and recommended payment or denial of claims.
- Reviewed policies to determine appropriate levels of coverage and assist with approval or denial decisions.
- Gathered information from various third parties to determine claim acceptability.
- Delivered exceptional customer service to clients by communicating information and actively listening to concerns.
- Maintained accurate documentation of all claim activity within designated system.
- Adaptable and proficient in learning new concepts quickly and efficiently.
- Proven ability to learn quickly and adapt to new situations.
- Skilled at working independently and collaboratively in a team environment.
CLAIMS HANDLER /ADJUSTER
LIBERTY MUTUAL INSURANCE
PLANO, TEXAS
01.2022 - 09.2022
- Engage with customers who have just been in an accident
- Interview the insured as well as the claimant by way of a recorded or written statement
- Gather the necessary evidence photos, videos, police reports, witnesses etc
- Establish coverage and liability
- Start the repair process by finding a repair shop and make a reservation for rental car if applicable
- Explain the repair process with the insured/claimant
- Issue payments for repairs done on behalf of insured/claimant to the repair shop
- Refer claims to Subrogation if applicable.
CLAIMS HANDLER/ADJUSTER SUBROGATION
HEALTH MANAGEMENT SYSTEMS
IRVING, TX
09.2015 - 01.2022
- Review claim files to evaluated recovery potential and open subrogation files on those with adequate potential
- Evaluate completeness and accuracy of documented evidence as to amount of damage and liability
- Develop resolution plans by determining filing solutions such as arbitration, suit, and collection agency to recover payments where subrogation potential has been identified on moderately complex claims
- Negotiate liability, settlements, and payments
- Interact with field staff and investigative agencies/vendors to obtain documentation to assist in recovery
- Maintain proper claims documentation and process claim subrogation in a timely manner and in accordance to company as well as state guidelines.
INSURANCE VERIFICATION SPECIALIST
TMI SPORTS MEDICINE
ARLINGTON, TX
12.2012 - 10.2014
- Verified patient eligibility and benefit package information via phone or online in advance of patient appointments
- Handled client/patient questions, complaints, request, and inquiries with the highest degree of courtesy and professionalism, the goal of one-call resolution and patient retention
- Gathered needed information from PCP and HMO payers to initiate managed care authorizations
- Worked closely with clinic managers and designated leaders regarding issues with scheduling and insurance
- Provided patients with accurate, timely and satisfactory solutions to potential and arising, complaints and concerns regarding billing and insurance
- Maintained patient privacy and HIPAA standards while keeping appropriate case file documentation.
Education
MEDICAL INSURANCE BILLING AND CODING -
EVEREST COLLEGE
11.2012
High School Diploma -
L.G. Pinkston
Dallas, TX05-1990
Skills
- Proficient with Customer and client relationship management, proficient at client retention, excellent verbal and written communication, excellent editing skills, proficient in office management, proficient in implementation and review of performance improvement plans, staff development, mentoring and monitoring of staff, office coordination, calendaring and scheduling, data analysis, planning/event planning, ability to work under pressure, decision maker, time management, self-motivated, conflict resolution, leadership, adaptability, teamwork, creativity, quick learner, flexible, responsible, detail oriented, proficient in multi-tasking and organization
- KCC (Knowledge Center Claims, Navigator, Lumen, ISO, Archie, CS(Com Search), LSAMS, Davox, Shaw Collections, Automated Dialer, Medi-TECH, Centricity, Zscaler, Perceptive content, Microsoft Teams and Microsoft Office 365, TxDot, Snapsheet, etc
- Auto/Property Damage & Total Loss Adjusting
- Advanced Computer Skills
- Highly Motivated
- Claims Investigations
Licensing
ALL LINES ADJUSTER LICENSE, TEXAS DEPARTMENT OF INSURANCE, 2272863, 05/31/24
Certification
State Farm Certification Auto, Property, Estimatics.
References
References available upon request.
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Quote
Any shot not taken, is still a missed shot!
Lamonica White
Timeline
Claims Adjuster
Sea Harbor Insurance
02.2023 - Current
CLAIMS HANDLER /ADJUSTER
LIBERTY MUTUAL INSURANCE
01.2022 - 09.2022
CLAIMS HANDLER/ADJUSTER SUBROGATION
HEALTH MANAGEMENT SYSTEMS
09.2015 - 01.2022
INSURANCE VERIFICATION SPECIALIST
TMI SPORTS MEDICINE
12.2012 - 10.2014
MEDICAL INSURANCE BILLING AND CODING -
EVEREST COLLEGE
High School Diploma -
L.G. Pinkston