NATALIE BANNER

• Handled complaints and grievances using negotiating and problem-solving skills.
• Examined photographs and statements.
• Worked with private investigators and attorneys on preparation of evidence, witness statements and other documentation in preparation for trial.
• Interviewed claimants and witnesses to gather factual information.
• Evaluated insurance policies and analyzed damages to determine coverage.
• Prepared summaries of damage, payments, and policy coverage.
• Established relationships with clients and insurance companies to foster timely claims resolution.
• Answered customer questions regarding deductibles.
• Verified insurance claims and determined fair amount for settlement.
• Examined claims forms and other records to determine insurance coverage.
• Negotiated with policyholders and claimants to reach mutually satisfactory resolutions.
• Researched and analyzed policy contracts to verify proper payment of claims.
• Documented all investigation activity and presented reports to management.
• Substantiated legitimate claims and denied unjustified claims.
• Conducted comprehensive interviews of witnesses and claimants to gather facts and information.
• Mitigated risks and increased profitability with well-developed strategies for reducing future claims and costs.
• Directed claims negotiations within allowable limit of settlement authority and supported successful litigation for advanced issues

• Clarified coverage of losses to policyholders and provided assistance in itemizing damages and finding alternative living arrangements.
• CAT / hail/ fire/ water / vandalism/ auto/ claims for Canada.
• Responsible for handling general liability and commercial claims in litigation.
• • Completed investigation for premises liability, product liability, and some construction defect claims.
• • Managed workload of 80-150 litigated claims.
• • Acknowledged and provided written responses to Plaintiff demands, Notice of Intents, and Civil
• Remedy Notices.
• • Negotiated settlements with third party claimants and plaintiff counsel. Attended mediation and

• Interviewed claimants and witnesses to gather factual information.
• Examined photographs and statements.
• Researched claims and incident information to deliver solutions and resolve problems.
• Investigated properties to determine extent of damage and estimate repair costs.
• Examined claims forms and other records to determine insurance coverage.
• Conducted day-to-day administrative tasks to maintain information files and process paperwork.
• Rendered liability determination on each claim in accordance with statutory requirements.
• • Investigated complex municipal 3rd party auto and general liability claims, including litigation.
• • Established reserves and authorized payments within reserving authority limits.
• • Communicate claim status with claims manager, client, and claimants.
• • Adhere to client and carrier guidelines and participate in claim reviews as needed.

Perils included fire, water, wind, hail, theft, sink holes and lightning

• Responsible for investigation, evaluation, coverage determination
• Negotiated settlements with policy holders, public adjusters and attorneys
• Assigned experts: field adjusters, engineers, Water mitigation, Mold remediation, set up
• And process ALE, peer reviews, General Contractors
• Drafted ROR/RFI, Inspection delay letters, Non-contact letters
• Responsible of establishing and maintaining contact with insured and or representatives
• Maintaining accurate reserves and expenses for claim files
• Staying updated with current codes and state statues

• Issued payouts to claimants.
• Documented all findings in concise reports.
• Examined photographs and surveillance and any other documents relating to claims.
• Negotiated with claimants to settle claims.
• Kept current on insurance regulations, laws, policies and procedures.
• Coordinated with local body shops to assign repair jobs and obtained rental vehicles for customers for duration of restoration process.
• Carried and managed consistently heavy project workload through exemplary organizational, time management and collaboration talents.
• Enhanced customer satisfaction by delivering honest advice to policyholders in regards to repair work and body shop processes.
• Assessed complex claims and accurately determined value of damages.
• Analyzed complex data and prepared accurate and comprehensive reports for clients.
• Created detailed assessments of damages to property and vehicles.
• Skilled at working independently and collaboratively in team environment.
• Self-motivated, with strong sense of personal responsibility.
• Proven ability to learn quickly and adapt to new situations.
• Worked effectively in fast-paced environments.
• Managed time efficiently in order to complete all tasks within deadlines.
• Excellent communication skills, both verbal and written.
• Passionate about learning and committed to continual improvement.
• Proved successful working within tight deadlines and fast-paced environment.
• Used critical thinking to break down problems, evaluate solutions and make decisions.
• Paid attention to detail while completing assignments.
• Worked flexible hours across night, weekend and holiday shifts.
• Adaptable and proficient in learning new concepts quickly and efficiently.
• Organized and detail-oriented with strong work ethic.
• Cultivated interpersonal skills by building positive relationships with others.
• Evaluated and investigated over 350 auto claims in 1year and decided whether insurer should pay claim

Responsible for negotiating and adjudicating attorney represented and non-represented bodily injury claims.

• Adjusted injury claims from both personal lines and commercial lines policies in multiple venues and jurisdictions.
• Used problem solving and strategic thinking skills through conducting telephone interviews with claimants and witnesses to drive claim resolution.
• Consistently met high metrics including auditing, quality, efficiency and decision making.
• Reviewed medical notes, processed medical bills, and obtained recorded statements to confirm coverage and liability.
• Collected evidence form claimants to investigate and cover treatment cost.
• Managed parking lot injury claims from inception to resolution.

• Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
• Verified patient insurance coverage and benefits for medical claims.
• Managed large volume of medical claims on daily basis.
• Researched and resolved complex medical claims issues to support timely processing.
• Paid or denied medical claims based upon established claims processing criteria.
• Evaluated medical claims for accuracy and completeness and researched missing data.
• Monitored and updated claims status in claims processing system.
• Identified and resolved discrepancies between patient information and claims data.
• Followed up on denied claims to verify timely patient payment and resolution.
• Assessed medical claims for compliance with regulations and corrected discrepancies.
• Used administrative guidelines as resource or to answer questions when processing medical claims.
• Issued payouts to claimants.
• Documented all findings in concise reports.
• Examined photographs and surveillance and any other documents relating to claims.
• Kept current on insurance regulations, laws, policies and procedures.
• Coordinated with local body shops to assign repair jobs and obtained rental vehicles for customers for duration of restoration process.
• Created detailed assessments of damages to property and vehicles.
• Analyzed complex data and prepared accurate and comprehensive reports for clients.
• Assessed complex claims and accurately determined value of damages.
• Successfully negotiated settlements with claimants and insurers.