Nikiria Brown
New Orleans,LA
Summary
To enter a position that will allow for company and individual growth in a fast-paced, challenging environment. Which will allow me to utilize my skills and previous working experiences for future growth and career advancement.
Overview
18
18
years of professional experience
1
1
Certification
Work History
Property Claim Adjuster (Daily Claims)
Alacrity
07.2023 - 12.2023
- I determined whether the insured's policy covers claimed loss
- Interviewed insured to gather loss facts
- Reviewed damage estimates for property damages
- Issued payments per damage estimates
- Managed a caseload of over 100 claims
- Meeting deadlines and consistently exceeding performance targets.
Premise General Liability Claims Adjuster
Morris Bart Attorney's Office
03.2023 - 05.2023
- I monitored and audited premises accident legal cases, reviewed evidence obtained in investigations to evaluate a claim
- Managed strict confidential documents and complied with HIPPA regulations
- I also was responsible for sending certified letters of Representation to Defendants, called and interviewed clients to gather information to begin investigations while working closely with 4 different attorneys.
Travel Claims Adjuster
Crawford and Company
12.2022 - 03.2023
- My position consisted of me Investigating travel claims for General, Starr, and Custard
- I determined if Coverage was proper to award refund for cancellation of trips
- I also interviewed claimants to gather facts of loss while issuing payments if loss was granted per policy.
Auto Claims Adjuster
Custard Insurance Adjuster
02.2021 - 01.2022
- Upon my daily working duties I educated and assisted the insured on claimants' policy and the claim process
- I Collaborated cooperatively with claimants or clients to arrange vehicle inspections, analyzed case files for clients to determine the level of loss and compensation
- Upon that I contacted lien holders for payoff information
- I denied, settled, and authorized payments based upon field adjuster reports along with damaged photos
- Further more I set accurate amounts of reserves, worked daily diaries, emails, and returned voicemail calls in a timely matter.
CAT Property Claim Adjuster
QA Claims, Inc.
05.2020 - 01.2021
- My position consisted of me Assisting Mitigation exposure to reduce claims cost
- I reviewed claims for strategy to insure that claims moved forward towards closure
- I Also denied, settled, and authorized payments based on field adjuster reports along with damaged photos
- Interpreted policy and evaluated coverage issues on different policies and endorsements
- I wrote and sent denial letters when coverage was denied and interviewed policy holders to gather loss information.
Bodily Injury Claim Adjuster
Allstate Insurance Company
01.2019 - 05.2020
- My position consisted of me determining Coverage and providing customers with detailed estimates and the policy
- I worked independently, within a team, and virtually providing empathy to the insured, while helping them through the claims process
- I also issued payments or denied claims in a timely manner in accordance with policy
- I took recorded statements from insured and claimants, finalized liability and negotiations with medical providers, ordered police reports and other records for ISO database.
Authorization Specialist
TriWest Healthcare Alliance
09.2016 - 01.2020
- Optimized workflow processes through effective communication between departments regarding authorization needs and statuses.
- Supported clinical staff by providing timely updates on the status of prior authorizations for various services.
- Collaborated with healthcare providers to obtain necessary documentation for prior authorization requests.
- Contributed to team goals by consistently meeting or exceeding individual productivity targets for processing authorization requests.
- Maintained compliance with HIPAA regulations, safeguarding sensitive patient information during the authorization process.
- Prevented delays in care delivery by proactively identifying potential issues during the pre-authorization process and seeking clarification from providers when needed.
Housing Inspector
Vanguard Emergency Management (FEMA)
09.2017 - 11.2017
- Reduced the prevalence of substandard housing through diligent enforcement of regulations and corrective measures.
- Collaborated with other inspectors and agencies for comprehensive evaluations of housing units.
- Utilized specialized equipment for precise measurements and accurate assessments of structural integrity.
- Streamlined inspection processes, resulting in more efficient time management and increased productivity.
Claim Representative
BrownGreer Law Firm
04.2013 - 10.2016
- Developed strong relationships with clients, fostering trust and loyalty to the company.
- Maintained comprehensive knowledge of insurance policies and regulations, leading to accurate decision-making on claim eligibility.
- Continuously improved personal knowledge of industry trends and developments through ongoing training initiatives, enhancing job performance capabilities.
- Decreased claim processing time by streamlining workflows and implementing efficient task prioritization.
- Conducted regular audits on processed claims to maintain quality control standards within the department.
- Reduced fraudulent claims by conducting thorough investigations and verifying information accurately.
- Reviewed medical records diligently when necessary for injury-related cases ensuring correct assessment was made regarding the claim.
Data Entry Clerk
McKesson Health
03.2008 - 02.2013
- Completed data entry tasks with accuracy and efficiency.
- Followed established procedures to enter and process data correctly.
- Organized, sorted, and checked input data against original documents.
- Scanned documents and saved in database to keep records of essential organizational information.
- Prioritized tasks effectively to ensure timely completion of all assigned projects without sacrificing attention to detail.
- Resolved discrepancies in data entry activities for accurate, complete jobs.
- Maintained a high level of accuracy and speed through continuous self-assessment, surpassing company standards consistently.
Claim Processing Specialist
HGI Catastrophe Service
03.2007 - 01.2008
- Streamlined communication between departments, ensuring timely resolution of complex claims.
- Assisted colleagues with complex cases, sharing expertise and knowledge to achieve favorable outcomes for clients and the company.
- Enhanced claim processing efficiency by implementing new software and optimizing workflows.
- Contributed to the development of user-friendly online claim submission tools, simplifying procedures for clients while increasing data accuracy.
- Collaborated with other specialists to develop best practices in claim processing, resulting in a more consistent approach across the organization.
- Reduced claim errors by providing thorough training for team members on policy changes and regulations.
- Improved customer satisfaction by efficiently addressing inquiries and resolving disputes.
- Conducted regular audits of processed claims to maintain a high level of accuracy and compliance with industry standards.
Medical Collections Specialist
McKesson Pharmaceutical Company
04.2006 - 11.2006
- Prevented potential legal issues by adhering to federal and state regulations governing medical collections activities.
- Strengthened relationships with referring providers by maintaining open communication lines regarding patient financial matters.
- Enhanced revenue recovery through diligent follow-up on delinquent accounts.
- Worked closely with clinical staff to verify services rendered, enabling accurate coding and billing procedures.
- Collaborated with insurance companies to expedite claims processing and secure timely reimbursements.
Education
High School Diploma -
Alcee Fortier Senior High School
New Orleans, LA05.2000
Skills
- Microsoft Office
- Investigate and Confirms Coverage
- Negotiation and Analytical Skills
- Strong Communication and Customer Service Skills
- Issue Settlement payments within Authority Limits
- Documenting Claims Files Timely and Accurately
- Interview insured/ Claimants and Witnesses to gather pertinent information
- Handle Property Claims Involving Damage to building and Structures or Liability Claims Involving Personal Injuries
- Claims Investigation
- Damage Assessment
- Property valuation
- Policy Interpretation
- Coverage assessments
- Data Analysis
- Critical Thinking
- Decision-Making
- Payment Processing
- Computer Skills
- Claims Evaluation
- Coverage Determination
- Client Interviewing
- Liability Determination
Certification
- National Flood Insurance Program Certification (NFIP)
- State Farm Auto Certified
- State Farm Property Certified
- TWIA Certified
- Louisiana Citizens Certified
Professionalreferences
- Jason Willis, (512) 554-2054, AVP Catastrophe Operations Manager
- Veronica Windings, (225) 280-0796, Allstate Team Lead
Licensedadjusterstates
- Louisiana, 842974
- Texas, 2597216
- Florida, W668179
- Mississippi, 10709514
- Main, ADN409108
- Michigan, 19266258
- New Mexico, 19266258
- Washington, 11036335
- Oklahoma, 3001066390
- Georgia, 3577011
- North Carolina, 19266258
- Montana, 3002284071
Timeline
Property Claim Adjuster (Daily Claims)
Alacrity
07.2023 - 12.2023
Premise General Liability Claims Adjuster
Morris Bart Attorney's Office
03.2023 - 05.2023
Travel Claims Adjuster
Crawford and Company
12.2022 - 03.2023
Auto Claims Adjuster
Custard Insurance Adjuster
02.2021 - 01.2022
CAT Property Claim Adjuster
QA Claims, Inc.
05.2020 - 01.2021
Bodily Injury Claim Adjuster
Allstate Insurance Company
01.2019 - 05.2020
Housing Inspector
Vanguard Emergency Management (FEMA)
09.2017 - 11.2017
Authorization Specialist
TriWest Healthcare Alliance
09.2016 - 01.2020
Claim Representative
BrownGreer Law Firm
04.2013 - 10.2016
Data Entry Clerk
McKesson Health
03.2008 - 02.2013
Claim Processing Specialist
HGI Catastrophe Service
03.2007 - 01.2008
Medical Collections Specialist
McKesson Pharmaceutical Company
04.2006 - 11.2006
High School Diploma -
Alcee Fortier Senior High School
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