Sharon Marshall
Insurance
Myrtle Beach,South Carolina
Summary
Resourceful Sr Claims Analyst professional promoting years of expertise assessing coverage and overseeing claims review. Leverages well-developed communication skills to deliver information to policyholders and litigation management. Exceptional knowledge of latent injury claims.
Overview
20
20
years of professional experience
Work History
SR CLAIMS ANALYST
Travelers Insurance
12.1988 - 05.2020
- Legal Bill Review / Financial Requests
- Ensure sufficient estimates are available and/ or maintained
- Utilize appropriate resources to search for policies including databases and document management department sources
- Gather information from additional sources, as required(claims, websites, producers, etc)
- Complete policies by identifying and adding missing endorsements
- Input and summarize data on spreadsheets or other reports, analyzing data, and making observations based on research and analysis, Policy understanding
- Determine coverage
- Sets and adjusts reserves
- Claim evaluation
- Negotiates settlements
- Authorizes and pay claims
- Asbestosis, chemicals, lead and mold knowledge
- Working skills and knowledge of abuse of Boy Scouts and the Catholic priests of children
- Excellent Attorney relationships
- Coding using ICD9 and ICD10 for diseases obtained through exposure to chemicals and also child abuse
- Medicare evaluation and review and coding Determinations
- Liability Molestation
- Toxic tort Claims
- Active Listening
- Dispute Tracking
- Sexual Molestation Determinations
- Settlement
- Worker's Comp policy review and completion experience
- Excellent people and communication skills and problem solving skills
- Access
- Excel
- Word
- Negotiated settlement agreements to resolve disputes
CLIENT SERVICES SUPERVISOR
Blue Cross And Blue Shield
06.1980 - 12.1988
- Blue Cross of MD, Client Services and Medical Claims Service
- Make claims decisions on routine and complex medical procedures and claims
- Assist customer with appeals and any issues regarding medical procedures or claims concerns
- Member of Claims Committee with Medical Director
- Taught Medical coding inpatient and outpatient using ICD9 coding
- Medical Terminology to new employees for BC
- Sales of our products and Marketing our products to employers and giving a presentation to their
Education
Diploma - Business
Patapsco Center for the Arts
Skills
- Interpersonal and Written Communication
- Investigative Research
- Claims History Analysis
- Diagnostic Codes
- Claims Investigations
- Insurance Claims
- Attorney billing/payments
- Asbestos Claims
- Workers Compensation & Latent Injury Claims
- Conflict Resolution
- Negotiation and Mediation Skills Management
- Settlement Documents
- Coverage Determination
- Reserve Management
Timeline
SR CLAIMS ANALYST
Travelers Insurance
12.1988 - 05.2020
CLIENT SERVICES SUPERVISOR
Blue Cross And Blue Shield
06.1980 - 12.1988
Diploma - Business
Patapsco Center for the Arts
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