Timothy Darsey
Kathleen,GA
Summary
Talented Special Investigations Unit Intake Specialist offering 22 years of experience in the insurance industry. I have held a number of different jobs in the insurance industry, mainly focused on claims. From this experience I have curated a number of skills making me a well rounded candidate. From the 22 year tenure with my current employer, it is evident that I am a dedicated and dependable employee with a willingness to take on added responsibilities to meet team goals and the ability to handle multiple projects simultaneously with a high degree of accuracy.
Overview
21
21
years of professional experience
1
1
Certification
Work History
Special Investigations Unit Intake Analyst
GEICO
Macon, GA
02.2019 - Current
- Timely review and analysis of manually submitted and AI generated referrals by conducting database research and review of the family auto insurance policies to determine whether additional investigation is warranted. The comprehensive review of individuals, policies, claims history is an attempt to examine frequencies of claims, losses that occurred in close proximity to recent endorsements, explore the possibility of individuals involved in larger rings, staged accidents or generally suspicious activity.
- Effective distribution of workload and meeting deadlines consistently in order to ensure all field and desk investigators recieve sufficient assignments.
- Data mining by searching and reviewing multiple excel spreadsheets to identify potential fraud.
- Assisted in training new team members on intake procedures, contributing to their rapid integration into the team.
- Maintained strict confidentiality of sensitive client information, adhering to company policies and relevant regulations.
- Continuously updated job knowledge through ongoing professional development opportunities, staying current with industry best practices.
- Contributed to a positive work environment by fostering collaboration and open communication among team members.
Continuing Unit Litigation Claims Examiner
GEICO
Macon, GA
04.2013 - 02.2019
- Conducted liability and coverage investigations on motor vehicle losses involving serious injuries lawsuits and deaths.
- Familiarize myself with legal terminology and common Motions filed in cases in litigation.
- Handled sensitive information with discretion, ensuring confidentiality of personal and financial details for claimants throughout the claims examination process.
- Utilized analytical skills to evaluate medical bills for accuracy and appropriateness of charges before approving payments and setting adequate reserves as part of the claims process.
- Participated in cross-functional team meetings to address organizational challenges related to claims management and develop solutions collaboratively.
- Reduced claim processing time by implementing efficient workflow strategies and prioritizing tasks effectively.
- Enhanced customer satisfaction by promptly addressing inquiries and providing accurate information on claim status.
- Maintained detailed records of all claims activities, ensuring compliance with regulatory requirements and company policies.
- Interpreted policy provisions, endorsements, and exclusions to accurately determine coverage for claims.
- Finalized bodily injury files for insurance claim payment release. This included both commercial liability and personal auto liability policies.
- Provided exceptional customer service by empathetically addressing claimants'' concerns and effectively explaining the claims process to them.
- Maintained current knowledge of industry developments, regulations, and best practices through continuous professional development activities and continuing education to maintain my resident Georgia adjusters license, which I still currently have maintained.
- Investigated and processed non litigated and litigated insurance claims for policyholders.
- Mitigated fraud risks by identifying suspicious patterns in claims data and escalating concerns to appropriate teams for further investigation.
- Examined photographs and statements.
- Achieved streamlined communication between departments by collaborating closely with underwriters, management, regional liability administrators and claims home office legal throughout the claims handling process.
- Negotiated settlements with both unrepresented third party claimants, and claimants' attorneys when needed, achieving favorable outcomes for both parties while minimizing costs.
- Conducted thorough investigations of complex claims, gathering relevant documentation and interviewing witnesses when necessary.
- Consulted police and hospital records when needed.
- Identified opportunities for subrogation recovery through careful analysis of third-party liability cases, facilitating successful recoveries from at-fault parties or their insurers.
- Handled complaints and grievances using negotiating and problem-solving skills.
- Managed caseloads effectively while maintaining high-quality work standards and meeting strict deadlines consistently.
- Collaborated with insurance adjusters to expedite claim settlements, ensuring fair resolutions for all parties involved.
- Worked with private investigators and attorneys on preparation of evidence, witness statements, and other documentation in preparation for trial.
- Investigated properties to determine extent of damage and estimate repair costs.
- Read over insurance policies to ascertain levels of coverage and determine whether claims would receive approvals or denials.
- Explore any and all available addional lines of coverage which may supplement available coverage.
- Examined claims forms and other records to determine insurance coverage.
- Directed claims negotiations within allowable limit of $25k and supported successful litigations for advanced issues. Any amounts exceeding this had to be discussed and approved with supervisors, managers, regional claims administrators or claims home office legal dependent on the specific claim value. This developed the skill of being able to remember nuances related to specific claims and being able to recite them when seeking authority.
- Identified insurance coverage limitations with thorough examinations of claims documentation and related records detailing specific exclusions.
- Reviewed police reports, medical treatment records, and physical property damage to determine extent of liability.
- Delivered exceptional customer service to policyholders by communicating important information and patiently listening to issues.
- Maintained contact with claimants and attorneys to determine treatment status.
- Dive into subjects of litigation to determine how their character and history play into how a jury would perceive them, and decide claims handling based on the likely verdict.
- Attend settlement conferences in Indiana and Kentucky.
- Handled and responded to subpoenas.
TA2 Soft Tissue Injury Claims Adjuster
GEICO
Macon, GA
12.2011 - 04.2013
- This was my introduction to handling bodily injury claims. The injuries resulting were soft tissue in nature.
- The repetitive examination of medical records caused irregular treatment plans and injuries to stand out.
- Maintained strong relationships with policyholders, colleagues and claims management by consistently demonstrating professionalism, empathy, and effective communication skills.
- Ensured compliance with state regulations and company policies through diligent review of all claim-related materials.
- Assisted clients in understanding their insurance coverage by explaining complex terms and conditions clearly and concisely.
- Improved claim processing efficiency by conducting thorough investigations and promptly addressing discrepancies.
- Investigated and assessed damage to property and reviewed property damage estimates.
- Reviewed police reports, medical treatment records, and physical property damage to determine extent of liability.
- Examined claims forms and other records to determine insurance coverage.
- Leveraged strong negotiation skills to resolve claim disputes, resulting in favorable settlements for both the company and policyholders.
- Enhanced client satisfaction by providing timely updates and effectively resolving claim disputes.
- Conducted comprehensive interviews of witnesses and claimants to gather facts and information.
- Evaluated insurance policies and analyzed damages to determine coverage.
- Verified insurance claims and determined fair amount for settlement.
- Substantiated legitimate claims and denied unjustified claims.
TA1 Liability Claims Adjuster
GEICO
Macon, GA
09.2010 - 12.2011
- Investigated non-injury disputes regarding liability and simple coverage disputes.
- Maintained detailed records for each claim, ensuring accuracy and completeness for future reference and audit purposes.
- Established rapport with policyholders through clear communication, empathy, and professionalism during difficult circumstances.
- Became a member of the arbitration board resolving liability disputes amongst other insurance companies.
- Reduced claims processing time by implementing efficient workflow strategies and prioritizing tasks.
- Enhanced customer satisfaction by providing timely updates on claim status and addressing concerns promptly.
- Obtained my Georgia resident adjuster insurance license, which is still currently active.
- Investigated liability claims thoroughly, analyzing evidence and interviewing involved parties to determine fault accurately.
- Examined claims forms and other records to determine insurance coverage.
- Answered customer questions regarding deductibles.
- Prepared summaries of damage, payments, and policy coverage.
- Substantiated legitimate claims and denied unjustified claims.
Subrogation Specialist
GEICO
Macon, GA
06.2009 - 09.2010
- Pursued individuals or adverse carriers to recover funds paid under the policy when someone else was legally liable.
- Filed and answered arbitrations when parties could not agree on liability or damages resulting from a claim.
- Utilized analytics tools to evaluate claim data patterns for better identification of potential subrogation targets.
- Collaborated with legal teams to prepare cases for litigation, ensuring comprehensive documentation and well-organized files.
- Reviewed policy documents to determine coverage applicability in various subrogation scenarios.
- Analyzed information gathered by investigation and reported findings and recommendations.
- Reviewed police reports, medical treatment records, and physical property damage to determine extent of liability.
Claims Service Representative
GEICO
Macon, GA
03.2008 - 07.2009
- Took initial loss reports, creating a record with the company of the loss.
- Enhanced customer satisfaction by efficiently processing and resolving claims in a timely manner.
- Provided exceptional customer service by addressing concerns, answering questions, and explaining complex policy information to clients.
- Actively contributed ideas during team meetings aimed at enhancing overall department efficiency and effectiveness.
- Demonstrated strong negotiation skills in settling disputes between insured parties and third-party claimants fairly while protecting company interests.
- Managed high-volume caseloads and prioritized tasks effectively to meet strict deadlines without compromising on quality or accuracy.
- Followed up with customers on unresolved issues.
- Interviewed policyholders to verify information and obtain additional details.
- Was rated on a metric related to selling the guaranteed repair facility (body shop).
- Generated, posted and attached information to claim files.
Accounts Receivable Help-Desk
GEICO
Macon, GA
08.2006 - 03.2008
- Analysis of the billing side of a policy to identify issues/discrepancies.
- Self-motivated, with a strong sense of personal responsibility.
- Worked effectively in fast-paced environments.
- Skilled at working independently and collaboratively in a team environment.
- Proven ability to learn quickly and adapt to new situations.
- Excellent communication skills, both verbal and written.
- Demonstrated respect, friendliness and willingness to help wherever needed.
- Paid attention to detail while completing assignments.
- Used critical thinking to break down problems, evaluate solutions and make decisions.
Electronic Banking Unit
GEICO
Macon, GA
02.2004 - 08.2006
- Helped customers prepare documents required to complete transactions and process requests.
- Assisted customers with banking needs and inquiries.
- Connected and disconnected automatic payments for payment of insurance premiums.
- Educated customers on online banking and mobile banking applications.
- Executed wire transfers, stop payments and account transfers.
- Wrote and distributed customer correspondence.
Glass Claims Representative
GEICO
Macon, GA
11.2002 - 02.2004
- Collaborated with repair shops for accurate estimates, ensuring cost-effective solutions for both the company and clients.
- Coordinated appointments between customers and repair facilities, streamlining the claims process for all parties involved.
- Enhanced customer satisfaction by efficiently processing glass claims and providing timely resolutions.
- Served as a liaison between insurers, adjusters, and auto glass technicians to expedite claim resolution.
- Identified fraudulent claims through careful analysis, protecting company resources from misuse.
- Conducted thorough investigations of each claim to determine liability and ensure accuracy in payouts.
- Reduced claim processing time by effectively managing a high volume of daily claims.
- Educated customers about preventive measures they can take against future glass damage incidents.
- Continuously updated personal knowledge of evolving industry standards and best practices, ensuring top-quality service for customers.
- Worked productively in fast-moving work environment to process large volumes of claims.
- Maintained accurate and up-to-date records of claim information for future reference.
Education
Associates - Business Management
Middle Georgia College
Cochran, GABusiness
Macon State College
Macon, GASkills
- Microsoft Office
- Customer Service
- Confidentiality handling
- Scheduling appointments
- Insurance Verification
- Appointment Scheduling
- Follow-up skills
- Inventory Management
- Multi-Line Phone Systems
- Effective communication skills
- Documentation and paperwork
- Schedule Management
- Eligibility Determination
- Payment Collection
- Telephone Etiquette
- Proficiency in claims applications
- Data Compilation
- Fraud investigation
- Conflict Resolution
- Litigation
- Commercial liability
- Claim Investigation
- Personal Injury Claims
Certification
GA Resident Adjusters Insurance License
Timeline
Special Investigations Unit Intake Analyst
GEICO
02.2019 - Current
Continuing Unit Litigation Claims Examiner
GEICO
04.2013 - 02.2019
TA2 Soft Tissue Injury Claims Adjuster
GEICO
12.2011 - 04.2013
TA1 Liability Claims Adjuster
GEICO
09.2010 - 12.2011
Subrogation Specialist
GEICO
06.2009 - 09.2010
Claims Service Representative
GEICO
03.2008 - 07.2009
Accounts Receivable Help-Desk
GEICO
08.2006 - 03.2008
Electronic Banking Unit
GEICO
02.2004 - 08.2006
Glass Claims Representative
GEICO
11.2002 - 02.2004
Associates - Business Management
Middle Georgia College
Business
Macon State College