Larvetta Douglass
Summary
Organized and detail-oriented Investigator dedicated to improving efficiency, productivity and profitability through continuous process improvement. Analytical thinker skilled at developing innovative solutions to complex problems.
Overview
12
12
years of professional experience
1
1
Certification
Work History
Claims Adjuster
Pilot Catastrophe Services
10.2017 - 01.2024
- Negotiated favorable settlements with claimants, attorneys, and other insurance carriers to minimize financial risk for the company.
- Examined claims forms and other records to determine insurance coverage.
- Documented all investigation activity and presented reports to management.
- Verified insurance claims and determined fair amount for settlement.
- Improved customer satisfaction by providing timely updates and resolutions to their claims inquiries.
- Developed positive relationships with policyholders, fostering trust through transparency during the claim process.
- Exercised proper judgment and decision making to analyze over 50 claims per week.
- Achieved timely resolution of property claims by investigating, evaluating, and settling a variety of cases.
- Maintained compliance with state regulations and company guidelines through diligent adherence to policies and procedures.
- Facilitated smooth transitions during catastrophes as part of a disaster response team, quickly addressing large volumes of claims while maintaining high-quality service standards.
- Prepared sketch of floor plan and roofline and entered data into Xactimate to develop line-by-line item costs of damages.
- Used excel with xactimate to compile estimates for personal property and structure damage.
- Developed effective techniques to mitigate losses.
- Verified accuracy of Iso records to maintain accuracy of records database.
Patient Access Representative
EGS
04.2014 - 11.2017
- Secured patient information and confidential medical records in compliance with HIPAA privacy rule standards to protect patient's privacy.
- Ensured compliance with HIPAA regulations to maintain confidentiality of sensitive patient information during all interactions.
- Stayed calm under pressure to and successfully dealt with difficult situations.
- Obtained patient's insurance information and determined eligibility for benefits for specific services rendered.
- Collected and entered patient demographic and insurance data into computer database to establish patient's medical record.
- Performed patient scheduling and registration functions to serve as initial contact point for medical office visits.
- Managed challenging situations effectively by remaining calm under pressure while resolving conflicts or addressing dissatisfied patients professionally.
- Facilitated smooth billing processes by verifying insurance eligibility, obtaining authorizations, and accurately entering claim details into the system.
- Identified insurance payment sources and listed payers in proper sequence to establish chain of payment.
- Utilized knowledge of electronic medical record systems and medical terminology to perform diverse data entry tasks.
- Trained new hires on department procedures, policies, and software systems, ensuring consistent quality service delivery from all team members.
- Answered incoming calls, scheduled appointments and filed medical records.
- Handled customer inquiries and suggestions courteously and professionally.
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
Capital One Credit Specialist
NCO Financial
03.2012 - 04.2014
- Increased customer satisfaction, resolving disputes and offering payment solutions tailored to individual needs.
- Maintained accurate documentation of all credit-related activities, ensuring compliance with company policies and industry regulations.
- Obtained and reviewed credit reports, credit references, credit insurance and financial statements to establish credit limits for new accounts.
- Reduced risk exposure by conducting thorough credit analyses for new and existing clients.
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
- Actively listened to customers, handled concerns quickly and escalated major issues to supervisor.
- Answered constant flow of customer calls with minimal wait times.
- Displays expertise in product and service knowledge
Education
No Degree - Political Science
University of South Alabama
Mobile, ALNo Degree - Political Science
Alabama A & M University
Normal, ALHigh School Diploma -
John S. Shaw High School
Mobile, ALSkills
- Claims Investigation
- Highly motivated
- Claims Processing
- Advanced oral and written communication skills
- Alabama, South Carolina, Louisiana, Kentucky, Minnesota, Mississippi and Texas Claims Adjuster License
- Critical Thinking
- Computer Skills
- Decision-Making
- MS Office
- Payment Processing
Certification
- CIE - Certified Insurance Examiner
Timeline
Claims Adjuster
Pilot Catastrophe Services
10.2017 - 01.2024
Patient Access Representative
EGS
04.2014 - 11.2017
Capital One Credit Specialist
NCO Financial
03.2012 - 04.2014
No Degree - Political Science
University of South Alabama
No Degree - Political Science
Alabama A & M University
High School Diploma -
John S. Shaw High School