Regina Anthony
Grand Prairie
Summary
Dynamic Claims Adjuster with extensive experience at Liberty Mutual, excelling in auto liability and PIP claims handling. Proven track record in effective investigation and resolution, ensuring compliance and accuracy. Strong negotiation skills complemented by exceptional customer service, consistently delivering timely results and maintaining organized case files.
Overview
26
26
years of professional experience
Work History
Med-Pay/PIP/Liability Claims Representative
Davies Group (TPA)
New York
07.2022 - 02.2026
- Conducted thorough investigations and obtained statements to accurately determine liability and facilitate claims resolution.
- Reviewed and analyzed coverage, verifying benefits and eligibility for all parties to ensure compliance and accuracy.
- Reviewed and interpreted policy language to assess coverage details accurately.
- Evaluated insurance claims for accuracy and compliance with company policies.
- Processed large medical and wage-loss payments while effectively communicating with attorneys and providers to expedite claims processing.
- Issue denial, exhaust, and reservation of rights letters in compliance with policy terms.
- Maintain prompt responses to all calls, emails, and correspondence.
- Managed case files, ensuring all records were updated and organized properly.
Med-Pay/PIP Claims Adjuster
Liberty Mutual (PRG)
09.2021 - 07.2022
- Reviewed coverage and verified eligibility for injured parties, facilitating prompt claims processing.
- Processed wage-loss and medical payments to ensure timely compensation for injured parties.
- Investigated claims to determine coverage, liability, and damages, ensuring fair resolution for all parties involved.
- Communicated effectively and provided high-quality customer service, enhancing client satisfaction throughout claims process.
Containment Specialist
Wells Fargo
03.2020 - 06.2021
- Researched and verified customer data to ensure compliance with policies and procedures, enhancing data integrity.
- Supported customers with promissory notes and updated them on loan status, facilitating informed decision-making.
- Managed inbound calls for PPP loans, applications, and forgiveness, ensuring accurate information delivery.
Claims Adjuster
HallMark
10.2019 - 03.2020
- Investigated claims to determine liability, damages, and medical necessity.
- Verified insured eligibility and issued denial, exhaust, and reservation letters to ensure compliance with policy terms.
- Processed wage-loss and medical payments to facilitate timely financial support for claimants.
Claims Representative II
Horace Mann
10.2016 - 10.2019
- Managed 250 claims, ensuring accuracy and timely processing to support customer satisfaction.
- Reviewed medical bills and records for necessity and billing accuracy, contributing to compliance and cost management.
- Investigated coverage, processed payments, and issued denial and reservation letters to uphold policy standards and customer communication.
- Communicated with clients to gather necessary claim information.
- Maintained accurate records in claims management systems.
- Handled customer inquiries regarding insurance policy coverage details and payment status updates.
Manager
EZ Cash / Title Loan
01.2000 - 09.2011
- Managed daily branch operations, ensuring efficient scheduling, accurate collections, and timely reporting.
- Supervised staff to ensure compliance with company policies and regulations.
- Processed title loans and check cashing with full compliance to regulations.
- Provided exceptional customer service while accurately processing large bank deposits.
- Analyzed loan applications to assess risk and determine approval status.
Education
Associate of Applied Science - Process Operation Technology
Mississippi Gulf Coast Community College
05-2016
Associate of Science - Medical Assisting
Virginia College
01-2013
Skills
- Claims handling
- Claims Negotiation
- Claims resolution
- Claims Payment Processing
- Eligibility verification
- Bill review
- Statement gathering
- Liability assessment
- Time Management & Organization
- Cross-Functional Collaboration
- Verbal and written communication
- Time management
- Office systems
Community Service
- Volunteer Tax Preparer - Jackson County Civic Action
- Volunteer - Bethesda Free Clinic
- Curriculum Developer - MGCCC Process Technology Program
- 40 Hours Community Service - Habitat for Humanity
Timeline
Med-Pay/PIP/Liability Claims Representative
Davies Group (TPA)
07.2022 - 02.2026
Med-Pay/PIP Claims Adjuster
Liberty Mutual (PRG)
09.2021 - 07.2022
Containment Specialist
Wells Fargo
03.2020 - 06.2021
Claims Adjuster
HallMark
10.2019 - 03.2020
Claims Representative II
Horace Mann
10.2016 - 10.2019
Manager
EZ Cash / Title Loan
01.2000 - 09.2011
Associate of Applied Science - Process Operation Technology
Mississippi Gulf Coast Community College
Associate of Science - Medical Assisting
Virginia College