Lavar Peoples
Adjuster
Fort Worth,TX
Summary
Dedicated Claims Adjuster with 7 years of experience in property loss investigation, coverage analysis, and repair cost estimation. Proven expertise in utilizing Xactimate for accurate assessments and negotiating settlements, ensuring regulatory compliance and customer satisfaction. Seeking to leverage strong problem-solving skills and attention to detail in a Claim Adjuster role.
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
7
7
years of professional experience
6
6
Certifications
Work History
Claims Adjuster
Apex Era
08.2024 - Current
- Investigate and evaluate property loss claims of moderate to high severity through on-site and virtual assessments
- Utilize the Xactimate estimating system to determine repair scopes and prepare bids
- Negotiate and finalize repair costs with insured parties and contractors, including Network Repair Program participants
- Oversee the repair process to ensure compliance with agreed terms
- Settle and disburse payments for dwelling or structural damages after conducting thorough coverage analysis
- Manage all correspondence to maintain regulatory compliance of claim files
- Determine and advise on applicable coverage for claims, resolving any coverage-related questions
- Arrange emergency services to protect properties from further damage and address insured parties' needs
- Identify subrogation potential and conduct necessary investigations and referrals
Senior Member Service Specialist
Christus Health
05.2021 - 08.2024
- Resolved complex healthcare inquiries to enhance member satisfaction with benefits, claims, and eligibility across multiple programs
- Acted as a liaison to effectively address issues among members, providers, and insurers
- Maintained up-to-date knowledge of healthcare regulations to ensure compliance and provide accurate information
- Utilized advanced problem-solving skills to resolve challenging member situations
- Maintained a 95% customer satisfaction rating while managing a high volume of member inquiries
- Analyzed and resolved medical claim information in accordance with policies, procedures, and federal regulations
- Handled medical claims on CMS-1500 and CMS-1450/UB-04 claim forms from various healthcare providers
- Managed claim projects resulting from overpayments or underpayments related to manual processing errors and policy changes
Loan Operations Analyst
Caliber Home Loans
11.2019 - 05.2021
- Ensured compliance and mitigated financial risks by reviewing loan documentation
- Analyzed financial transactions related to claims, maintaining strict adherence to underwriting standards
- Supported dispute resolution and policy interpretation, enhancing the accuracy of claims processing
Telehealth Specialist
Teladoc
03.2018 - 09.2019
- Verified medical records and insurance policies to ensure claims compliance and accuracy
- Assisted adjusters by reviewing documentation, contributing to timely claims resolutions
- Provided exceptional customer support, effectively resolving disputes and enhancing claimant satisfaction
Legal Assistant
U.S. Small Business Administration
10.2017 - 03.2018
- Evaluated insurance documents and financial statements to ensure compliance with loan agreements
- Processed claims-related legal documents, facilitating adherence to regulatory standards
Education
GED -
Success High School
Fort Worth, TX 05.2001 -
Skills
Claims Handling & Adjusting
Damage Assessment & Repair Cost Estimation
Estimating & Inspection
Xactimate
CCC One
Guidewire
Symbility
Coverage Analysis & Policy Interpretation
Fraud Detection
Special Investigations (SIU)
Litigation & Settlement Negotiation
Regulatory Compliance
Risk Assessment
Customer Relations
Dispute Resolution
Problem Solving
Attention to Detail
Strong Communication Skills
Conflict Resolution
Data Entry
Meditech
Credentialing
HCPCS
Medical Billing
Claims investigation
Empathy and patience
Customer service
Problem-solving
Highly motivated
Data entry
Negotiation techniques
Decision-making
Caseload management
Claims processing
Verbal and written communication
Critical thinking
Team collaboration
Active listening
Multitasking and organization
Property valuation
Texas claims adjuster license
Certification
Texas All Lines Adjuster License, 2024
Timeline
Claims Adjuster
Apex Era
08.2024 - Current
Senior Member Service Specialist
Christus Health
05.2021 - 08.2024
Loan Operations Analyst
Caliber Home Loans
11.2019 - 05.2021
Telehealth Specialist
Teladoc
03.2018 - 09.2019
Legal Assistant
U.S. Small Business Administration
10.2017 - 03.2018
GED -
Success High School
05.2001 -