Highly Personable and knowledgeable customer service oriented Claim Adjuster with 15 yrs insurance experience (Standard and Non-Standard). Handled initial investigations and coverage evaluations to settlement negotiations and claims resolution.
Overview
20
20
years of professional experience
Work History
Patient Counselor
Accelerated Claims Inc.
Gainesville, GA
01.2020 - Current
Interview, investigate and make phone calls in relation to medical claims associated with motor vehicle, general liability and workers compensation accidents
Determine medical benefits and pursue payments on behalf of the client
Interview patients entering the ER. Gather accident details and insurance carrier information for the use of determining available medical coverage
Create patient files in the system and maintain files accuracy
Investigate and confirm any medical coverage related to motor vehicle, general liability, and/or workers compensation insurance available to the patient
Identify any patient attorney and confirm patients representation with the attorneys office
Multi-line Claim Adjuster
State Farm Insurance (Contractor)
Duluth, GA
05.2012 - 07.2019
PROPERTY CLAIMS ADJUSTER (4 years):
Promptly contacted insured's to provide accurate & timely investigation and loss analysis
Investigated, analyzed and determined the extent of liability concerning personal, casualty and property losses and damages
Reviewed estimates in Xactimate for accuracy and necessary amendments
Estimated and settled contents claims by investigating and evaluating the loss details about every article damaged or lost
Maintained an active diary and monitored diary to achieve timely development of file and timely disposition of the claim
Presented settlements and payments to insured's and/or attorney's/public adjusters
Composed and sent letters
Set and updated reserves
Adhered to all statutory regulations and unfair claim practices
AUTO CLAIMS ADJUSTER: (3 years):
Handled a variety of auto losses including complex (more than 3 vehicles), Total losses, and Bodily injury claims
Set inspections and rental vehicles when applicable
Thoroughly reviewed the time limit demands, what the conditions of the demands were
Labeled incoming documents from attorneys, healthcare facilities and/or insureds
Researched Vehicle market value to determine total loss value
Recognize & pursued recovery where possible
Maintained the salvage log and processed the salvage proceeds
Transferred titles & all paperwork
Ordered Police reports and/or motor vehicle reports if applicable
Investigated catastrophe related auto claims when applicable
LITIGATION ASSOCIATE (3 months):
Class Action lawsuit project
Reviewed Georgia claims for possible diminished value settlements
Reviewed scope of damages via estimate and photos taken at time of loss to determine if diminished value was owed under class action lawsuit against State farm
P&C Insurance Sales Agent (Non-Standard)
Lindsay General Insurance Agency
Duluth, GA
07.2010 - 01.2012
Prepared and bind auto policies
Assisted existing customers with policy info and/or documents
Collected premium payments and made outbound calls to remind customers of document deadlines to insure continuous coverage
Explained all policy coverage's, exclusions and premiums to insured
Processed premium payments to begin coverage
Issued Declaration page/proof of insurance to insured
Data Entry Clerk
Thomson Reuters
Valhalla, NY
01.2009 - 03.2010
Entered data into databases
Verified accuracy
Added documents to file records and created new records to support filing needs
Obtained scanned records and uploaded into database
Managed documents by organizing forms, making photocopies, filing records, preparing correspondence and creating reports
P&C Insurance Sales Agent
Homesite Insurance
White Plains, NY
01.2004 - 12.2007
Quoted and bind homeowners insurance policies for various carriers such as GMAC, AIG, Progressive, and Unitrin
Sold additional products and service after identifying customer needs and requirements
Determined financial needs by assessing existing coverage and aligning new products and services with long-term goals
Responded to customer calls within 24 hours to swiftly resolve issues and answer questions
Built and maintained long-term relationships with clients through active listening and outstanding customer service
Displayed consistent, positive attitude towards customers, peers, and other personnel, even during high stress situations
Education
GED -
Georgia Department of Education
Lawrenceville, GA
12.2013
Skills
P&C Adjuster License in multiple states
Standard & Non Standard Insurance Handling
Proficient with Microsoft office system (Including Word, Excel and Outlook)
Proficient with Xactimate, XactAnalysis, XactContents, Symbility, CCC pathways, NextGen, Audatex, and guidewire software/Systems
Aircraft Fleet Maintenance Student Worker at Middle Georgia State UniversityAircraft Fleet Maintenance Student Worker at Middle Georgia State University