Organized and detail-oriented Investigator dedicated to improving efficiency, productivity and profitability through continuous process improvement. Analytical thinker skilled at developing innovative solutions to complex problems. Service-oriented Claims Adjuster skilled at applying creative approaches to solving complex problems. Adept at developing profitable and quality-focused processes. Highly trained professional with a background in verifying insurance benefits and creating appropriate patient documentation.
Overview
8
8
years of professional experience
1
1
Certification
Work History
Inside Property Adjuster
Pilot Catastrophe
1020 Downtowner Blvd Mobile, AL 36609
06.2023 - 10.2024
Interviewed insured, claimants and witnesses and requested official reports as part of investigations.
Mitigated losses through timely on-site inspections, ensuring accurate damage assessments were conducted in accordance with company guidelines.
Presented evidence at legal proceedings and produced reports and other documents as evidence.
Examined claim forms, policies and endorsements and client instructions to determine coverages.
Maintained organized case files throughout the adjustment process, enabling seamless handoffs between involved parties and promoting efficient claim resolution.
Collaborated with outside experts such as contractors and engineers to accurately assess property damages and determine repair costs.
Streamlined documentation processes for more efficient claim handling, reducing overall timelines for closure.
Developed strong relationships with agency partners, fostering trust and collaboration in resolving complex claims.
Claims Associate
Statefarm Insurance
Richardson, TX
03.2020 - 05.2023
Worked with claims adjusters and examiners to expedite processing in alignment with procedures.
Affirmed or denied coverage fairly based on thorough investigations.
Investigated damages, gathering information from diverse sources and delivering comprehensive reports.
Worked productively in fast-moving work environment to process large volumes of claims.
Followed up with customers on unresolved issues.
Proposed settlements for uncomplicated issues to resolve claims.
Oversaw claim recoveries, subrogation and salvage.
Posted payments to accounts and maintained records.
Made contact with insurance carriers to discuss policies and individual patient benefits.
Evaluated and settled complex insurance claims in strict timeframes.
Customer Service Representative
Cotiviti Holdings Inc
02.2018 - 02.2020
Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
Answered customer telephone calls promptly to avoid on-hold wait times.
Answered constant flow of customer calls with minimal wait times.
Offered advice and assistance to customers, paying attention to special needs or wants.
Provided excellent customer care by responding to requests, assisting with product selection and handling ordering functions.
Communicated professionally with colleagues, freelancers and clients.
Verification Representative
Globe Life Insurance
12.2016 - 01.2018
Verified insurance benefits and obtained pre-authorizations before any medical procedures were performed.
Maintained patient records and paperwork while observing company protocols for data confidentiality.
Contacted insurance companies to determine levels of coverage and benefits information for patients.
Maintained strong knowledge of basic medical terminology to better understand services and procedures.
Observed strict procedures to protect sensitive patient information, medical records and payment data.
Assured timely verification of insurance benefits prior to patient procedures or appointments.
Notified insurance agents and accounting departments of policy cancellations and changes.
Reviewed outstanding requests and redirected workloads to complete projects on time.
Communicated effectively with staff members of operations, finance and clinical departments.
Prepared insurance claim forms or related documents and reviewed for completeness.
Education
High School Diploma -
Princeton High School
Princeton, TX
Bachelor of Science - Business Administration And Management
Dallas College
Dallas, TX
05-2025
Skills
Excellent customer service
And organizational skills
Valid driver's license
Creative problem solving
Training development
Aptitude
Customer billing
Problem resolution
Detail oriented
Advanced oral and written
Communication skills
Strong computer skills
Good listening
Claims Knowledge
Microsoft Word
Professional Development
Billing Software
Certification
Licensed Adjuster 2019 - currently
Timeline
Inside Property Adjuster
Pilot Catastrophe
06.2023 - 10.2024
Claims Associate
Statefarm Insurance
03.2020 - 05.2023
Customer Service Representative
Cotiviti Holdings Inc
02.2018 - 02.2020
Verification Representative
Globe Life Insurance
12.2016 - 01.2018
High School Diploma -
Princeton High School
Bachelor of Science - Business Administration And Management