Moy'na Cunningham
Plant City,FL
Summary
Senior Claims Investigator with extensive experience in fraud detection and claims analysis. Proven track record of improving operational efficiency and enhancing customer satisfaction through strategic problem-solving. Skilled in managing complex claims, conducting in-depth investigations, and collaborating with law enforcement to ensure compliance and uphold integrity in insurance operations.
Overview
7
7
years of professional experience
Work History
Senior Claims Investigator/Claims Adjuster
USAA
Tampa , FL
02.2023 - Current
- Conduct in-depth investigations into suspicious and complex auto theft and fire claims to identify potential fraud, misrepresentation, or policy violations.
- Analyze data, claims files, and documentation to detect red flags and patterns of fraudulent activity, and escalate findings as appropriate.
- Collaborate with law enforcement agencies, attorneys, and regulatory bodies to ensure compliance with federal and state insurance regulations.
- Interview claimants, witnesses, and third parties to obtain recorded statements, verify facts, and assess the validity of claims.
- Review and audit estimates , invoices, and repairs documentation to confirm accuracy and legitimacy prior to settlement.
Senior Inside Auto Claims Adjuster
GEICO, Government Employees Insurance
Lakeland, FL
04.2021 - 02.2023
- Conducted comprehensive evaluations of insurance policies, analyzing damage assessments to ascertain coverage limits, and ensure accurate claims processing.
- Develop and implement strategic action plans for new injury claims by reviewing case files to assess the current status and necessary steps forward, enhancing efficiency in claims resolution.
- Lead the investigation into suspicious and potentially fraudulent insurance claims through detailed analysis, ensuring the integrity of insurance operations.
- Provide quality customer support by addressing inquiries related to deductibles, demonstrating knowledge of policy details, to improve customer satisfaction and trust.
Maintenance Coordinator
Sharp Transit/ Account Temps/ Robert Half
Jefferson, GA
02.2020 - 04.2021
- Adhere to service requests, and proactively diagnose and manage preventive maintenance for the fleet of trucks.
- Perform data entry and parts ordering processes for a nationwide fleet, enhancing operational efficiency and data accuracy.
- Conduct vendor sourcing and negotiations to obtain quality parts at cost-effective rates, improving supply chain effectiveness.
- Managed billing and invoicing procedures, ensuring timely financial management. transactions, and fostering positive vendor relationships.
- Maintain operational uptime by managing inbound/outbound calls to schedule tows, rental truck pickups, and delivery of fuel and oil.
Transportation Dispatcher
Acertus/ Account Temps/ Robert Half
Alpharetta, GA
01.2020 - 03.2020
- Worked closely with new clients in setting up vehicle transport, title and registration, vehicle storage, car care services, and compliance services.
- Enhanced process efficiency by utilizing a transportation management system to dispatch vehicles to carriers.
- Collaborated with the dispatch staff and other departments to facilitate seamless communication, updates, and efficient problem resolution.
- Accurately performed data collection, audit, and reporting of various performance metrics, and reported to management for further actions.
Pre-Invoice Specialist
Mansfield Energy Corp/AccountTemps/ Robert Half
Gainesville, GA
11.2019 - 01.2020
- Collaborated with customer operations team to support set up processes for new consigned inventory customers including new billing spreadsheets
- Ensured all billings are complete and timely for the month, end close process; gather data for missing deliveries and/or sales not yet posted as required
- Proficiently utilized entinuum development software system to schedule daily carrier fuel deliveries for contracted vendors
Cash Applications Specialist
Mansfield Energy Corp/AccountTemps/ Robert Half
Gainesville, GA
08.2019 - 11.2019
- Efficiently processed payments transfers and posted payments that came in EFT, ACH, item adjustments and wires
- Maintained meticulous attention to details to assist in posting all daily cash receipts, ensuring accuracy and completeness
- Accurately processed Canadian eft's, payments and also bank transfers
Escalations Specialist, Compliance
Health Insurance Innovations LLC
Tampa, Florida
09.2018 - 06.2019
- Handled escalated calls for patients requesting to change healthcare providers, resulting in scheduling patients' follow-ups and transportation to routine doctors' appointments.
- Take inbound escalation calls for patients and members covered by various health insurance plans.
- Ensure daily operations are performed, including scheduled patient cancellations, patient account maintenance, and vendor billing, such as discrepancies.
- Conducted meetings and reviews with supervisors and health insurance agents to review members' health insurance policies to make sure they are updated and accurate.
Education
GED -
Tampa Bay Testing Center
Tampa, FL06-2011
Skills
- Multi-state property and casualty auto claims adjuster license in 15 states
- Claims file management processes
- Strategic problem solving and the ability to deescalate situations
- Customer service experience
- Communication skills
- Fraud detection and prevention
- Strategic negotiations
- Operational efficiency
- Claims analysis and settlement
- Administrative support
- Strong attention to detail
- Data collection and evaluation
- Risk management
- Technology implementation
- Ccc portal
- LexisNexis
- Carfax
- MS Office Suite
References
References available upon request.
Timeline
Senior Claims Investigator/Claims Adjuster
USAA
02.2023 - Current
Senior Inside Auto Claims Adjuster
GEICO, Government Employees Insurance
04.2021 - 02.2023
Maintenance Coordinator
Sharp Transit/ Account Temps/ Robert Half
02.2020 - 04.2021
Transportation Dispatcher
Acertus/ Account Temps/ Robert Half
01.2020 - 03.2020
Pre-Invoice Specialist
Mansfield Energy Corp/AccountTemps/ Robert Half
11.2019 - 01.2020
Cash Applications Specialist
Mansfield Energy Corp/AccountTemps/ Robert Half
08.2019 - 11.2019
Escalations Specialist, Compliance
Health Insurance Innovations LLC
09.2018 - 06.2019
GED -
Tampa Bay Testing Center
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