Melissa Pierce
Hurst,Texas
Summary
Established record of accurately handling client insurance claims related to property damage, liability, and bodily injury claims while working in a fast-paced, high-volume environment. Proven skillset in insurance-related investigative research with a strong attention to detail and ensuring clear and succinct supporting documentation. Adept in building rapport and relationships with clients, listening to client needs, and determining the best approach to meet and address those requests. Proficient in Microsoft Office Suite, Outlook, phone systems, and Windows and Mac operating systems; high accuracy with 10-key.
Overview
15
15
years of professional experience
1
1
Certification
Work History
Claims Examiner II
Wellington Claim Service, LLC
10.2023 - Current
- Manage property claims; use investigative data to assess coverage and damages
- Recognize subrogation and salvage opportunities
- Settle claims within settlement authority
- Efficiently managed large losses for the policyholders for fire, wind, hail and hurricane
Claims Examiner
Compass Adjusting
06.2023 - 10.2023
- Managed property claims in an overflow capacity for Wellington Claim Services as an independent contractor
Agency Owner
The Pierce Agency, LLC – Farmers Insurance
08.2022 - 11.2023
- Insurance sales to existing and prospective customers
- Manage day to day operations of agency and staff
- Networking and Marketing events in the local area
Claims Adjuster
Hallmark Financial
11.2019 - 05.2022
- Manage property damage and liability claims; use investigative data to assess coverage, liability, and damages
- Recognize subrogation and salvage opportunities
- Settle claims within settlement authority
- Efficiently manage fast paced desk within multiple states and maintain a 100% closing ratio monthly
- High volume call center handling over 50 calls per day
Senior Claims Representative
Amerisure Mutual Insurance Company
10.2018 - 11.2019
- Manage property damage, liability, and bodily injury claims and use investigative data to assess coverage, liability, and damages
- Recognize subrogation, salvage opportunities and file subrogation with Arbitration Forums, including supporting documentation
- Settle claims within settlement authority
- Efficiently manage a capacity of 140 claims across jurisdictions in multiple states
Referral Management
Texas Health Resources
Dallas, USA
04.2015 - 06.2018
- Attended to patient needs regarding specialist referrals has provided by primary care physicians
- Scheduled specialist and imaging center appointments on behalf of patients and acquire insurance plan approvals
- Executed client requests marked as escalated (STATS) within thirty minutes of referral, urgent requests within four hours, and routine orders within 72 hours
Certified Medical Assistant
Texas Health Resources
Dallas, USA
05.2012 - 04.2015
- Settled patients into rooms, confirmed medical history and checked vitals
- Performed phlebotomy and injection needs on patients
- Helped physicians with regular office needs and processes
- Ensured patients received timely and accurate messages from physicians both in writing and over the telephone
- Managed incoming and outgoing calls to internal and external vendors
Claims Representative
Direct Adjusting Company
Irving, USA
04.2010 - 05.2012
- Managed property damage, liability, and bodily injury claims and used investigative data to assess coverage, liability, and damages
- Recognized subrogation and salvage opportunities and filed subrogation with Arbitration Forums, including supporting documentation
- Participated in litigation activities and settled claims within settlement authority
- Efficiently managed a capacity of 100 claims across jurisdictions in multiple states
Education
BS - Alternative Medicine
Everglades University
06.2023
Certified Medical Assistant -
Everest College
Fort Worth, Texas11.2011
Skills
- Data verification
- Claims processing
- Investigative skills
- Liability and coverage
- Policy interpretation
- Verbal communication
- Coverage analysis
- Microsoft Office Suite
- Negotiation abilities
Certification
- Texas All-Lines Adjuster License, Current
- General Agent License, Current
- Property & Casualty, Life Accident, Health & HMO, Current
Key Qualifications
- Established record of accurately handling client insurance claims related to property damage, liability, and bodily injury claims while working in a fast-paced, high-volume environment.
- Proven skillset in insurance-related investigative research with a strong attention to detail and ensuring clear and succinct supporting documentation.
- Adept in building rapport and relationships with clients, listening to client needs, and determining the best approach to meet and address those requests.
- Proficient in Microsoft Office Suite, Outlook, phone systems, and Windows and Mac operating systems; high accuracy with 10-key.
Timeline
Claims Examiner II
Wellington Claim Service, LLC
10.2023 - Current
Claims Examiner
Compass Adjusting
06.2023 - 10.2023
Agency Owner
The Pierce Agency, LLC – Farmers Insurance
08.2022 - 11.2023
Claims Adjuster
Hallmark Financial
11.2019 - 05.2022
Senior Claims Representative
Amerisure Mutual Insurance Company
10.2018 - 11.2019
Referral Management
Texas Health Resources
04.2015 - 06.2018
Certified Medical Assistant
Texas Health Resources
05.2012 - 04.2015
Claims Representative
Direct Adjusting Company
04.2010 - 05.2012
BS - Alternative Medicine
Everglades University
Certified Medical Assistant -
Everest College
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