Theresa Audain
Orlando
Summary
Customer-centric Financial and Claims Expert with over 10 years of experience in insurance and patient financial services
Overview
8
8
years of professional experience
1
1
Certification
Work History
Claims Adjuster
Liberty Mutual
02.2025 - Current
- Managed over 40 claims, ensuring thorough investigation and evaluation of automobile and casualty coverage.
- Investigated claims by analyzing statements, photos, estimates, and policy details to determine liability.
- Coordinated with Underwriting and Risk Management to ensure compliance with company standards.
- Negotiated settlements within authority limits to minimize costs while resolving claims efficiently.
- Conducted recorded interviews with claimants, insureds, and witnesses for accurate information gathering.
- Reviewed auto policy provisions to assess coverage for insured losses and evaluated subrogation opportunities.
- Communicated policy decisions and outcomes professionally to maintain customer satisfaction throughout claims process.
- Utilized claims systems to document actions accurately while managing high-volume caseload under strict deadlines.
CCO
Allstate Insurance Co
ORLANDO
05.2024 - 02.2025
- Resolved complex issues through collaboration with departments, ensuring customer needs were met.
- Achieved performance targets for accuracy and quality while maintaining detailed documentation of claims.
- Delivered knowledgeable and friendly service, promoting high customer satisfaction levels.
- Addressed customer inquiries, providing accurate information about products and services.
- Handled customer complaints efficiently, ensuring timely resolutions and enhanced service experience.
Claim Representative
The Hartford
07.2021 - 05.2024
- Processed auto and property claims, guiding customers through coverage verification and claim establishment.
- Maintained regulatory compliance with HIPAA and state claims procedures while ensuring empathetic service delivery.
- Collaborated with cross-functional teams to facilitate policyholder communication and claim resolution.
- Participated in catastrophe claim initiatives to assist policyholders during high-volume loss events.
- Delivered superior service through accurate documentation, proactive communication, and customer follow-up.
Auto Claim Representative
Travelers Insurance
10.2018 - 07.2021
- Processed new auto and property claims, providing detailed coverage explanations and next-step guidance.
- Efficiently gathered required documentation and established losses using the Claim Handling Platform.
- Ensured customer satisfaction by communicating with empathy and professionalism throughout claim resolution.
- Assisted catastrophe teams during surge events to maintain timely response and service quality.
Patient Registrar
AdventHealth
10.2017 - 10.2018
- Assisted patients in understanding hospital financial policies; verified insurance eligibility and coordinated benefits for care.
- Guided uninsured/underinsured patients through payment options and hospital financial assistance programs; set payment arrangements as needed.
- Ensured patient accounts were assigned to correct payor plans; verified pre-certifications and authorizations to prevent denials.
- Collaborated with case management, physician offices, and financial teams to resolve billing discrepancies and support accurate account reconciliation.
- Maintained HIPAA compliance and documented all patient and insurance interactions thoroughly to support audits.
Education
Associate of Arts - Psychology
Seminole State College of Florida
Sanford, FL08-2023
Skills
- Claims handling and evaluation
- Coverage assessment and compliance
- Estimate review and processing
- Customer advocacy and retention
- Negotiation and settlement support
- Vendor coordination and repair network
- Documentation and regulatory interpretation
- Conflict resolution and empathy
- Time management and multitasking
- Financial assistance program support
- Medicaid program familiarity
- Payment arrangements and follow-up
- Account reconciliation support
Certification
6-20 Adjuster License
Timeline
Claims Adjuster
Liberty Mutual
02.2025 - Current
CCO
Allstate Insurance Co
05.2024 - 02.2025
Claim Representative
The Hartford
07.2021 - 05.2024
Auto Claim Representative
Travelers Insurance
10.2018 - 07.2021
Patient Registrar
AdventHealth
10.2017 - 10.2018
Associate of Arts - Psychology
Seminole State College of Florida