Rylee Smith
Roseville,CA
Summary
Highly dedicated and passionate claims professional with a strong aptitude for prioritizing tasks and thriving in both independent and team-oriented environments. Known for being dependable and quick to grasp new concepts. I firmly believe in the power of effective communication and time management. I approach high-pressure situations with critical thinking and problem-solving abilities, ensuring successful outcomes. My unwavering commitment lies in providing customers with competent and empathetic service, striving to meet their needs with utmost care. As a highly responsible, self-directed, and motivated professional, I am driven to achieve excellence in all that I do.
Overview
7
7
years of professional experience
4
4
Certifications
Work History
Medical Only Adjuster
WCF Insurance
Roseville, California
08.2023 - Current
- Investigated claims to determine coverage and liability issues.
- Communicated with policyholders to gather necessary information effectively.
- Managed multiple claims simultaneously while maintaining attention to detail.
- Maintained detailed records of all claim activities in a timely manner.
- Evaluated subrogation opportunities to identify recoverable funds.
- Developed relationships with clients, underwriters, adjusters, brokers and other internal and external stakeholders.
- Demonstrated excellent communication skills when interacting with customers.
Claims Adjuster II
Intercare Holdings Insurance Services, Inc./
Rocklin, California
04.2022 - 08.2023
- Collaborated with legal teams to resolve complex claims issues effectively.
- Prepared detailed file reviews for clients.
- Provided valuable assistance to injured workers and employers promptly. Addressing inquiries and effectively resolving problems.
- Reviewed, evaluated and adjusted claims to promote fair and prompt settlement.
- Provided support in training new adjusters on company policies and procedures.
- Collaborated with Deputy CVity Attorneys for defense attorney tasks including DOR's, Petition to Dismiss, preparing cover letters for medical legal evaluations, Application, Settlement documents, and negotiating Applicant Attorneys.
Claims Adjuster
Intercare Holdings Insurance Services, Inc.
Rocklin, California
04.2019 - 08.2023
- Successfully handled Future Medical and Medical-only files for the San Jose Police Dept.
- Communicated with clients to gather necessary information for claim processing.
- Reviewed medical records and documentation to assess claim validity.
- Managed a high volume of claims while ensuring timely evaluations and decisions.
- Reviewed medical records, police reports and other documents related to claim investigations.
Education
Carrington College California-Citrus Heights
Citrus Heights, CA, United States01.2015
Skills
- Claims processing
- Customer service
- Effective communication
- Problem solving
- Team collaboration
- Conflict resolution
- Attention to detail
- Workflow management
- Verbal and written communication
- Empathy and patience
- Critical thinking
- Claims file documentation
- Tme management
Certification
WCCA 10 Foundation of CA Work Comp
Timeline
Medical Only Adjuster
WCF Insurance
08.2023 - Current
Claims Adjuster II
Intercare Holdings Insurance Services, Inc./
04.2022 - 08.2023
Claims Adjuster
Intercare Holdings Insurance Services, Inc.
04.2019 - 08.2023
Carrington College California-Citrus Heights