Summary
Overview
Work History
Skills
Certification
Licenses
Timeline
Generic

TARYN CARTER

Summary

Skilled in investigating and analyzing liability concerning personal, casualty or property loss. Proven history of leveraging excellent negotiation skills to facilitate settlements. Negotiates peaceful resolutions of all claims with emphasis on fairness and thoroughness. Trustworthy and organized. Dependable candidate, successful at managing multiple priorities with a positive attitude. Intrigued by challenging tasks. Willingness to take on added responsibilities to meet team goals.

Overview

9
9
years of professional experience
1
1
Certification

Work History

RESIDENTIAL INDEPENDENT DESK ADJUSTER

ALACRITY SOLUTIONS
05.2023 - 09.2023
  • Investigate origin and cause of claims by contacting the appropriate parties.
  • Makes prompt contact with customers to set expectations, develop an action plan, and perform an initial exposure assessment.
  • Explains coverage to policyholders providing excellent customer service
  • Handle 1st party claims under multiple policy types and numerous endorsements.
  • Effectively managing work through task driven queues while multi-tasking in a fast-paced call center environment
  • Proactively provide all parties with claim process and status, including local agents.
  • Work with customers over the phone to provide excellent customer service and coordinate the inspection process as well as payments for losses.
  • Maintains electronic records that accurately and thoroughly document all file-handling activity.
  • Determines and negotiates settlement amounts for damages claimed within assigned authority limits.
  • Ensures regular and timely follow-up and brings claims to prompt and appropriate conclusions while keeping the customer informed throughout the life cycle of the claim process.

RESIDENTIAL INDEPENDENT DESK ADJUSTER

BRUSH COUNTRY CLAIMS
10.2022 - 04.2023
  • Answer inbound calls from customers regarding existing claims.
  • Complete coverage analysis including review of policy coverages and provisions.
  • Thoroughly document the claim file and complete all claim closures.
  • Maintain confidentiality of claim information.
  • Analyze and evaluate damages including reserves and property estimates.
  • Maintain continuous and professional communication with our clients to ensure their needs are being met.
  • Complete timely follow up with all parties.
  • Pay and process claims within designated authority level.
  • Evaluated claims and performed investigations to accurately assess damages and liabilities.

RESIDENTIAL INDEPENDENT DESK ADJUSTER

ALACRITY SOLUTIONS
06.2021 - 10.2022
  • Investigate origin and cause of claims by contacting the appropriate parties.
  • Makes prompt contact with customers to set expectations, develop an action plan, and perform an initial exposure assessment.
  • Explains coverage to policyholders providing excellent customer service
  • Handle 1st party claims under multiple policy types and numerous endorsements.
  • Effectively managing work through task driven queues while multi-tasking in a fast-paced call center environment
  • Proactively provide all parties with claim process and status, including local agents.
  • Work with customers over the phone to provide excellent customer service and coordinate the inspection process as well as payments for losses.
  • Maintains electronic records that accurately and thoroughly document all file-handling activity.
  • Determines and negotiates settlement amounts for damages claimed within assigned authority limits.
  • Ensures regular and timely follow-up and brings claims to prompt and appropriate conclusions while keeping the customer informed throughout the life cycle of the claim process.

PRODUCER SUPPORT

LUMERIS
10.2018 - 08.2021
  • Act as an internal liaison for internal agents and external producers.
  • Resolve all inquiries and concerns relative to enrollment, policy questions, and system issues.
  • Educate brokers and partners in plan policies, benefit interpretation, and use of online self-service tools.
  • Support the needs of each producer based on personal preference via email or phone.
  • Identify and research common trends interfering with each producer's connection.
  • Work directly with development team to assist in improving producer experience and access.
  • Communicate directly with commissions team ensuring proper payments disbursed.
  • Facilitate enrollment data intake from producers.
  • Provide guidance to assist producer in system navigation.
  • Create spreadsheets for all new producers to gain access to required systems.

REIMBURSEMENT REPRESENTATIVE

BJC HOME CARE SERVICES
02.2016 - 10.2018
  • Meet established benchmarks and expectations for collections and aged accounts receivable balances.
  • Check claims for appropriate codes and quantities to make certain all claims are clean on initial submission.
  • Identify and investigate trends in claims processing.
  • Collaborate directly with management and external departments for solutions to ensure claims are adjudicated accurately.
  • Follow-up on denials and research denial trends.
  • Provide feedback and suggestions to management, assist in implementation.
  • Prepare and submit appeals.
  • Pursue collection activities to obtain reimbursement from payers and/or patients.
  • Submit electronic claims daily through Clearinghouse for multiple government, managed care, and private pay payers.
  • Engage in project-related work on an as needed basis (e.g., coverage and coding research).
  • Resolve all patient correspondence.
  • Process credit card payments.
  • Process all adjustments within allowed limit.

PATIENT SERVICE COORDINATOR

DOHMEN LIFE SCIENCE SERVICES
06.2014 - 02.2016
  • Responsible for coordinating the Lifetime Care of the patient's continued therapy of more than 300 patients.
  • Provide a high level of support to patients, clients, and physicians.
  • Responsible for managing all aspects of the reimbursement case management process.
  • Create patient profile, complete benefit verification, obtain and maintain prior authorizations, and submit appeals.
  • Monitor patient cases with regular follow-ups to coordinate the delivery of the patient's medication monthly.
  • Complete billing for all payers.
  • A continuous guide for all involved with entire evolution of care for the Lifetime Therapy each patient requires.

Skills

  • 25 Years of excellent customer service
  • Claims Handling
  • Microsoft Office
  • Microsoft Excel
  • Virtual Claims Adjusting
  • Working Under Pressure
  • Xactimate

Certification

  • CA Fair Claims
  • State Farm Estimatics
  • State Farm Policy
  • State Farm Auto Certification


Licenses

  • Alabama
  • Arkansas
  • Florida
  • Idaho
  • Indiana
  • Kentucky
  • Louisiana
  • Michigan
  • Minnesota
  • Mississippi
  • Montana
  • New Mexico
  • Oklahoma
  • Oregon
  • Rhode Island
  • Texas All-Lines Adjuster License

Timeline

RESIDENTIAL INDEPENDENT DESK ADJUSTER

ALACRITY SOLUTIONS
05.2023 - 09.2023

RESIDENTIAL INDEPENDENT DESK ADJUSTER

BRUSH COUNTRY CLAIMS
10.2022 - 04.2023

RESIDENTIAL INDEPENDENT DESK ADJUSTER

ALACRITY SOLUTIONS
06.2021 - 10.2022

PRODUCER SUPPORT

LUMERIS
10.2018 - 08.2021

REIMBURSEMENT REPRESENTATIVE

BJC HOME CARE SERVICES
02.2016 - 10.2018

PATIENT SERVICE COORDINATOR

DOHMEN LIFE SCIENCE SERVICES
06.2014 - 02.2016

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TARYN CARTER