Summer Morin
Tonawanda,NY
Summary
Highly-motivated employee with desire to take on new challenges. Strong worth ethic, adaptability and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills.
Overview
17
17
years of professional experience
Work History
Recovery Adjuster
Praxis Risk Management
01.2024 - Current
- Reviewed and evaluated subrogation claims to determine potential recovery opportunities.
- Negotiated settlements with responsible parties to maximize subrogation recoveries.
- Managed multiple tasks efficiently while adhering to strict deadlines.
- Adhered strictly to company policies regarding confidentiality and data security measures.
- Drafted correspondence related to claim investigations and settlements.
- Evaluated subrogation opportunities to identify recoverable funds.
Claims Specialist II
Utica National Insurance
04.2023 - Current
- Examined automobile policies with third-party liability, accident benefits and collision benefits.
- Assisted new policyholders with processing claims.
- Explain appropriate coverages to insureds
- Take insured and claimant statements
- Resolve liability
- Acknowledge coverage issues and verify appropriate coverages for each loss
- Work with internal and external auto damage adjusters to resolve property damage claims
- Assisted with filing appeals on denied claims with insurance companies.
- Maintained detailed records of all claim activities including notes about conversations with claimants or representatives.
- Provided customer service by responding promptly to inquiries from claimants regarding their benefits or coverage.
- Maintained knowledge of policies and procedures and insurance coverage benefit levels, eligibility systems and verification processes.
- Reviewed and analyzed insurance claims to determine validity, completeness, accuracy, and eligibility for payment.
- Communicated with other departments to establish action plans and manage open claims to closure.
- Investigated complex or high-value claims to identify discrepancies and fraud indicators.
- Researched medical records to evaluate claim validity and verify the existence of pre-existing conditions.
- Processed payments for valid claims according to established procedures.
- Facilitated communication between claimants, providers, attorneys, adjusters, employers, and other parties involved in a claim.
Senior Subrogation Litigation Adjuster
GEICO
10.2009 - 04.2023
- Reviewed evidence to verify liability
- Submitted underwriting and SIU referrals for questionable losses
- Examined claims forms and other records to determine insurance coverage
- Verified insurance claims and determined fair amount for settlement
- Evaluated insurance policies and analyzed damages to determine coverage
- Answered customer questions regarding deductibles
- Answered questions posed by insured and attorneys
- Negotiated settlement agreements to resolve disputes
- Submitted referrals to counsel if there was a statute of limitations approaching or dispute and the other party was not a member of arbitration forums
- Attend settlement conferences if needed
- Attended trials if needed
- Exceeded goals through effective task prioritization and great work ethic Learned new skills and applied to daily tasks to improve efficiency and Sensitivity: General/Internal productivity Resolved conflicts and negotiated mutually beneficial agreements between parties
- Examined reports, accounts, and evidence to determine integrity and accuracy of information
- Worked productively in fast-moving work environment to process large volumes of claims
- Followed up with customers on unresolved issues
- Interviewed policyholders and claimants to verify information and obtain additional details
- Set up inspections and issue payments for damages Review if there was subrogation potential
- Made follow up calls to adverse carriers and confirm if liability was pending and proceed with next steps to move claim towards closure.
- Investigated, analyzed and evaluated complex insurance claims to determine coverage and liability.
- Gathered evidence such as witness statements, medical records, police reports and accident reconstructions.
- Negotiated settlements with attorneys representing claimants in order to reach a fair resolution of the claim.
- Identified, investigated, and pursued subrogation recovery potentials for assigned claims.
- Developed strategies for recovering funds from third parties liable for the losses of the company's clients.
- Negotiated settlements with third party insurers and attorneys in order to maximize recoveries on behalf of the company's clients.
- Monitored legal proceedings involving assigned cases to ensure timely resolution of subrogation issues.
- Prepared detailed reports outlining claim information and settlement outcomes.
- Provided guidance and assistance to other members of the subrogation team as needed.
- Assisted in developing new methods to streamline processes related to subrogation activities.
- Coordinated with outside counsel regarding litigation matters as needed.
- Attended hearings and conferences related to assigned cases when necessary.
- Performed additional duties as requested by management.
- Received and posted payments to loan accounts.
Office Manager
Aspen Dental
07.2007 - 10.2009
- Maintained patient records, scheduled appointments, and handled billing inquiries.
- Ensured accurate data entry of patient information into the office management system.
- Managed all front desk operations, including phone calls and customer service inquiries.
- Provided guidance to staff on insurance coverage and payment options for patients.
- Developed procedures for tracking patient records and updating treatment plans as needed.
- Coordinated with dental providers regarding patient care and scheduling needs.
- Assisted in training new employees on office policies and procedures related to dental services.
- Collaborated with other healthcare professionals in order to provide quality care to patients.
- Advised administrative staff on proper filing techniques and methods for maintaining medical records.
- Resolved customer complaints in a timely manner by investigating issues thoroughly.
- Scheduled patient appointments and effectively handled cancellations and last-minute adjustments.
- Responded to patient queries and concerns to resolve issues in accordance with company policies and procedures, healthcare regulations and dental board standards.
- Managed operations for 10-person dental practice, facilitating excellent patient support services, direction and guidance.
- Coordinated execution and improvement of daily dental office practices.
- Implemented staff scheduling procedures to provide full coverage, supporting organizational needs.
Education
Paralegal Studies -
Erie Community College
Skills
- Settlement Negotiation
- Claims Evaluations
- Investigate Documentation
- Claims Procedures
- Customer Inquiries
- Accident Investigations
- Coverage Assessments
- Settlement Determinations
- Documentation Review
- Small Claims Payouts
- Client Interviews
- Insurance Claim Forms Review
- Customer Service
- Data Entry
- Patient Rapport
- Appointment Scheduling
- Attention to Detail
- Insurance Terminology
- Claims Processing
- Liability Management
- Coverage Determination
Timeline
Recovery Adjuster
Praxis Risk Management
01.2024 - Current
Claims Specialist II
Utica National Insurance
04.2023 - Current
Senior Subrogation Litigation Adjuster
GEICO
10.2009 - 04.2023
Office Manager
Aspen Dental
07.2007 - 10.2009
Paralegal Studies -
Erie Community College
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