PRISCILLA RAMIREZ
West Babylon,NY
Summary
Experienced workers' compensation medical only adjuster with a strong background in analyzing claims and determining coverage. Skilled in managing complex cases through thorough investigation and timely resolution. Proven ability to negotiate and provide exceptional customer service.
Overview
18
18
years of professional experience
Work History
Medical Only Adjuster
Gallagher Bassett
10.2022 - 03.2025
- Ensured compliance with state regulations and company policies through diligent review of all claim-related materials.
- Assisted clients in understanding their insurance coverage by explaining complex terms and conditions clearly and concisely.
- Contributed to team success by participating in regular training sessions, sharing best practices, and mentoring new adjusters.
- Increased overall productivity by managing a large caseload while maintaining strict attention to detail and accuracy in documentation.
- Documented information gathered in field and uploaded data to company database for efficient processing using RISXFACS.
Technical Assistant
Gallagher Bassett
04.2021 - 10.2022
- Verified client information by analyzing existing evidence on file.
- Prepared insurance claim forms or related documents and reviewed for completeness for NY, PA and NJ claims adjusters.
- Posted payments to accounts and maintained records.
Data Entry Clerk/Receptionist
All Type Auto
02.2018 - 12.2019
- Data Entry/Customer service rep; handling switchboard and obtaining phone messages from potential clients, filing all paperwork.
- Maintained good relationships with multiple dealers and obtained monthly rebates for pricing of vehicles.
- Assisted in vehicle pick up and deliveries.
Shop Clerk
Educational Bus Transportation
06.2015 - 04.2017
- Duties were to enter and file paperwork, calling vendors, and scheduling vehicle services for weekly DOT inspections.
- Approving mechanics hours for the week.
- Managed inventory to promote consistent supply of product and service items.
- Completed daily tasks accurately and on-time to support shop needs.
- Helped managers with daily checklists and last-minute requirements.
Customer Care Supervisor
Raymour and Flanigan Furniture
04.2007 - 10.2010
- Responded to customer requests for products, services, and company information.
- Enhanced customer satisfaction by promptly addressing concerns and providing accurate information.
- Handled complaints, provided appropriate solutions, and alternatives within appropriate timeframes and followed up to achieve resolution.
Education
High School Diploma -
Skills
- Claims investigation
- Insurance regulations
- Critical thinking
- Claims processing
- Risk assessment
- Advanced computer skills
- Caseload management
- Data analysis
- Highly motivated
- Data entry
- Attention to detail
- Multitasking and organization
Languages
Spanish
Native or Bilingual
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Work Preference
Work Type
Full TimePart TimeWork Location
RemoteHybridOn-SiteImportant To Me
Work-life balanceFlexible work hoursWork from home optionHealthcare benefitsPersonal development programsCareer advancement4-day work weekPaid time off401k matchPaid sick leaveTeam Building / Company RetreatsCompany CultureTimeline
Medical Only Adjuster - Gallagher Bassett
10.2022 - 03.2025
Technical Assistant - Gallagher Bassett
04.2021 - 10.2022
Data Entry Clerk/Receptionist - All Type Auto
02.2018 - 12.2019
Shop Clerk - Educational Bus Transportation
06.2015 - 04.2017
Customer Care Supervisor - Raymour and Flanigan Furniture
04.2007 - 10.2010
Babylon High School - High School Diploma,
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