Rachel Alley
Macon,GA
Summary
Efficient Senior Audit Associate equipped with skills in team leadership, audit planning and report preparation. Proven capabilities 120 audits each month. Accomplished in training and mentoring staff to build strong teams and consistently achieve auditing goals. Thoughtful Senior Audit Associate with over 15 years of experience performing audits for internal associates. Proficient with Audit Express. Offering strong leadership and problem-solving skills. Meticulous Senior Audit Associate skilled in performing risk assessments claim files and recommending improvements. Proven history of ensuring compliance through implementing measurable compliance enforcement actions. Hardworking and passionate job seeker with strong organizational skills eager to secure entry-level Claims position. Ready to help team achieve company goals. Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy.
Overview
30
30
years of professional experience
Work History
Subrogation - Senior Audit Associate
Geico
09.2019 - 05.2022
- Assessed internal controls by identifying variances and deficiencies and recommending critical changes.
- Delegated work to team members and student interns to share workload and continue meeting audit goals.
- Developed and executed strategy for audit engagements.
- Collaborated with clients' management teams to collect audit information and recommend strategic business improvements.
- Kept audits working smoothly to meet in order to keep productivity up.
- Employed expertise in auditing, recovery and claims generally accepted principles to accurately assess claims.
Claims Representative
GEICO
03.1995 - 09.2021
- Analyzed and addressed escalated claims to resolve issues quickly.
- Worked productively in fast-moving work environment to process large volumes of claims.
- Researched and analyzed complex claims to determine next steps and possible outcomes.
- Updated claims system to track claim status and provide relevant information to other department.
- Followed up with customers on unresolved issues.
- Negotiated claim settlements with claimants and attorneys to resolve claims efficiently and fairly.
- Interviewed policyholders to verify information and obtain additional details.
- Examined reports, accounts, and evidence to determine integrity and accuracy of information.
- Investigated accidents or incidents to determine cause and extent of damages.
- Maintained confidentiality of patient finances, records, and health statuses.
Subrogation Claims Representative
GEICO
11.2016 - 09.2019
- Generated, posted and attached information to claim files.
- Verified client information by analyzing existing evidence on file.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
- Prepared Subrogation Demands either manually or sending through ESHUB for the Adverse carrier to review for payment.
- Made continuous follow-ups to adverse carrier and to update insured.
- Once payment has been received from the adverse carrier e will then contact the insured to advise we are sending their deductible.
Arbitration Adjuster & Arbitration Panelists
GEICO
11.2013 - 09.2019
- Managed holistic case inventory for arbitration team, driving mutually beneficial outcomes and leveraging state-specific methods for mediation.
- Worked with Recovery Director and other arbitration team managers to establish best practices, training modules and evaluation systems for company employees.
- Provided onboarding and training to staff members, coordinating IT system access and conducting training specific to individual roles.
- Performed required monthly audits, following arbitration agreement details and documenting observations in computer system for further review.
- Advised parties on dispute resolution processes, policies and procedures, helping disputants make informed choices.
- Prepared written opinions or decisions regarding cases.
- Heard several cases each month to listen to arbitration's filed by other carriers and then make a decision based on evidence.
Bodily Injury & Property Damage Claims Adjuster 2
GEICO
12.2009 - 11.2011
- Negotiated terms and handled settlements and adjustments with attorneys, claimants and co-defenders.
- Evaluated coverage, liability and damages and investigated suspicious claims.
- Interviewed policyholders, witnesses and third parties to gather information and details regarding injury event.
- Referred extreme cases to Special Investigation Unit (SIU) for further review.
- Conducted claims investigations by obtaining written statements, preparing reports, researching public records and conducting personal interviews.
Telephone Claims Representative 1
GEICO
08.2007 - 12.2010
- Responded to customer requests for products, services, and company information.
- Answered incoming phone calls to articulate product value to prospective customers and support current policyholders.
- Documented customer interactions and transactions for accurate, up-to-date records.
- Fielded customer complaints, escalating complex issues to management for resolution.
- Investigated Liability
- Investigated Coverage
- If any first party injuries we would issue payments to the providers and/or Attorney.
- Provided primary customer support to internal and external customers.
- Reviewed and adjusted customer coverage levels to address, identify, and resolve customer conflicts.
- We would also follow up on medical treatment.
- Issued payment's for property damages.
Florida PIP Class Actio
GEICO
04.2006 - 08.2007
- We would receive the participants of the class action based on the provided documents that were returned to GEICO
- Once we received the documentation from the participate we input all relevant information into a compute program.
- The documentation we received we were taught Medical Coding so that we could input into the computer and provide EOBs.
Florida PIP Adjuster
GEICO
09.2001 - 04.2006
- Negotiated, facilitated, and managed real estate transactions.
- Maintained connections with clients to encourage repeat business and referrals.
- Advised clients on market conditions and property value for informed decision-making.
- Conducted comprehensive market analysis to identify opportunities for investors.
- Liaised between buyers and sellers to provide positive experiences for both parties.
- Issued PIP/MPC for medical payments; expense that occurred as a result of this accident.
- Resolved client concerns related to home purchases to maintain high satisfaction ratings.
- Wrote contracts to outline sales and purchases of properties.
- Promoted sales of properties through advertisements, open houses and online advertising platforms.
- Liaised between buyers and sellers to establish favorable prices and negotiate contract terms.
- Advised and informed prospective clients on current market activities and conditions.
- Completed property walkthroughs before completing deals to uphold accuracy in listings and appraisals.
, Government Employees Insurance - Mailroom Assoc
GEICO
08.1992 - 06.1997
- Placed incoming or outgoing letters and packages into sacks or bins, adding identifying tags.
- Loaded and unloaded packages to prepare for outbound and inbound distribution.
- Used scales and charts to weigh packages or letters to determine postage needs.
- Demonstrated great customer service by answering employee questions regarding mailings and rates.
- Unloaded and lifted mail containers and parcels to prepare for distribution to sortation stations.
- Utilized stamping machines and stencils to stamp, tag and label printed materials.
- Sorted, opened and date stamped incoming mail for all departments.
- Operated postage meters, mail sealers and labeling machines.
Education
High School Diploma -
Central High School
Macon05.1992
Skills
- Correspondence Writing
- Quality Production
- Report on Findings
- Quality Assessments
- Process Auditing
- Negotiation and Conflict Resolution
- Microsoft Office
- Reliability and Integrity Improvement
- Internal Audits
- Active Listening
- Risk Mitigation Strategies
Timeline
Subrogation - Senior Audit Associate
Geico
09.2019 - 05.2022
Subrogation Claims Representative
GEICO
11.2016 - 09.2019
Arbitration Adjuster & Arbitration Panelists
GEICO
11.2013 - 09.2019
Bodily Injury & Property Damage Claims Adjuster 2
GEICO
12.2009 - 11.2011
Telephone Claims Representative 1
GEICO
08.2007 - 12.2010
Florida PIP Class Actio
GEICO
04.2006 - 08.2007
Florida PIP Adjuster
GEICO
09.2001 - 04.2006
Claims Representative
GEICO
03.1995 - 09.2021
, Government Employees Insurance - Mailroom Assoc
GEICO
08.1992 - 06.1997
High School Diploma -
Central High School
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