Tiffany Tinsley
Fairfield,OH
Summary
Results-driven Claims Resolution Specialist recognized for productivity and efficiency in task completion. Specialize in claim analysis, negotiation strategies, and regulatory compliance to navigate complex claims environments. Excel in problem-solving, communication, and decision-making, ensuring optimal outcomes in high-stakes situations. Bring focused approach to managing caseloads and achieving resolution goals.
Overview
23
23
years of professional experience
1
1
Certification
Work History
Senior Claims Resolution Specialist
LIBERTY MUTUAL INSURANCE COMPANY
Fairfield, Ohio
12.2010 - 10.2024
- Reviewed, evaluated and processed incoming claims to determine eligibility for coverage based on policy provisions.
- Analyzed claim documents, such as medical records, bills and invoices, to ensure accuracy of information.
Workers’ Compensation Claim Coordinator
CATHOLIC HEALTH INITIATIVES
Erlanger, Kentucky
09.2002 - 08.2009
- Managed and resolved workers’ compensation lost time and litigated claims
- This included building and maintaining working relationships with defense counsel, injured workers and their attorneys, internal Risk and Insurance staff and hospital management
Workers’ Compensation Claim Representative
CATHOLIC HEALTH INITIATIVES
Erlanger, Kentucky
08.2001 - 08.2002
- Managed and resolved workers’ compensation losses
- This included researching and determining policy coverage and state guidelines, investigation and evaluation of claims
Education
- AIC 33, AIC34
The Institutes
Fairfield, OhioFairfield Senior High School -
Fairfield Senior High School
Fairfield, OhioSkills
- Kentucky Insurance Arbitrator
- Policy Knowledge
- Claims Investigation
- Vendor Collaboration
- Adjustments processing
- Billing Procedures
- Documentation skills
- Policy coverage determinations
- Insurance terminology
- Customer Relations
- Medical Terminology
- Anatomy
- Windows
- Microsoft Office
- Excel
- PowerPoint
Certification
Adjuster licenses:
- California
- Connecticut
- Delaware
- Florida
- Georgia
- Kentucky
- Louisiana
- North Carolina
- New Hampshire
- New Mexico
- Oklahoma
- Rhode Island
- South Carolina
- Texas
- Vermont
- West Virginia
- Wyoming
References
Available upon request.
Timeline
Senior Claims Resolution Specialist
LIBERTY MUTUAL INSURANCE COMPANY
12.2010 - 10.2024
Workers’ Compensation Claim Coordinator
CATHOLIC HEALTH INITIATIVES
09.2002 - 08.2009
Workers’ Compensation Claim Representative
CATHOLIC HEALTH INITIATIVES
08.2001 - 08.2002
- AIC 33, AIC34
The Institutes
Fairfield Senior High School -
Fairfield Senior High School