Miriam Adams
Southfield,MI
Summary
Service-oriented Claims Adjuster skilled at applying creative approaches to solving complex problems. Adept at developing profitable and quality-focused processes.
Overview
29
29
years of professional experience
Work History
Insurance Claims Analyst
Michigan Automobile Insurance Placement Facility MAIPF
01.2022 - Current
- Maintained strict confidentiality with all personal data as per company guidelines.
- Viewed reports regularly to make sure processing was conducted efficiently.
- Interacted with clients and employees, which helped cultivate positive working relationships.
- Investigate injury claims assigned and run reports to confirm auto insurance coverage as it relates to injuries sustained from motor vehicle accidents.
- Examined claims forms and other records to determine insurance coverage.
- Read over insurance policies to ascertain levels of coverage and determine whether claims would receive approvals or denials.
- Conducted day-to-day administrative tasks to maintain information files and process paperwork.
- Reviewed police reports, medical treatment records, and physical property damage to determine extent of liability.
Personal Injury Claims Adjuster
The Auto Club Group - AAA
11.1994 - 12.2021
- Examined claims forms and other records to determine insurance coverage.
- Reviewed police reports, medical treatment records, and physical property damage to determine extent of liability.
- Prepared summaries of damage, payments, and policy coverage.
- Researched and analyzed policy contracts to verify proper payment of claims.
- Evaluated insurance policies and analyzed damages to determine coverage.
- Answered customer questions regarding deductibles.
- Established relationships with clients and insurance companies to foster timely claims resolution.
- Documented all investigation activity and presented reports to management.
- Substantiated legitimate claims and denied unjustified claims.
- Mitigated risks and increased profitability with well-developed strategies for reducing future claims and costs.
- Delivered exceptional customer service to policyholders by communicating important information and patiently listening to issues.
- Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
- Conducted day-to-day administrative tasks to maintain information files and process paperwork.
- Maintained contact with claimants and attorneys to determine treatment status.
Education
Master of Science - Human Resources Management
Keller Graduate School
Southfield, MI06.2015
Bachelor of Science - Public Administration And Community Development
Central Michigan University
Mount Pleasant, MI06.2013
Skills
- Subrogation Expertise
- Bank Deposits
- Familiar with Fraud Statutes
- Onsite Evaluation
- Customer Feedback
- Standards Compliance
- Coverage Determination
- Complex Coverage Issues
- Reserves Adjustment
- Authorize Payments
- Reserves Recommendations
- Claims Investigations
- HIPAA Compliance
- Active Listening
Community Volunteering for over 20 years.
Through the course pf my past and current employment, I volunteer for varies community organizations such as Forgotten Harvest, Chic Time , UNCF and Big Brother Big Sister, just to name a few.
Additional Information
I have attained Customer Service experience over the past 8 years as a Sales Associate where I have worked for Home Depot, DSW Shoes, DoorDash and Rally House.
Timeline
Insurance Claims Analyst
Michigan Automobile Insurance Placement Facility MAIPF
01.2022 - Current
Personal Injury Claims Adjuster
The Auto Club Group - AAA
11.1994 - 12.2021
Master of Science - Human Resources Management
Keller Graduate School
Bachelor of Science - Public Administration And Community Development
Central Michigan University