PATRICIA JONES
Spring Hill,FL
Summary
Proven track record in claims adjustment, leveraging technical knowledge and critical thinking to enhance claims processing efficiency at Crawford & Company (US). Excelled in risk assessment and policy interpretation, significantly improving client satisfaction. Skilled in MS Office, with a strong ability to maintain professional relationships through active listening and empathy. Insurance Adjuster skilled in investigating and analyzing liability concerning personal loss. Proven history of leveraging excellent negotiation skills to facilitate settlements. Excellent communication skills demonstrated through 21 years of experience interviewing specialists, witnesses and claimants to compile information. Motivated Medical Only Adjuster specializing in work injuries. Negotiates peaceful resolutions of all claims with emphasis on fairness and thoroughness. Trustworthy and dependable.
Overview
21
21
years of professional experience
Work History
Medical Only Workers' Compensation Adjuster
Broadspire Services
02.2014 - Current
- Maintained strong relationships with clients, claimants, and colleagues by consistently demonstrating professionalism, empathy, and effective communication skills.
- Ensured compliance with state regulations and company policies through diligent review of all claim-related materials.
- Reviewed police reports, medical treatment records, and physical property damage to determine extent of liability.
- Collaborated with medical professionals to review injury claims, ensuring proper treatment plans were in place and accurately calculating compensation based on severity and long-term impact.
- Optimized data management processes by accurately documenting claim details in company systems for easy retrieval during audits or future inquiries.
- Participated in ongoing professional development opportunities to maintain current knowledge of insurance laws, regulations, and best practices within the field of claims adjustment.
- Organized, planned and documented materials for Workers' Compensation claims.
- Analyzed information gathered by investigation and reported findings and recommendations.
- Maintained claims data in Risk Management systems. .
Medical Only Workers' Compensation Adjuster
Crawford & Company (US)
09.2011 - 02.2014
- Maintained strong relationships with clients, claimants and colleagues by consistently demonstrating professionalism, empathy, and effective communication skills.
- Ensured compliance with state regulations and company policies through diligent review of all claim-related materials.
- Improved claim processing efficiency by conducting thorough investigations and promptly addressing discrepancies.
- Reviewed police reports, medical treatment records, and physical property damage to determine extent of liability.
- Collaborated with medical professionals to review injury claims, ensuring proper treatment plans were in place and accurately calculating compensation based on severity and long-term impact.
- Analyzed information gathered by investigations to report findings and recommendations.
- Reviewed questionable claims by client and claimant interviews to correct omissions and errors.
- Researched claims and incident information to deliver solutions and resolve problems.
- Reviewed new files to determine current status of injury claim and to develop plan of action.
Clerk
Crawford & Company (US)
09.2003 - 09.2011
- Utilized strong multitasking skills to manage multiple priorities and tasks, ensuring timely completion of each assignment.
- Interacted with customers by phone, email, or in-person to provide information.
- Reduced errors in data entry by carefully inputting information into computer systems with attention to detail.
- Improved customer satisfaction by promptly answering inquiries and providing accurate information.
- Supported administrative staff with timely completion of daily tasks, ensuring smooth office operations.
- Maintained filing system and organized customer documents for easy retrieval of information.
- Enhanced office organization with regular maintenance of files, records, and supplies inventory.
- Ensured confidentiality of sensitive documents through proper storage methods and restricted access control implementation.
- Processed mail accurately and efficiently, ensuring that all correspondence was distributed to correct recipients in timely manner.
- Input data into spreadsheets and databases.
- Reviewed files, records and other documents to obtain information to respond to requests.
- Answered and managed incoming and outgoing calls while recording accurate messages for distribution to office staff.
Education
High School Diploma -
Roosevelt High School
Atlanta, GA05.1985
Skills
Claims Investigation
Technical knowledge
Claims Processing
Advanced computer skills
Best Practices Implementation
Casualty and property loss as a clerk
Highly motivated
Decision-Making
Computer Skills
Claims Evaluation
Accredited Claims Adjuster
Microsoft Office Suite
Timeline
Medical Only Workers' Compensation Adjuster
Broadspire Services
02.2014 - Current
Medical Only Workers' Compensation Adjuster
Crawford & Company (US)
09.2011 - 02.2014
Clerk
Crawford & Company (US)
09.2003 - 09.2011
High School Diploma -
Roosevelt High School
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