Nancy A. Jodice
Senior Claims Representative
Central Valley,NY
Summary
Highly-qualified and experienced Insurance Claims Representative successful at managing high caseloads in fast-paced environments. Versed in investigating claims and managing settlements. Friendly and upbeat team player focused on timely claim handling while providing exceptional customer service. Offering 10+ years of insurance experience and willingness to take on any challenge.
Overview
29
29
years of professional experience
3
3
years of post-secondary education
Work History
Senior APD Claims Representative
Amica Mutual Insurance Company
07.2016 - Current
- Investigate and evaluate coverage and liability to settle APD claims of varied complexity in timely manner
- Process payments to settle claims to insureds, claimants, providers and adverse carriers
- Negotiate and settle Diminishment of Value claims
- Manage diary system to ensure timely communication, payments, claim monitoring and file reporting
- Address claim-related communication via phone, voicemail, email and web messages
- Pursue and respond to subrogation and Arbitration filings
- Set up and monitor rentals through Hertz and ARMS system
- Identify claims that merit EOR, SIU, BI and subrogation referral for supplemental handling
- Maintain licenses in designated states (NJ, DE, NC, FL, RI) and complete continuing education as needed for compliance
- Additional claim handling experience with Amica: PIP 2 years, Homeowner and Total Loss 3 years.
C0-Owner/Operator
Artisan Granite Plaques & Designs
01.2010 - 07.2016
- Create new product designs
- Developed and maintain web sites and social media accounts
- Process and fulfill orders and shipments
- Place orders for shop supplies and materials
- Determine merchandise pricing and promotions
- Establish new customer accounts and solicit new markets
- Evaluated suppliers to maintain cost controls and improve operations
- Managed day-to-day business operations
- Conducted target market research to discover customer needs and analyze competitor trends
- Developed and implemented marketing strategies to generate new customers and increase sales and profit margins
Insurance Reimbursement Specialist/Enteral Program Coordinator
Praxair Healthcare
08.1996 - 05.2005
- Implemented and managed Enteral Nutrition program for 250 patients
- Coordinated hospital discharge with enteral nutrition home set-up for new patients
- Verified patient insurance and program eligibility
- Coordinated Certificates of Medical Necessity, prescriptions and invoicing for patient insurance billing
- Managed collections, appeals and ALJ's
- Analyzed new products resulting in 30% higher receivables
- Managed and maintained inventory of nutritional products and supplies
- Provided patients, caregivers and hospital staff with clinical support, training and education.
- Demonstrated respect, friendliness and willingness to help wherever needed
- Worked well in team setting, providing support and guidance
Education
College - Dietetic Technology
SUNY Rockland
Suffern, NY 09.1997 - 05.2000
Skills
Liability Investigations
undefinedAdditional Information
- Certifications and Licenses , Licensed Claims Adjuster in DE, FL, NC, RI.
Accomplishments
Employee of the Month - Individual Service Levels
May 2021
Exceptional job of maintaining 100% service level.
Employee of the Month - Payment Cycle Time
July 2021
High percentage of expeditious payments.
Best Phone Presence
September 2022
Best Phone Presence.
Timeline
Senior APD Claims Representative
Amica Mutual Insurance Company
07.2016 - Current
C0-Owner/Operator
Artisan Granite Plaques & Designs
01.2010 - 07.2016
College - Dietetic Technology
SUNY Rockland
09.1997 - 05.2000
Insurance Reimbursement Specialist/Enteral Program Coordinator
Praxair Healthcare
08.1996 - 05.2005
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