Tasanka Campbell
West Palm Beach,FL
Summary
Resourceful Licensed Claims Adjuster with a knack for productivity and efficiently completing tasks. Specialize in claim investigation, damage assessment, and negotiation, ensuring thorough and fair resolutions. Excel in communication, problem-solving, and organizational skills, contributing to streamlined claims processing and customer satisfaction.
Overview
9
9
years of professional experience
Work History
Billing Specialist
Access Medical Labs
Jupiter, Florida
06.2024 - Current
- Reviewed medical records to ensure accuracy of billing information and patient data.
- Prepared itemized statements, bills, or invoices and recorded amounts due for items purchased or services rendered.
- Calculated billing charges, prepared and submitted claims to insurance companies.
- Verified insurance coverage and identified third-party payers for billing purposes.
- Monitored accounts receivable activity to ensure timely payment of invoices.
- Resolved discrepancies between customers' remittances and invoices received.
- Answered customer inquiries regarding billings, payments, account status.
- Investigated incorrect billings and processed refunds as necessary.
- Reconciled daily cash receipts with total deposits on bank statement.
- Processed credit card transactions through Point-of-Sale terminals or online systems.
- Worked closely with patients to discuss payment arrangements when needed.
- Performed data entry into accounting software programs such as QuickBooks.
- Provided support to other departments within the organization as needed.
Customer Service Representative
Shoreline Insurance Agency
Palm Beach Gardens, FL
09.2023 - 05.2024
- Policy Processing: Efficiently process insurance policies, including new applications, endorsements, renewals, cancellations, and other policy-related transactions
- Review all documentation on for completeness and accuracy and ensure compliance with company policies and regulatory requirements
- Data Entry and Documentation: Accurately enter and update policy information into the company's database or insurance management system
- Maintain organized and up-to-date records of all insurance-related documents and transactions
- Customer Support: Assist clients and policyholders with inquiries regarding their insurance policies, coverage options, premium payments, and claims processes
- Provide exceptional customer service and resolve issues promptly and professionally
- Claims Processing Support: Collaborate with the claims department by verifying policy details, coverage eligibility, and other pertinent information to facilitate efficient claims processing
- Policy Review and Analysis: Conduct policy reviews to ensure that policyholders have adequate coverage based on their specific needs and that they are aware of any policy changes or updates
- Regulatory Compliance: Stay updated on industry regulations and compliance requirements to ensure that all insurance processing activities adhere to legal standards and best practices
- Collaboration: Work closely with underwriters, agents, and other team members to facilitate smooth policy processing and resolve any discrepancies or issues that may arise
- Quality Control: Conduct periodic audits of processed policies to ensure accuracy and compliance with company guidelines and industry standards
- Reporting: Generate reports related to policy processing metrics, claim activities, and any other relevant data to assist in decision-making and improve operational efficiency
Property Claims Adjuster
Progressive Insurance
West Palm Beach, Florida
10.2022 - 09.2023
- Determines insurance coverage by interviewing, telephoning, or corresponding with insureds and other parties
- Examines and appropriately interprets insureds' policies, forms in force, and other records
- Approves and adjusts estimates of damage and loss amounts
- Determines extent of company's liability by interviewing, telephoning, or corresponding with insureds and witnesses
- Uses varying methods of investigation, including taking recorded statements, consulting with police, inspecting property damage, and reviewing documents
- Identifies and communicates potential underwriting concerns
- Estimates cost of repair, replacement, or compensation
- Sets appropriate case reserves; revises case reserves in assigned files to cover probable costs
- Submits assignments to vendors
- Manages diaries and tasks in the Claims System
- Prepares report of findings and negotiates settlement
- Prepares settlement letters, denial letters, Reservation of Rights, and other letters as needed
- Writes clear and concise diary notes, uses the Special Handling area, sets field assignments, sets and saves contacts, and makes payments
- Recognizes the need for Special Investigation Unit involvement and identifies files for potential subrogation
- Effectively manages pending files in accordance with Claims Best Practices
- Appropriately applies knowledge of multiple state statutes, including the insurance code of ethics, rules, regulations and guidelines
- Effectively handles difficult calls from customers, vendors, and others
Claims Generalist
Progressive Insurance
West Palm Beach, FL
09.2016 - 10.2022
- Diminished Value Department
- Member of a specialized group handling diminished value claims for leasing & rental companies
- Triage new claims for diminished value that’s received via diary system on claims software
- Upload demand from outlook to the claim and add claim # to tracking system using Microsoft excel spreadsheet
- Confirm coverage and liability are in order on every claim
- Add and complete diminished value review template, claims are reviewed in the order they are received, unless otherwise noted ie Time limit demand
- Use claims software ie ADD, ISO, Auto Check to run reports
- Negotiate and settle diminished value claims within remaining policy limits if diminished value is present
- Create and obtain executed property damage releases and issue Draft payments for settlements
- Document and send request for appropriate denial letter if diminished value is not owed
- Manage Microsoft outlook personal and specialized group email
Financial Counselor
Palm Beach Gardens Medical Center
Palm Beach Gardens, FL
10.2015 - 09.2016
- Insurance Verification-Admitting Dept
- Perform insurance verifications on all scheduled and non-scheduled radiologic exams, cardiopulmonary surgeries, outpatient procedures and patients admitted for observation
- Obtain authorizations from ordering physicians and insurance companies
- Calculate all patient financial responsibilities including copays, deductible payments, and self-pay accounts
- Work with Hospital Business office to discuss financial goals for the department
- Make hospital rounds to collect outstanding balances and update inventory tracker of all patients admitted with payments due
Education
Medical Assistant Program -
Med Vance Institute
Palm Springs, FL10.2006
Skills
- Claims Adjuster All lines620 License W419532
- Automobile & Property claims specialist
- Policy investigations
- Critical thinking
- Active listening
- Coverage assessments
- Claims file documentation
- Evidence & damage assessment reviews
- Attention to detail
- Claims investigations & settlement negotiations
References
References Available Upon Request
Timeline
Billing Specialist
Access Medical Labs
06.2024 - Current
Customer Service Representative
Shoreline Insurance Agency
09.2023 - 05.2024
Property Claims Adjuster
Progressive Insurance
10.2022 - 09.2023
Claims Generalist
Progressive Insurance
09.2016 - 10.2022
Financial Counselor
Palm Beach Gardens Medical Center
10.2015 - 09.2016
Medical Assistant Program -
Med Vance Institute