Ricarra Farmer
Tucson,AZ
Summary
Prior Airforce and experienced insurance professional with 10-year career assessing properties, determining liabilities and negotiating settlements. Detail-oriented, observant and knowledgeable with excellent interpersonal and documentation skills. Efficiently handle high case volumes with accuracy and care. Energetic and enthusiastic insurance professional motivated to succeed in fast-paced and deadline-driven professional environment. Comprehensive knowledge of claims adjustments with special knowledge of auto appraisals and CCC pathways estimations.
Overview
10
10
years of professional experience
Work History
Senior Bodily Injury Adjuster
GEICO, Government Employees Insurance
Tucson, AZ
10.2022 - 11.2023
- Experienced and well versed in handling Time Limit Demands and attorney involved Bodily Injury claims.
- Managed, investigated, and resolved high volume of claim & settled claims within prescribed authority levels of $100,000 while providing exceptional customer service and professionalism.
- Proficient negotiating claim settlements with claimants or their representatives in an effort to resolve claims expeditiously.
- Communicated regularly with internal departments such as underwriting and loss control in order to identify potential areas of risk exposure.
- Demonstrated strong organizational and time management skills while managing multiple projects.
- Mitigated risks and increased profitability with well-developed strategies for reducing future claims and costs resulting in 60% reduction in overpayment of claims.
- Reviewed new files to determine current status of injury claim and to develop plan of action.
- Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
- Interviewed policyholders, witnesses and third parties to gather information and details regarding injury event.
- Prepared and presented complex cases to management, in-house legal team and Claims Committee.
Medical Claims Examiner
GEICO, Government Employees Insurance
Tucson, AZ
10.2019 - 10.2022
- Reviewed and processed medical claims for accuracy and completeness according to established guidelines.
- Verified insurance coverage and eligibility of patients for services rendered.
- Assessed coding accuracy, using ICD-10 codes, CPT codes, HCPCS codes, and modifiers.
- Determined the appropriate payment amount based on contractual agreements with providers.
- Interacted with providers regarding claim status or other related issues as required.
- Monitored accounts receivable aging reports to ensure timely payments from payers.
- Performed audits of submitted claims to validate accuracy of payment calculations.
- Provided training and guidance to new staff members on procedures related to claim processing.
- Ensured HIPAA compliance by maintaining strict confidentiality of patient information.
- Developed strategies for reducing denials due to incorrect coding or lack of supporting documentation.
- Stayed current on HIPAA regulations, benefits claims processing, medical terminology and other procedures.
- Reviewed claims for accuracy before submitting for billing.
- Accurately processed 100-200 medical claims every shift.
- Inputted data into the system, maintaining accuracy of provider coding information and reported services.
- Documented file notes clearly and concisely in ATLAS.
- Delivered exceptional customer service to clients by communicating information and actively listening to concerns.
- Reduced loss ratios through fair and prompt processing of claims.
- Reviewed police reports, medical treatment records, medical bills and physical property damage to determine extent of liability.
- Researched and resolved complex medical claims issues to support timely processing.
Claims Examiner
GEICO, Government Employees Insurance
09.2013 - 10.2019
- Reviewed claims to ensure accuracy, resulting in multiple claim reductions.
- Gathered information from various third parties to determine claim acceptability.
- Completed required investigations on referred files within established timeframes.
- Used multiple systems to program, set up functions and enter data for claims.
- Reviewed police reports, medical treatment records, and physical property damage to determine extent of liability.
- Determined liability outlined in coverage and assessed documentation such from police and healthcare providers to understand damages incurred.
- Examined photographs and statements.
- Reviewed questionable claims by conducting agent and claimant interviews to correct omissions and errors.
- Analyzed information gathered by investigation and reported findings and recommendations.
Education
Human Resources - Human Resources Management
Community College of The Air Force
Montgomery, AL06-2013
Hazelwood East High School
St Louis, MO05-2007
Skills
- Claims Investigation
- Database Management
- Medical Coding
- Claims Investigations
- Damage Assessment
- Quality Control
- Stress Management Techniques
- Medical Terminology Proficiency
- Claims Processing
- Property Claims
- Policy Investigations
- Innovation and Creativity
- Policy Interpretation
- Claims File Management Processes
- Coverage Assessments
- Highly Motivated
- Proficient in Microsoft Word/Outlook/Excel
- Sales Background
Accomplishments
- Obtained highest tier Gold Chairman's Club in 2020 with 1028 excellent customer surveys and top 20 rating and in 2018 Bronze Chairman's club with 888 excellent customer surveys.
- Hand selected to implement new Atlas cloud online mangement system resulting in 70% reduction in customer call backs and reduced workload
- Hand selected by Director to handle medical/RV Specialty claims in 2019 resulting in 35% reduction in overall workload and claims loss.
- Prior Airforce
Timeline
Senior Bodily Injury Adjuster
GEICO, Government Employees Insurance
10.2022 - 11.2023
Medical Claims Examiner
GEICO, Government Employees Insurance
10.2019 - 10.2022
Claims Examiner
GEICO, Government Employees Insurance
09.2013 - 10.2019
Human Resources - Human Resources Management
Community College of The Air Force
Hazelwood East High School
References
References available upon request.
References
References available upon request.
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