Tracey Bowery
Claims Administrator
Denton,TX
Summary
Claims professional well-versed in managing and resolving insurance claims. Proven expertise in navigating regulatory requirements and resolving disputes efficiently. Recognized for collaborative approach and commitment to achieving results, with adaptability to changing scenarios. Key skills include claims processing, attention to detail, and customer service.
Overview
28
28
years of professional experience
Work History
Claims Administrator
City of Denton
09.2021 - Current
- Process Auto and General Liability insurance claims efficiently, ensuring compliance with city regulations.
- Investigate, evaluate and reserve on medical-only and indemnity workers compensation claims, working with the TPA to ensure appropriate medical management, claim investigation, reserving and resolution.
- Conduct audits on processed claims to ensure adherence to policies and identify areas for improvement.
- Manage a high volume of daily claims, consistently meeting deadlines without compromising attention to detail or accuracy.
- Balance workload effectively, prioritizing tasks to ensure timely completion of all claim-related responsibilities.
- Review documentation for accuracy, identifying discrepancies to enhance claim processing integrity.
- Coordinate communication between claimants and insurance providers to resolve inquiries in a timely and efficient manner.
- Maintain detailed records of claims activities using claims management software for tracking and reporting.
- Stay updated with industry regulations, ensuring compliance in all claim-handling procedures.
- Provide exceptional customer service during stressful situations involving accident victims or property damage incidents.
- Contribute to risk management strategies by identifying trends in claim types or emerging risks requiring further investigation.
- Negotiate settlements within approved authority limits to achieve fair outcomes for both customers and the city.
Risk Analyst
Oil States International, Inc.
08.2018 - 09.2021
- Evaluated and processed workers' compensation and auto claims to ensure compliance with regulations and company policies.
- Managed case files, documenting all communications and maintaining organized records for audits and reviews.
- Collaborated with policyholders to gather necessary documentation for claim processing.
- Created and analyzed risk data to identify trends and potential impacts on business operations.
- Developed risk assessment models to evaluate existing controls and recommend improvements.
- Collaborated with cross-functional teams to enhance risk management strategies and processes.
- Conducted regular audits of risk management practices to ensure compliance with regulatory standards.
- Administered RMIS system data imports, configuration changes and user issues.
Claims Administrator
Sally Beauty Holdings Inc.
08.1997 - 04.2018
- Responsible for the workers' compensation claims program for the 50 states in the US, including Puerto Rico.
- Processed and reviewed claims to ensure compliance with the organization's policies and state regulations.
- Investigated, evaluated, and reserved on medical-only and indemnity workers' compensation claims, working with TPA to ensure appropriate medical management, claim investigation, reserving, and resolution.
- Maintained accurate records in the claims management system, enhancing accessibility for auditing purposes.
- Developed detailed reports on claim statuses, providing insights for departmental decision-making processes.
- Balanced workload effectively, prioritizing tasks to ensure timely completion of all claim-related responsibilities.
Education
High School Diploma -
Denton High School
Denton, TXSkills
- Claims auditing
- Customer communication
- Claims processing
- Microsoft office
- Deadline oriented
- Settlement negotiation
- Attention to detail
- Problem-solving abilities
Timeline
Claims Administrator
City of Denton
09.2021 - Current
Risk Analyst
Oil States International, Inc.
08.2018 - 09.2021
Claims Administrator
Sally Beauty Holdings Inc.
08.1997 - 04.2018
High School Diploma -
Denton High School
Adjuster License - Texas
License Number: 2621915
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