TAALIA Whitehead
Oak Park,IL
Summary
Licensed Senior Claims Adjuster focused timely and accurate settling of complex claims. Comprehensive knowledge of claims adjustments with special knowledge of mass tort and medical malpractice claims. Expertise in managing a large caseload and negotiation of high-level settlements with attorneys, third party liability adjustors, and health plan participates. Strong and extensive knowledge of healthcare, personal injury, and contract law with emphasis on applications to ERISA, Medicare and Medicaid. Looking to leverage my 16 years experience, expertise, and skills to embark on a new phase of my professional career.
Overview
16
16
years of professional experience
1
1
Certification
Work History
Senior Bodily Injury Adjuster
Allstate Insurance Companies
Northbrook, IL
12.2021 - Current
- Review, evaluated and adjusted claims to promote fair and prompt settlement.
- Negotiate and settled claims according to information presented through reports, research and data verification.
- Identify and obtained evidence to ascertain claim value.
- Gather information from various third parties to determine claim acceptability.
- Conduct witness interviews to assist claim information gathering process.
- Investigate potentially fraudulent claims with focus on thoroughness, quality and cost control.
- Draft statement of loss to summarize damages, payments and underlying policy coverage.
- Decrease loss ratios through fair and timely claim processing.
- Interview claimants, medical specialists and employers to determine pertinent claim information.
- Explained premiums owed to policyholders, agents and underwriters.
Subrogation Consultant
GLG
New York, NY
12.2021 - Current
- Assisted in developing and implementing different workflows and communication processes.
- Provided consultation and training support to clients regarding Subrogation.
- Collaborated with stakeholders to contribute recommendations and deliver client objectives.
- Applied techniques to analyze requirements, system capabilities and workflows.
- Identified areas for improvement, narrowing focus for decision-makers in making necessary changes.
- Created plans to propose solutions to problems related to efficiency, costs or profits.
- Analyzed key performance indicators to identify effective strategies.
Senior Recovery/Subrogation Analyst
Conduent
Rosemont, IL
10.2010 - 12.2021
- Developed and maintains two-way dialogue through strong written and verbal communication with attorneys, claims adjusters and patients, resulting in consistently exceeding the department goal by 54%
- Negotiate high-dollar and high-profile liens recovering over $49 million in healthcare over payments and ranked among the top 3
- With credibility and confidence, communicate extensive knowledge of case law to maximize recover, with extensive knowledge of state federal Medicare and Medicaid law
- Settled complex Mass Tort and Medical Malpractice liens
- Gathered and documented evidence to support court proceedings
- Prepared departmental documents for attorney approval
- Effectiveness in this area aids in accurate and speedy recovery
- Verified liability extent with reviews of police reports, medical treatment histories and other records
- Attention to these details allows the opportunity to handle a case load of 1300 files with 99% accuracy
- Trained internal staff members on administrative processes, work instructions and procedures to facilitate consistent and seamless company operations
Recovery/Subrogation Analyst
Rosemont, IL
09.2007 - 10.2010
- Recovered funds from bodily injury, uninsured, underinsured, premises, commercial, medical payments and personal injury protection policies
- Understood, interpreted, and analyzed different types of employee benefit plans (medical, dental, short and long-term disability, life and AD&D plans), as well as understand and evaluate ERISA compliance
- Handled a case load of 1800 files with 99% accuracy
- Ranked among the top ten.
Legal Assistance - Assistant Secretary
Students, Northern Illinois University
DeKalb, IL
01.2007 - 08.2007
- Publicized and promoted the services of Students' Legal Assistance
- Scheduled office appointments greeted students and maintained a lawyer activities database
- Drafted legal documents.
Education
Bachelor of Arts - Political Science, English
Northern Illinois University
01.2007
Skills
- Analyst
- Mass tort and Medical Malpractice
- Auto Bodily Injury
- Knowledgeable of Health Plan and Automobile Policy Language
- Insurance company knowledgeable
- Verbal communication
- Written communication
- Claims Evaluation
- Liability Determination
- Settlement Negotiations
- Knowledgeable of Medical Terminology and CPT Code
Certification
- Non Residential Insurance License - All Lines- Florida Department of Financial Services issued 02/11/2022
- Management Accelerator, McKinsey & Company- 2022
Affiliations
- Secretary AAWN, Allstate (2022-Present)
- Volunteer, Chicago Cares (2009-Present)
- Present, Sigma Gamma Rho Sorority Inc., Zeta Nu Chapter (2006-2007)
Timeline
Senior Bodily Injury Adjuster
Allstate Insurance Companies
12.2021 - Current
Subrogation Consultant
GLG
12.2021 - Current
Senior Recovery/Subrogation Analyst
Conduent
10.2010 - 12.2021
Recovery/Subrogation Analyst
09.2007 - 10.2010
Legal Assistance - Assistant Secretary
Students, Northern Illinois University
01.2007 - 08.2007
Bachelor of Arts - Political Science, English
Northern Illinois University
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