Nhaieemah Horne
Forney
Summary
Analytical Claims Manager with expertise in managing team functions and ensuring high-quality production. Developed concurrent objectives to enhance operational efficiency and drive positive results. Committed to fostering team success and resolving issues independently.
Overview
8
8
years of professional experience
Work History
Property Damage Claims Supervisor
Seaharbor Insurance
Farmers Branch
09.2024 - Current
- Trained new staff on procedures for managing customer inquiries and complaints.
- Collaborated with IT to implement system upgrades, improving Claims Department efficiency.
- Researched complex claim issues to resolve disputes among involved parties.
- Attended industry conferences to remain updated on insurance law changes and claims regulations.
- Conducted quality assurance reviews on claims for compliance with company standards.
- Developed strategies to enhance customer satisfaction through streamlined processes and communication.
- Monitored performance metrics, including turnaround times and resolution rates, for departmental improvement.
- Coordinated dispute resolutions involving multiple parties, including attorneys and medical providers.
Property Damage Adjuster
Seahabor
Dallas
10.2023 - Current
- Investigated insurance policies for coverage concerns and escalated claims to underwriting for final confirmation.
- Examined policies to validate insurance coverage and compliance with regulations.
- Processed document requests related to garaging, vehicle ownership, and unlisted household matters.
- Analyzed insurance estimates, ensuring consistency with initial statements and verifying demographic details.
- Collected recorded statements for new claims and communicated total loss estimates on property value.
- Escalated total loss claims to specific departments and generated payments on initial estimates and rental invoices.
- Provided training sessions on best practices for new adjusters handling property damage claims.
- Collaborated with attorneys on complex legal issues related to property damage cases.
Property Damage Adjuster
GEICO, Government Employees Insurance
Richardson
07.2021 - 10.2023
- Inspected property damage and personal injury claims to assess insurance payouts.
- Spearheaded investigations to evaluate and settle insurance claims, gathering relevant information.
- Negotiated settlements with insured parties regarding property damage claims.
- Determined fraudulent claims and ensured policy coverage for valid losses.
- Collaborated with attorneys on complex legal matters related to property damage cases.
- Calculated repair costs using cost estimation software for accurate assessments.
- Reviewed police reports and medical records to ascertain liability extent.
- Coordinated emergency repairs with contractors to facilitate efficient claim handling.
Medical Biller
Conifer Health Solutions
Frisco
10.2019 - 07.2021
- Educated patients on financial responsibilities while adhering to hospital cash agreements and policies.
- Secured timely payment entry in compliance with financial regulations.
- Verified insurance coverage, benefits, and eligibility according to Medicare and Medicaid standards.
- Maintained security of protected health information (PHI) during all transactions.
- Generated monthly aging reports for management review of delinquent accounts.
- Processed refund requests accurately and promptly per established protocols.
- Submitted electronic claims to multiple insurance carriers for reimbursement.
- Collaborated with management to enhance revenue cycle strategies.
Auto Claims Adjuster
Esurance
Richardson
07.2017 - 10.2019
- Analyzed insurance claims to assess coverage and determine liability.
- Investigated claims, collaborating with underwriters and agents to establish cause and damages.
- Conducted interviews with witnesses and reviewed records for accuracy and completeness.
- Identified potential fraud by examining previous claims and reporting discrepancies.
- Negotiated settlements, ensuring accurate documentation for title processing and branding.
- Evaluated repair estimates to authorize reasonable costs prior to repairs.
- Pursued subrogation opportunities to recover claim expenses.
- Ensured compliance with company policies and state regulations throughout claim handling.
Education
High School Diploma -
North Mesquite High School
Mesquite05-2012
Some College (No Degree) - Business Management
Butler Community College
El Dorado, KSSome College (No Degree) - Business Management
University of Texas At Tyler
Tyler, TXTimeline
Property Damage Claims Supervisor
Seaharbor Insurance
09.2024 - Current
Property Damage Adjuster
Seahabor
10.2023 - Current
Property Damage Adjuster
GEICO, Government Employees Insurance
07.2021 - 10.2023
Medical Biller
Conifer Health Solutions
10.2019 - 07.2021
Auto Claims Adjuster
Esurance
07.2017 - 10.2019
High School Diploma -
North Mesquite High School
Some College (No Degree) - Business Management
Butler Community College
Some College (No Degree) - Business Management
University of Texas At Tyler
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