Nikole Smith
Insurance Claims Adjuster
Lincoln,NE
Summary
Professional licensed claims adjuster with comprehensive experience in handling bodily injury claims, focused on delivering precise and fair evaluations. Skilled in negotiation, risk assessment, and legal compliance, consistently ensuring optimal outcomes. Strong team collaborator, adaptable to changing circumstances, and reliable in achieving results.
Overview
9
9
years of professional experience
3
3
Certificates
1
1
Licensed Adjuster - DHS Texas
Work History
Represented Bodily Injury Claims Specialist
State Farm
Lincoln, NEBRASKA
03.2023 - 05.2025
- Managed a high volume of claims efficiently, prioritizing tasks based on urgency and complexity.
- Collaborated with medical professionals, attorneys, and other experts to gather evidence and validate claims accurately.
- Continuously improved job performance by attending training sessions and seeking feedback from supervisors regularly.
- Conducted timely negotiations with claimants'' representatives to reach fair settlements within policy limits.
- Provided guidance to junior staff members on complex case scenarios involving multiple parties or liability disputes.
- Utilized strong analytical skills to identify potential subrogation opportunities, reducing company payout expenses.
- Reduced company exposure to potential lawsuits by identifying potential fraud and adhering to legal guidelines during claim handling.
- Improved negotiation outcomes for settlements with meticulous documentation and clear communication.
- Educated policyholders about their coverage benefits, helping them understand how their policies applied to specific situations.
- Maintained detailed records of each claim, streamlining the process for future reference and audits.
- Developed strong relationships with claimants, ensuring empathetic communication while maintaining professionalism.
- Achieved successful claim resolutions by thoroughly investigating and evaluating bodily injury claims.
- Provided support to colleagues in the resolution of complex claims, sharing expertise and knowledge as needed.
- Ensured compliance with state regulations during every stage of the claims process, minimizing risk for both the company and policyholders.
- Delivered exceptional customer service through consistent communication regarding updates on the status of their claims.
- Evaluated and settled complex insurance claims in strict timeframes.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
Insurance Claims Analyst
AFBA-Armed Forces Benefit Association
Lincoln, NE
04.2022 - 11.2022
- Interacted with clients and employees, which helped cultivate positive working relationships.
- Created a benefit that helped drive policy sales.
- Maintained strict confidentiality with all personal data as per company guidelines.
- Viewed reports regularly to make sure processing was conducted efficiently.
- Identified key areas not performing well and implemented effective, new processes.
- Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
- Evaluated original investigation reports and documents to resolve secondary concerns.
- Directed claims negotiations within allowable limit of $5,000 and supported successful litigations for advanced issues.
- Maintained suspicious claims database and prepared reports for supervisors.
Medical Records Specialist
Nebraska Orthopedic Center
Lincoln, NE
01.2022 - 04.2022
- Monitored legal and financial statuses of various offices.
- Kept accurate log of requests for medical information and records.
- Communicated effectively with staff, patients and insurance companies by email and telephone.
- Processed medical records requests from outside providers according to facility, state and federal law.
- Obtained necessary signatures on information release forms to obtain medical and treatment records from other service providers.
- Reviewed recordkeeping procedures for patients and doctors.
- Maintained patient confidence by keeping patient records information confidential.
- Uploaded physician progress notes, history and physicals into electronic medical records.
OFFICE MANAGER
COPART
Lincoln, NE
09.2021 - 03.2022
- Established workflow processes, monitored daily productivity and implemented modifications to improve overall performance of personnel.
- Prepared meeting rooms and materials and recorded important information.
- Implemented project management techniques to overcome obstacles and increase team productivity.
- Evaluated employee records and productivity and submitted evaluation reports.
- Coached new hires on company processes while managing employees to achieve maximum production.
- Maintained computer and physical filing systems.
- Communicated corporate objectives to various divisions to meet deadlines and adhere to company budgets.
- Reviewed client and staff feedback and made appropriate business adjustments to meet needs and address concerns.
- Updated reports, managed accounts and generated reports for company database.
- Delivered performance reviews, recommending additional training or advancements.
- Optimized organizational systems for payment collections, AP/AR, deposits and recordkeeping.
- Oversaw office inventory activities by ordering and requisitions and stocking and shipment receiving.
- Coordinated and aligned corporate and office schedules and disseminated important work information to employees.
- Coordinated special projects and managed schedules.
- Oversaw work processes and performed quality control tasks to increase revenue and reduce production times.
House Manager
EDWIN BUXTON CAREGIVERS
Charleston, IL
01.2018 - 02.2021
- Communicated with delegating nurse to coordinate and complete medical services.
- Supervised employees preparing meals and handling chores and provided constructive feedback.
- Developed detailed plans based on broad guidance and direction.
- Monitored shift changes to uphold successful operations strategies and maximize success.
- Trained and developed personnel to improve safety, employee relations and resolve issues.
- Evaluated performance, adjusted strategies and maintained agile, sustainable operations.
- Managed day-to-day operation of home to comply with regulations and agency standards.
- Improved staffing during busy periods by creating employee schedules and monitoring call-outs.
- Reduced workflow inconsistencies by recruiting and hiring capable staff members.
- Established team priorities, maintained schedules and monitored performance.
- Cultivated positive rapport with fellow employees to boost company morale and promote employee retention.
- Established performance goals for employees and provided feedback on methods for reaching those milestones.
- Defined clear targets and objectives and communicated to other team members.
- Maintained financial accuracy when handling revenue each day.
Certified Nursing Assistant
DOUGLAS NURSING AND REHABILITATION CENTER
Mattoon, IL
05.2016 - 01.2018
- Evaluated patients to identify and address wounds, behavioral concerns and medically relevant symptoms.
- Answered call lights and supported patient comfort and safety by adjusting bed rails and equipment.
- Supported ambulation and physical therapy needs by conducting planned exercise routines.
- Promoted good oral and personal hygiene by aiding patients with shaving, bathing and teeth brushing.
- Obtained client medical history, medication information, symptoms and allergies.
- Delivered individualized patient care by recording vital signs, documenting observations, administering treatments and evaluating patient needs.
- Offered immediate assistance in emergency and routine paging situations to evaluate needs and deliver care.
- Checked patient vitals such as temperature, blood pressure and blood sugar levels.
- Cared for residents in assisted living facility and delivered high-quality support to meet needs.
- Cared for clients with diagnoses such as respiratory failure, diabetes, Parkinson's disease and muscular dystrophy.
Education
All Lines Adjusters License - All Lines Adjuster
Adjuster Academy of Texas
Boerne, TX 12.2025 - 01.2026
Bachelor’s - Healthcare Administration, Business Administration
Colorado State University
01.2021 - Current
General classes and Nursing track -
Lake Land College
01.2014 - 01.2017
Certified Nursing Assistant Certificate -
Lake Land College
03.2010 - 07.2010
Skills
Valuation knowledge
Policy investigations
Dispute tracking
Claims
Document workflow
Claims review
Insurance policy coverage knowledge
Benefits review
Risk management
Microsoft Word
Coverage determination
Healthcare Common Procedures Coding System (HCPCS)
Microsoft Office Suite
Accomplishments
Created insurance benefit
Wrote 3 children's books
Certification
CNP - Certified Notary Public
Timeline
All Lines Adjusters License - All Lines Adjuster
Adjuster Academy of Texas
12.2025 - 01.2026
Represented Bodily Injury Claims Specialist
State Farm
03.2023 - 05.2025
Insurance Claims Analyst
AFBA-Armed Forces Benefit Association
04.2022 - 11.2022
Medical Records Specialist
Nebraska Orthopedic Center
01.2022 - 04.2022
OFFICE MANAGER
COPART
09.2021 - 03.2022
Bachelor’s - Healthcare Administration, Business Administration
Colorado State University
01.2021 - Current
House Manager
EDWIN BUXTON CAREGIVERS
01.2018 - 02.2021
Certified Nursing Assistant
DOUGLAS NURSING AND REHABILITATION CENTER
05.2016 - 01.2018
General classes and Nursing track -
Lake Land College
01.2014 - 01.2017
Certified Nursing Assistant Certificate -
Lake Land College
03.2010 - 07.2010