MELISSA TUGMAN
State Farm
Dacula,GA
2027
years of professional experience
Bodily Injury Claims Specialist with a proven track record in managing high-volume inventories of over 150 attorney-represented, litigation, commercial, and complex injury claims. Expertise includes liability investigations, medical record analysis, coverage evaluation, damage assessment, and settlement negotiations, consistently resolving 10-15 claims monthly while maintaining exceptional customer service standards and regulatory compliance. A unique background as a Diagnostic Medical Sonographer enhances the evaluation of medical records and understanding of injury severity, driving accurate and defensible claim decisions. Actively seeking to contribute to a forward-thinking organization by leveraging a distinctive combination of medical expertise and litigation focused claims experience to reduce exposure and streamline resolution processes.
Work History
Bodily Injury Claims Specialist
3 Years 3 Months- As a Bodily Injury Adjuster at State Farm, I investigate, evaluate, and resolve complex injury claims by analyzing liability, reviewing medical records, and negotiating settlements with defense attorney's in litigation. I am responsible for delivering fair and timely claim resolutions while maintaining compliance with state regulations and company standards. Known for being hardworking and driven, I manage a high-volume caseload with attention to detail, strong communication, and a commitment to customer service
Assistant Manager
- Monitored employee performance to improve efficiency and accountability; Assisted in human resource functions including
- Patient Information Management, Medical Record Keeping, Scheduling & Client/Customer Care, Issue Management &
- Resolution, Insurance & Financial Management
- Provided management with assistance with various key duties to facilitate the day-to-day operation of the business,
- Resulting in becoming proficient at all positions in the store and at many managerial tasks
- Maintained regular communication and working relationships with families, service coordinators, and community
- Contacts. Coordinated with staff, and professional consultants to ensure patients receive necessary services
Diagnostic Medical Sonographer
- Operated advanced ultrasound equipment to perform diagnostic imaging procedures.
- Assisted radiologists in interventional procedures such as biopsies or drainages under ultrasound guidance for improved accuracy.
- Collaborated with healthcare professionals to review patient histories and prepare for examinations.
- Ensured compliance with safety standards and maintained accurate imaging records.
- Conducted quality control checks on ultrasound equipment to ensure optimal performance.
- Evaluated images for diagnostic accuracy, documenting findings for physician review.
- Optimized workflow by assisting with clerical duties such as updating patient records and entering data into electronic health record systems.
Diagnostic Medical Sonographer Intern
- Assisted in performing diagnostic ultrasound examinations for various medical conditions.
- Maintained ultrasound equipment, ensuring optimal functionality and safety standards.
- Collaborated with healthcare team to discuss patient histories and imaging requirements.
- Documented examination findings accurately in electronic health records for physician review.
Office Manager
- Coordinated various administrative functions to enhance operational efficiency and serve as a liaison between management and staff.
- Facilitated resolution of work-related issues through contract interpretation and administration.
- Facilitated new employee orientation sessions to cultivate a positive alignment with organizational objectives.
- Assisted in identifying open positions and supporting the recruitment process. Conducted interviews and participated in the selection of candidates.
- Evaluated statistical data and reports to diagnose personnel challenges and formulate effective solutions.
- Cultivated strategic relationships with colleagues, business partners, customers, agents, and regulatory entities to foster collaboration. Led initiatives to strengthen partnerships across various departments and external stakeholders. Orchestrated engagement with stakeholders to align goals and drive organizational success.
- Oversaw maintenance of employee personnel files, ensuring accuracy and confidentiality of sensitive data.
- Completed bi-weekly payroll for 7 employees.
Education
Associate of Science - Diagnostic Medical Sonographer
- HIPPA
Skills
Medical records analysis
Claims investigation
Settlement negotiation
Liability assessment
Litigation management
Policy interpretation
Injury evaluation
Insurance regulations
Customer service
Problem-solving
Time management
CAREER HIGHLIGHTS
- Exceptional Customer Service: Strong communication skills to understand customer needs and provide exceptional results. Track record of successfully dealing with difficult personalities to resolve dissatisfaction. Proficient in developing strong relationships with clients by developing trust and exhibiting credibility early in the process.
- Independent and Team Player: Enjoy collaborating with colleagues, clients, and customers, as well as completing tasks independently. Eager to motivate and inspire others to deliver their best.
- Organized and Motivated: Skilled in maintaining order. Able to seamlessly multi-task long and short-term priorities to generate desired results.
Timeline
Bodily Injury Claims Specialist
State Farm
03.2023 - CurrentRead More
Assistant Manager
Peace Of Mind Psychological Services
2019 - 2021Read More
Diagnostic Medical Sonographer
Atlanta Hearth Associates
2018 - 2019Read More
Diagnostic Medical Sonographer Intern
Southern Regional Hospital
2016 - 2018Read More
Office Manager
Third Planet Solutions
2011 - 2016Read More
Cambridge College
Associate of Science from Diagnostic Medical Sonographer
Read More
Certification
from HIPPA
Read More