Meagan Heath
Philadelphia,PA
Overview
7
7
years of professional experience
Work History
Claims Adjuster, Workers Compensation
Sedgwick Claims Management Services Inc.
03.2023 - Current
- Manage a caseload of 150 litigated workers' compensation claims for the states of Pennsylvania, New Jersey, Delaware, and West Virginia.
- Achieved a high customer satisfaction rating of 97% by providing clear and timely communication throughout the claims process.
- Negotiated favorable settlements with claimants, attorneys, and other insurance carriers to minimize financial risk for the company.
- Investigated claims, reviewed coverage and liability, prepared reports, and recommended payment or denial of claims.
- Worked with private investigators and attorneys on the preparation of evidence, witness statements, and other documentation in preparation for trial.
Liability Claims Specialist
Healthcare Services Group
Bensalem, PA
08.2020 - 12.2022
- Act as a liaison between the company, attorneys, third-party administrators, insurance companies, and insurance brokers.
- Maintain a high track record of success in settling complex third-party liability claims.
- Made critical decisions to negotiate settlements of up to $1,000,000.00 to resolve third-party bodily injury and property claims.
- I attended all mediations and settlement hearings on behalf of the company.
- Verified client information by analyzing existing evidence on file.
- Managed a high volume of claims effectively by prioritizing tasks, and maintaining excellent organizational skills.
- Managed the company's entire auto fleet program.
- Collaborated with legal counsel to successfully defend against litigation related to disputed liability claims.
- Saved the company money through diligent fraud detection efforts during claim investigations.
- Analyzed claim documents to ensure accuracy and compliance, mitigating the risk of financial loss.
Claims Examiner
AMERICAN INDEPENDENT INSURANCE
Blue Bell, PA
05.2018 - 08.2020
- Contacted the insured, claimants, including guest passengers, to rule out any first-party medical or injury claims.
- Detailed coverage, liability, and reasons for denial of claims to policyholders, attorneys, and third-party providers.
- Ensured best practice guidelines were met and adhered to state insurance compliance requirements.
- Maintained knowledge of benefits claim processing, claims principles, medical terminology and procedures, and HIPAA regulations.
- Provided exceptional service while managing up to 200 claims at a time.
- Exposed a fraud ring consisting of fraudulent, staged accidents by 45 claimants in an attempt to receive uninsured motorist and first-party medical benefits.
Risk Management Intern
INTEGRATED ADJUSTMENT SERVICES
Philadelphia, PA
01.2015 - 12.2017
- Prevented costly claims on behalf of Lincoln Financial Field by uncovering and reducing third-party liability.
- Conducted over 100 thorough property investigations to identify any potential environmental hazards.
- I interviewed up to 30 injured spectators and workers at a given event, and examined the location of the incident in order to assess exposure.
- Verified testimonies, reviewed written statements, and photos were used to properly research claims and pinpoint the cause of injuries.
Education
BBA - Insurance And Risk Management
Temple University
Philadelphia, PA05-2018
Skills
- Negotiation strategies
- Regulatory compliance
- Claim investigation
- Liability assessment
- Excellent verbal and written communication skills
- Settlement negotiation
- Risk Assessment
- Analytical Skills
Timeline
Claims Adjuster, Workers Compensation
Sedgwick Claims Management Services Inc.
03.2023 - Current
Liability Claims Specialist
Healthcare Services Group
08.2020 - 12.2022
Claims Examiner
AMERICAN INDEPENDENT INSURANCE
05.2018 - 08.2020
Risk Management Intern
INTEGRATED ADJUSTMENT SERVICES
01.2015 - 12.2017
BBA - Insurance And Risk Management
Temple University
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