Summary
Overview
Work History
Education
Skills
Professional Licenses & Certifications
Timeline
Generic

Tracy Griffin

Daphne,AL.

Summary

Hardworking and reliable professional with strong ability in customer service and multitasking. Offering strong communication skills, several professional licensing. Highly organized, proactive and punctual with team-oriented mentality. Offering extensive Insurance Claims Adjusting, Examiner & Claims Processor experience gained over progressive insurance industry background. Closely examine documentation and property to identify damage, estimate costs and maintain liability limitations. Keen to balance company and customer interest with fair and equatable policies.

Overview

8
8
years of professional experience

Work History

Medical Claims Adjuster

Results Call Center
Wichita, KS
09.2023 - Current
  • Reviewed medical records to determine the appropriateness of services rendered and billed by healthcare providers.
  • Analyzed medical claims for accuracy, completeness, and compliance with company policies and procedures.
  • Documented all decisions made on claims in accordance with established guidelines.
  • Provided customer service support to healthcare providers regarding denied or disputed claims.
  • Resolved complex claim issues through research, negotiation, and collaboration with other departments.

Auto Claims Adjuster

CNC Catastrophe & National Claims
Mobile, AL
02.2021 - 05.2023
  • Researched and verified insurance policy coverage.
  • Communicate with team members, policyholders, claimants and witnesses by telephone, email and written correspondence to gather facts of loss to aid in claim resolution.
  • Evaluated extent of damage and documented findings.
  • Utilized resources and prior experience in adjusting industry to determine if claims should be approved for payment or denied.
  • Investigated 100 accidents or losses in 2022.
  • Provided policyholders with advice regarding vehicle repairs and body shop procedures to maximize customer satisfaction.
  • Evaluated claims for possible fraud, contacting appropriate department for assistance and further investigation.
  • Resolved repair cost inquiries, consulting with various appraisers for second opinions to resolve disagreements.
  • Managed heavy workload of 50+ ongoing cases thanks to strong organizational, time management and collaboration skills.
  • Coordinated direct repair assignments with local body shops and rental vehicles during restoration processes.
  • Maintain quality standards by reviewing claims while working off project list.
  • Provided evidence leading to recovery in insurance overpayments.

Claims Examiner

Mid- America Claims Services
Mobile, AL
10.2022 - 01.2023
  • Paid and processed claims within designated authority level.
  • Reviewed, evaluated and adjusted claims to promote fair and prompt settlement.
  • Double-checked and reviewed documentation for denied and accepted insurance claims.
  • Entered claim transactions, payments, reserves and other documentation.
  • Reviewed claims to ensure accuracy, resulting in multiple claim reductions.
  • Conducted daily reviews on claim files and verified sending of status letters to policyholders.
  • Evaluated acceptability of claims from third-parties and gathered comprehensive information.
  • Completed required investigations on referred files within established timeframes.

Independent Claims Adjuster

CNC Catastrophe & National Claims
Mobile, AL
06.2018 - 02.2021
  • Reviewed, evaluated and adjusted claims to promote fair and prompt settlement.
  • Negotiated and settled claims according to information presented through reports, research and data verification.
  • Investigated claims, determined losses and reported findings.
  • Completed required investigations on referred files within established timeframes.
  • Inspect property damage, conducted an analysis of claimant's policy limits; assessment of cost or value of an insured item.
  • Reviewed photos and other claim documents.
  • Negotiated with other professionals, such as contractors, on behalf of the policyholder, to come to agreement to restore the policyholder to a pre-loss condition.
  • Drafted statement of loss to summarize damages, payments and underlying policy coverage.
  • Continuously analyzed claims to identify fraudulent activity or abuse throughout the claim process.

Call Center Representative

Hertz Car Rental Call Center
Mobile, AL
01.2016 - 08.2018
  • Answered incoming calls from customers and provided assistance with product inquiries, billing questions, and other customer service related issues.
  • Resolved customer complaints in a timely manner to ensure customer satisfaction.
  • Greeted customers, answered their questions and provided information about car rental services.
  • Processed customer reservations and payments.
  • Explained the terms of rental agreements to customers.
  • Assisted customers in selecting appropriate car models based on their needs.
  • Updated and maintained rental agreement files and documents.

Education

Associate of Science -

James H. Faulkner State Community College
XactAnalysisBay Minette, AL
05.2007

High School Diploma -

Daphne High School
Daphne, AL
08.1992

Skills

  • Claims Investigations
  • Policy Interpretation
  • Multi-Line Phone System
  • Damage Mitigation
  • Fraud Detection Knowledge
  • Claims Investigation
  • Customer Support and Assistance
  • Data Management
  • Team Building
  • Computer Skills
  • Critical Thinking
  • Planning & Organizing
  • Training & Development
  • Microsoft Office
  • Customer Service
  • People Skills
  • Conflict Resolution
  • Reliable & Trustworthy
  • Good Work Ethic
  • Friendly, Positive Attitude
  • Organizational Skills
  • Active Listening
  • Problem Resolution
  • Relationship Building
  • Maintenance & Repair
  • Xactimate
  • XactAnalysis
  • Symblility
  • Excel
  • Adobe Creative Suite

Professional Licenses & Certifications

Symblility

Licensed Independent Insurance Adjuster ( All Lines)

Alabama Designated Home State 

NPN# 19572239

  • Alabama # 300911791
  • Florida # W837410
  • Georgia # 3493078
  • Kentucky # DOI- 1210255
  • Louisiana # 971952
  • Michigan # 19572239
  • Minnesota # 40803269
  • Montana # 3002023411
  • South Carolina # 19572239
  • Texas # 2732302
  • West Virginia # 19572239

* Show License Upon Request

CERTIFICATIONS

  • Alabama P&C, Workers' Comp & Crop Adjusters Exam
  • Certificate of Training in Microsoft Word Office- Alabama Career Center- Daphne, AL.
  • XactAnalysis for Property Desk Adjusters

Timeline

Medical Claims Adjuster

Results Call Center
09.2023 - Current

Claims Examiner

Mid- America Claims Services
10.2022 - 01.2023

Auto Claims Adjuster

CNC Catastrophe & National Claims
02.2021 - 05.2023

Independent Claims Adjuster

CNC Catastrophe & National Claims
06.2018 - 02.2021

Call Center Representative

Hertz Car Rental Call Center
01.2016 - 08.2018

Associate of Science -

James H. Faulkner State Community College

High School Diploma -

Daphne High School

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Tracy Griffin