Summary
Overview
Work History
Education
Skills
Timeline
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Laverne Dunlap

Claims Adjuster
Gardenda,CA

Summary

Dedicated and professional individual with a strong background in customer service, time management, and trend tracking. Skilled at troubleshooting problems and developing successful solutions. Excellent verbal and written communicator with a proven ability to cultivate positive relationships and exceed goals. Able to effectively manage demands in fast-paced environments by utilizing slow periods efficiently. Seeking an opportunity to expand skills and contribute to company success. Considered hardworking, ethical, and detail-oriented. As an Insurance Adjuster, honed skills in investigating and analyzing liability concerns related to personal, casualty, or property loss. Proven track record of leveraging excellent negotiation skills to facilitate settlements. Communication skills demonstrated through years of experience interviewing specialists, witnesses, and claimants to compile information. Organized and detail-oriented Investigator dedicated to improving efficiency, productivity, and profitability through continuous process improvement. Analytical thinker who excels at developing innovative solutions to complex problems. Service-oriented Claims Adjuster who applies creative approaches to solving complex problems. Adept at developing profitable and quality-focused processes. Motivated Claims Adjuster specializing in personal, property, and casualty loss and damages, negotiating peaceful resolutions of all claims with emphasis on fairness and thoroughness. Trustworthy and dependable, brings hands-on law enforcement experience along with exceptional leadership and communication skills. Background includes criminal investigation, insurance fraud, and surveillance. Several years of experience as a detailed Adjuster in corporate insurance claims, with a strong command of claimant information intake processes, records documentation, and fraudulent investigation protocols. Additionally, possess impactful skills in preparing operational reports, presenting various types of information to audiences, and approving claim payouts.

Overview

10
10
years of professional experience

Work History

Medical records Technician

Advantmed LLC
09.2023 - Current
  • Review patients' records for timeliness, completeness, and accuracy
  • Use classification systems to assign clinical codes for patients' diagnoses, procedures, medical services, and related information
  • Maintain and retrieve records for insurance reimbursement and data analysis.

Claims Specialist/Clinical Specialist

State Farm
03.2023 - 09.2023
  • Responsible for the handling and management of accidental and weather-related incidents homeowners and commercial large loss claims in a work from home and virtual office environment
  • Act as the point of contact with insureds to explain coverages, arrange virtual or site inspections determine the scope of damages and estimate those damages utilizing Xactimate to help the recovery of the determined loss
  • Review and interpret financial documents and contractors estimate as well as negotiate with vendors, contractors and third parties to pay what is owed in a prompt and efficient manner
  • Explain settlements to insureds by guiding them through the resolution of their claim based on a foundation of good customer service, strong negotiation skills and overall ability to connect with the insured by utilizing versatile communication styles.

Insurance Adjuster

EA Renfroe
01.2019 - 01.2022
  • Creates and manages timely, clear and accurate documentation and workflow throughout the life of a claim in accordance with the Standard Operating Procedures
  • Use estimating software to establish indemnity values of claimed damages
  • Review documents to develop damage estimates
  • Complies with agency management system data standards and data integrity (enters and maintains complete and accurate information)
  • Identifies exposures and establishes reserves on assigned claim files
  • And maintain professional and technical knowledge through continuing company provided industry best education
  • Working knowledge of Microsoft Word, Excel, and Outlook.

Medical Records Technician

Episource LLC
08.2018 - 09.2021
  • Organize and manage patients' health information
  • Ensure paperwork is properly filled out
  • Verify accuracy and accessibility of files
  • Ensure all files are secure
  • Communicate with physicians and other healthcare professionals to clarify diagnoses or to obtain additional information
  • Supported Anesthesia, Surgi Net and Power Chart.

Surveyor

JLM Strategic Talent Partner
05.2018 - 06.2018
  • Conduct Surveys for the Los Angeles Metro Transit System.

Clinical Trial Coordinator and Field Interviewer (Ophthalmology Clinical Trial Contract)

University of Southern California, Keck School of Medicine, Battelle
08.2015 - 04.2018
  • Recruit subjects for data collection adhering to strict eligibility criteria
  • Maintain participant study database with 96% consistency
  • Conduct field-study visits with respondents in their home
  • Make and confirm appointments for study medical office visits
  • Train clinicians on the use of multiple Cerner Millennium applications that make up Electronic Medical Record (EMR) including Power Chart, Capstone Scheduling, Surgi Net, FirstNet, Pharm Net and Rad net
  • Build, implement and support Cerner Surgi Net
  • Facilitate ongoing communication with participants to ensure proper procedures are followed
  • Maintain current records of medical history and updates between appointments.

Front Office and Placement Coordinator

Alternative Healthcare LA
04.2014 - 10.2017
  • Making and confirming patient appointments
  • Patient check-in, payment collection, insurance verification
  • Coordinate medical staff for remote-site patient visits
  • Assist patients with government programs providing tools for people needing medical assistance
  • Ensure smooth communication between the field team and headquarters staff.

Field Interviewer/ Data collector for Tobacco Study

Westat Research Company
05.2016 - 01.2017
  • Recruit subjects for data collection adhering to strict eligibility criteria
  • Maintain participant study database with 96% consistency
  • Conduct field-study visits with respondents in their home
  • Make and confirm appointments for study medical office visits
  • Facilitate ongoing communication with participants to ensure proper procedures are followed
  • Maintain current records of medical history and updates between appointments.

Education

Bachelor of Science (BS) - Health info management

Ashford University
San Diego, CA

Skills

  • Quality Assurance
  • Agile Methodologies
  • Risk Management
  • Idea Development and Brainstorming
  • Work Planning and Prioritization
  • Liability Determination
  • Conflict Resolution
  • Best Practices Implementation
  • Critical Thinking
  • Litigation Specialist
  • Negotiation skill
  • Investigation Skills
  • Sound Decision-making
  • Complex Problem Solving
  • Information Verification
  • HIPAA Compliance
  • Health Information Systems
  • Document Scanning
  • Insurance Verification
  • Medical Terminology

Timeline

Medical records Technician

Advantmed LLC
09.2023 - Current

Claims Specialist/Clinical Specialist

State Farm
03.2023 - 09.2023

Insurance Adjuster

EA Renfroe
01.2019 - 01.2022

Medical Records Technician

Episource LLC
08.2018 - 09.2021

Surveyor

JLM Strategic Talent Partner
05.2018 - 06.2018

Field Interviewer/ Data collector for Tobacco Study

Westat Research Company
05.2016 - 01.2017

Clinical Trial Coordinator and Field Interviewer (Ophthalmology Clinical Trial Contract)

University of Southern California, Keck School of Medicine, Battelle
08.2015 - 04.2018

Front Office and Placement Coordinator

Alternative Healthcare LA
04.2014 - 10.2017

Bachelor of Science (BS) - Health info management

Ashford University
Laverne DunlapClaims Adjuster