Nicole Mercado
Lackawanna
Summary
Motivated, detail-oriented Bodily Injury Examiner with over 10 years of claims experience. Strong command of conflict resolution and negotiation combined with excellent investigative and reporting skills. Thorough understanding of claims process and proven track record in handling complex claims with precision and providing outstanding customer service.
Overview
12
12
years of professional experience
1
1
Certification
Work History
Telephone Claims Representative II
GEICO
03.2014 - Current
- Deliver prompt, quality customer contact/experience throughout the life cycle of the claim
- Review and analyze coverage and applies policy conditions, provisions, exclusions and endorsements for moderate complexity Bodily Injury liability claims in assigned jurisdictions
- Consider and resolve all lien types, including Medicare, Medicaid, Workers Compensation or others relevant to the jurisdiction
- Investigate each claim to obtain relevant facts necessary to determine coverage, the extent of liability, damages, and contribution potential with respect to the various coverages provided through prompt contact with appropriate parties
- Establish timely and maintain appropriate claim and expense reserves.
- Determines settlement amounts, negotiates and conveys claim settlements within authority limits to claimants or their representatives
- As appropriate, writes denial letters, Reservation of Rights and other necessary correspondence to claimants.
- Managed high-volume claims processing while ensuring compliance with company policies and regulatory requirements.
Education
Diploma - Advanced Culinary Arts
Connecticut Culinary Institute
02.2024
Graduate High School Diploma - undefined
Nashoba Regional High School
06.2002
Skills
- Multitasking
- Problem-solving abilities
- Attention to detail
- Time management
- Insurance policy knowledge
- Critical thinking
- Organizational skills
- Team leadership
- Verbal and written communication
- Adaptability and flexibility
Certification
Property and Casualty Claims Adjuster - Assigned home state RI - currently active | Current licenses provided upon request
Timeline
Telephone Claims Representative II
GEICO
03.2014 - Current
Graduate High School Diploma - undefined
Nashoba Regional High School
Diploma - Advanced Culinary Arts
Connecticut Culinary Institute