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
Hammond, LA
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
New Orleans, LA
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
Atlanta, GA
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
Peach Corners, GA
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.
Armarillo, TX
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
Dallas, TX
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
New Orleans, LA
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)
Winchester, VA
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
New Orleans, LA
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
New Orleans, LA
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
New Orleans, LA
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
New Orleans, LA
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