Robynne Robinson
Mexia,TX
Summary
Excellent communicator and dependable team player with strong understanding of insurance industry. Adept at building relationships with clients, brokers and other stakeholders while delivering outstanding service. Highly organized and detail-oriented with strong ability to identify potential risks and develop solutions.
Overview
7
7
years of professional experience
Work History
Insurance Specialist (Claims Adjuster)
The BestIRS Claims (Remote)
2021.04 - 2024.02
- Performed contract administration or oversight for coverage benefits or related programs;
- Reviewed and analyzed evidence submitted to ensure the policy was in force. Recommended approval or rejection of applicants with supporting documentation.
- Monitored the contracts, policies, and maintained the contract files for assigned benefits carriers.
- Worked with carriers to assist them in providing reports and documentation related to their performance in providing services and benefits for the insured. Assisted in resolving and documenting actions to address any and all negative findings.
- Consulted with other staff offices within the agency to obtain advice on various technical and insurance related questions.
- Participated in meetings to assess the carrier's contractual compliance with and full understanding of, contractual requirements and to preclude unauthorized changes or alterations in contract provisions.
- Reviewed all documentation, correspondence, and reports submitted by the carrier(s) to ensure that actions taken, services and products provided, and processes/procedures followed are in compliance.
- Enhanced customer satisfaction by addressing insurance-related inquiries and resolving issues promptly.
- Processed eligibility and benefits verification and authorization requests.
- Followed up on denials, late payments, extensions and other special circumstances.
- Tracked pending authorizations to resolve discrepancies and avoid revenue loss.
- Maintained a high level of industry expertise through continuous professional development courses and certifications in the field of insurance specialty.
Insurance Specialist (Claims Adjuster)
Barrett Claims Management (Remote)
2020.08 - 2021.04
- Enhanced customer satisfaction by addressing insurance-related inquiries and resolving issues promptly.
- Processed eligibility and benefits verification and authorization requests.
- Followed up on denials, late payments, extensions and other special circumstances.
- Maintained high standards of customer service by building relationships with clients.
- Reduced claims processing time by effectively collaborating with adjusters, claimants, and internal departments.
- Maintained a high level of industry expertise through continuous professional development courses and certifications in the field of insurance specialty.
- Researched and resolved routine and complex issues.
- Ensured regulatory compliance through diligent monitoring of company practices and adherence to guidelines.
- Contributed to team performance by sharing industry knowledge and assisting colleagues in complex cases.
- Trained new hires on company policies and procedures, ensuring a seamless transition into the Insurance Specialist role.
Insurance Specialist (Claims Adjuster)
Griston Claims
2018.10 - 2019.07
- Performed contract administration or oversight for coverage benefits or related programs;
- Read over insurance policies to ascertain levels of coverage and determine whether claims would receive approvals or denials.
- Analyzed information gathered by investigation and reported findings and recommendations.
- Investigated and assessed damage to property and reviewed property damage estimates.
- Determined liability outlined in coverage and assessed documentation such from police and healthcare providers to understand damages incurred.
- Researched claims and incident information to deliver solutions and resolve problems.
- Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
- Collaborated with legal teams to defend against fraudulent claims, saving company resources and maintaining its reputation.
- Mitigated risks and increased profitability with well-developed strategies for reducing future claims and costs.
- Developed strong relationships with repair vendors, ensuring quality service and fair pricing for clients in need of repairs after an incident.
Insurance Specialist (Claims Adjuster)
Wardlaw Claims Service
2016.10 - 2018.09
- Experience with coordination of benefits.
- Developing and implementing health insurance, insurance, or similar benefits requirements
- Performed contract administration or oversight for insurance benefits or related programs;
- Applied broad knowledge of insurance regulations, policies, and procedures in the administration of health benefits programs;
- Streamlined policy management by regularly updating client information and tracking policy changes.
- Communicated effectively with members of operations, finance, and clinical departments.
- Maintained a high level of industry expertise through continuous professional development courses and certifications in the field of insurance specialty.
- Reduced claims processing time by effectively collaborating with adjusters, claimants, and internal departments.
- Followed up on denials, late payments, extensions and other special circumstances.
Education
Associate of Science - Criminal Justice
Community College of The Air Force
Montgomery, ALNo Degree - Real Estate
McLennan Community College
Waco, TXNo Degree - Insurance
Department of Insurance
Austin, TXSkills
- Attention to Detail
- Contracting/Procurement
- Decision Making
- Adaptable/Flexible
- Knowledge of Insurance regulations, policies, and procedures
- Interpersonal Skills
- Knowledge of insurance industry
- Oral Communication
- Reading Comprehension
- Reasoning
- Self-Management
- Teamwork
- Writing skills
- Documentation skills
- Policy analysis
- Reporting skills
- Claims Management
- Customer Service
- Policy Knowledge
- Client Relations
Additional Information
Address:
1032 E Evelyn Street
Mexia, TX 76667
Pay Plan: Ranged (Contractor) work on average $35-$41 per hour working six days a week.
Hours worked per week: On average 60 hours per week
Timeline
Insurance Specialist (Claims Adjuster)
The BestIRS Claims (Remote)
2021.04 - 2024.02
Insurance Specialist (Claims Adjuster)
Barrett Claims Management (Remote)
2020.08 - 2021.04
Insurance Specialist (Claims Adjuster)
Griston Claims
2018.10 - 2019.07
Insurance Specialist (Claims Adjuster)
Wardlaw Claims Service
2016.10 - 2018.09
Associate of Science - Criminal Justice
Community College of The Air Force
No Degree - Real Estate
McLennan Community College
No Degree - Insurance
Department of Insurance
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