LaToya Williams
Crowley,TX
Summary
I'm a hardworking and passionate job seeker with strong organizational skills that's eager to secure an entry-level adjuster position. I am seeking to maintain a full-time position that offers professional challenges that allow me to utilize my interpersonal skills, excellent time management and problem-solving skills. I'm able to handle multiple projects simultaneously with a high degree of accuracy.
Overview
1
1
year of professional experience
1
1
Certification
Work History
Adjuster Training
Pilot Catastrophe
03.2024 - 03.2024
- Attended training courses to build understanding of processes, techniques, and industry.
- Learned new materials, processes, and programs quickly.
First Notice of Loss Claims Adjuster
GM Financial
10.2023 - 02.2024
- Examined claims forms and other records to determine insurance coverage.
- Documented all investigation activity and presented reports to management.
- Maintained compliance with state regulatory requirements through meticulous documentation and adherence to company policies.
- Conducted thorough investigations of complex insurance claims, gathering evidence and analyzing relevant documentation.
- Prepared summaries of damage, payments, and policy coverage.
- Provided exceptional customer service during emotionally difficult situations for policyholders following accidents or natural disasters.
- Contributed to a positive work environment through active participation in team meetings and collaborating on cross-functional projects.
- Achieved high customer satisfaction ratings by providing clear and timely communication throughout the claims process.
- Answered customer questions regarding deductibles.
- Attended industry conferences and workshops to stay current on trends and developments within the field of claims adjusting.
- Evaluated coverage accurately by interpreting complex insurance policies and applying them to specific claim scenarios.
- Identified potential fraud indicators early in the investigation process, protecting company assets from potential losses due to fraudulent activity.
- Assisted in updating training materials for new hires based on evolving industry standards and best practices.
- Collaborated with legal teams to defend against fraudulent claims, saving company resources and maintaining its reputation.
- Provided exceptional customer service, addressing concerns, and answering questions promptly.
- Delivered exceptional customer service to policyholders by communicating important information and patiently listening to issues.
Insurance Advocate
United Healthcare
09.2022 - 10.2023
- Conducted thorough research on industry trends to maintain up-to-date knowledge and provide informed recommendations to clients.
- Reduced client frustrations by providing clear explanations of complex policy terms and conditions when needed.
- Developed strong relationships with insurance providers, fostering cooperation when resolving complex cases.
- Implemented strategies that improved communication between clients, insurers, and other relevant parties during the claims process.
- Acted as a liaison between clients and insurance carriers during claim disputes, advocating for fair resolutions in a timely manner.
- Assisted in training new employees, sharing expertise in insurance advocacy and boosting team performance levels.
- Ensured regulatory compliance by staying current with industry laws, regulations, and standards while updating company procedures accordingly.
- Enhanced client retention through exceptional customer service and consistent follow-up on claims.
- Proactively identified potential issues with client policies, offering solutions to avoid future complications.
- Examined claims forms and other records to determine insurance coverage.
- Educated clients on policy changes and updates, ensuring their understanding of insurance options.
- Contributed to company growth by providing valuable input on business development strategies and marketing efforts.
- Answered customer questions regarding deductibles.
- Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
- Read over insurance policies to ascertain levels of coverage and determine whether claims would receive approvals or denials.
- Researched claims and incident information to deliver solutions and resolve problems.
- Reviewed questionable claims by conducting agent and claimant interviews to correct omissions and errors.
- Identified suspicious losses and contacted manager for investigative assistance.
- Implemented quality control measures that resulted in increased accuracy rates for submitted health insurance claims across the entire team''s portfolio.
- Ensured compliance with federal and state regulations governing health insurance claims processes to avoid penalties or legal action.
- Developed strong communication skills to effectively advocate for patient needs with healthcare providers and insurance companies.
- Assisted clients with filing and tracking health insurance claims to facilitate swift settlements.
- Assisted patients with insurance claims, facilitating smooth transactions and proper coverage.
Education
Medical Billing And Coding -
Everest College
Arlington, TXSkills
- Claims Investigation
- Technical knowledge
- Damage Assessment
- Property valuation
- Policy Interpretation
- Quality Control
- Insurance policy coverage knowledge
- Claims Processing
- Risk Assessment
- Advanced computer skills
- Best Practices Implementation
- Policy investigations
- Casualty and property loss
- Data Analysis
- Legal proceedings knowledge
- Advanced oral and written communication skills
- Innovation and Creativity
- Healthcare Common Procedures Coding System (HCPCS)
- Regulatory Compliance
- Legal Compliance
- Highly motivated
- Decision-Making
- Active Listening
- Claims Evaluation
- Customer service and support
- MS Office
- Claims
- Microsoft Office Suite
Certification
- State Farm Estimatics
- State Farm Policy
- Texas Notary Public
Licenses
- All lines Adjuster; Texas, Florida, Rhode island, Louisiana, Wyoming, Michigan, Vermont, South Carolina, Oklahoma, New Hampshire, North Carolina, Connecticut and Delaware.
Timeline
Adjuster Training
Pilot Catastrophe
03.2024 - 03.2024
First Notice of Loss Claims Adjuster
GM Financial
10.2023 - 02.2024
Insurance Advocate
United Healthcare
09.2022 - 10.2023
Medical Billing And Coding -
Everest College