Summary
Overview
Work History
Education
Skills
Timeline
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Latosha Hughes

Semmes,United States

Summary

Organized and detail-oriented professional dedicated to improving efficiency, productivity and profitability through continuous process improvement. Analytical thinker skilled at developing innovative solutions to complex problems with a solid background working in highly dynamic and complex business environments. Strong negotiation skills with keen eye for complex data. Reliable and committed to working collaboratively with clients and vendors.

Overview

7
7
years of professional experience

Work History

Insurance Claims Adjuster

EA Renfroe
09.2021 - 08.2023
  • Hours per week: 60
  • Executed thorough investigations and resolutions of auto claims, emphasizing accuracy in verifying coverage, determining liability, and assessing damage
  • Identified and reported potential cases for Subrogation and Special Investigations Unit involvement, adhering rigorously to established procedures
  • Utilized negotiation skills to resolve cases involving property damage, bodily injury, and uninsured motorists, resulting in recognition for exceptional customer service
  • Coordinated and finalized payments for repairs, rentals, towing, and total losses; negotiated storage costs, documented claim files, dispatched correspondence, and maintained communication with all relevant parties
  • Analyzed claim details against coverage limits, evaluating associated charges to confirm total loss evaluation
  • Achieved 97% customer satisfaction rating through effective communication and timely resolution of claims
  • Reduced company liability by 25% by identifying and correcting errors in policy documentation
  • Trained and mentored new adjusters, resulting in 15% increase in team productivity
  • Supervisor: Zarah Webb (251-752-9732)
  • Okay to contact this Supervisor: Yes

Property Adjuster

Pilot Catastrophe
09.2018 - 11.2019
  • Hours per week: 72
  • Duties, Accomplishments and Related Skills:
  • Conducted thorough investigations to determine causes and origins of diverse claims, collaborating with insured parties, agents, and legal representatives
  • Maintained exceptional level of organization and promptness in handling open claims, resulting in timely follow-ups and efficient resolutions
  • Showed exceptional precision in verifying policy specifics and managing reserves, bolstering company's financial security through high accuracy rates
  • Enhanced claim resolution speed and accuracy by refining verification process and improving stakeholder communication efficiency

Provider Data Analyst

Broad-path Healthcare Solutions
07.2016 - 07.2018
  • Hours per week: 40
  • Duties, Accomplishments and Related Skills:
  • Reviewed, interpreted and verified contract language, information, and intent to load information into systems properly
  • Ensured contract templates can be administered across operations (pricing configuration and claims)
  • Communicated and identified discrepancies to Network Management, Contracting and Pricing Requirement teams
  • Reviewed company specific, CMS specific, State specific and competitor specific medical policies and reimbursement policies
  • Reviewed pricing configuration structure and provider billing set-up to ensure contract loading accuracy
  • Identified multiple potential solutions to resolve claims issues
  • Conducted testing of proposed solutions and changes made to determine their effectiveness and make necessary modifications
  • Created and provided loading documentation to instruct internal business partners on contract/non par loading procedures
  • Lead projects related to provider reimbursement initiatives
  • Worked with provider contracting staff when new/modified reimbursement contracts are needed
  • Performed SQL queries to pull reports when necessary
  • Assisted with audits and other quality controls to proactively identify issues
  • Performed audits of new and/or existing provider contracts to ensure accuracy of set up accurately into appropriate systems
  • Supervisor: Tavi Usher (423-400-0869)
  • Okay to contact this Supervisor: Yes

Education

Associate's degree -

Gwinnett Technical College
Lawrenceville, GA
05.2014

Skills

  • MS Office Word, Excel, Outlook, Powerpoint, Access
  • Google Drive, Open Office, pivot tables, vertical look-ups, macros
  • Typing 50 wpm
  • Customer Service
  • Negotiation
  • Detail Oriented
  • Time management
  • Data Analysis
  • Database Management
  • Strong Communication and Interpersonal Skills

Timeline

Insurance Claims Adjuster

EA Renfroe
09.2021 - 08.2023

Property Adjuster

Pilot Catastrophe
09.2018 - 11.2019

Provider Data Analyst

Broad-path Healthcare Solutions
07.2016 - 07.2018

Associate's degree -

Gwinnett Technical College

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Latosha Hughes