Yasmine Andrade
Elgin,IL
Summary
Results-driven Bodily Injury Claims Adjuster with comprehensive experience in handling bodily injury claims, conducting thorough investigations, and negotiating settlements. Possess strong analytical skills for determining liability, evaluating injuries, and quantifying damages. Noted for ability to maintain rapport with claimants while effectively managing multiple cases. Have consistently contributed to reducing company costs through effective claim resolution strategies.
Overview
14
14
years of professional experience
1
1
Certification
Work History
Senior Bodily Injury Claims Adjuster
Producers National
Niles, IL
10.2015 - Current
- Reviews initial notice of claim, determines extent and validity of coverage, and screens or determines qualification for flow process
- Determines measures to be taken in absence of coverage or questionable cases
- Manages, investigates, and resolves claims while identifying opportunities for third party subrogation
- Identifies potential suspicious claims and refers to SIU
- Coordinates with the litigation unit while managing claims
- Conducts quarterly claim audits while producing reports for management on findings and suggestions
- Communicates with policyholders, witnesses, and claimants in order to gather information regarding claims, refers tasks to auxiliary resources as necessary, and advise as to proper course of action
- Responds to various written and telephone inquires including status reports
- Negotiates settlements with attorneys, claimants, and/or co-defendants.
Claims Adjuster
American Access Casualty Company
Oakbrook Terrace, IL
06.2013 - 06.2014
- Reduced loss ratios through fair and prompt processing of claims
- Interviewed claimants, medical specialists and employers to determine pertinent claim information
- Managed a case load of 900 clients each quarter
- Investigated potentially fraudulent claims with a focus on thoroughness, quality and cost control
- Contacted injured parties and legal representatives to negotiate settlements for claims.
Claims Adjuster III
GEICO
Lakeland, FL
07.2010 - 05.2013
- Provided cross training to eight staff members
- Evaluated, negotiated and settled claims within authority levels
- Drafted statements of loss to summarize damages, payments and underlying policy coverage
- Recommended punitive action on fraudulent claims
- Scheduled auto repairs with preferred auto body shops and arranged rental vehicles for clients.
Freelance Medical Claims Analyst
Healthcare Financial Resources
Elgin, IL
04.2015
- Acquired insurance authorizations for procedures and tests ordered by the attending physician
- Demonstrated knowledge of HIPAA Privacy and Security Regulations by appropriately handling patient information
- Prepared and attached all required claims documentation including referrals, treatment plans or other correspondence to reduce incidence of denials
- Completed appeals and submitted claims within timely filing.
Education
Associate of Science - Criminal Justice
Colorado Technical University
01.2010
Skills
- Settlement Negotiation
- Policy investigations
- Proficiency of bodily injury claims
- Policy Interpretation
- Claims file management processes
- Caseload Management
Certification
Medical Careers Institute, Certification of Medical Billing/Coding, 2004
References
References available upon request.
Timeline
Senior Bodily Injury Claims Adjuster
Producers National
10.2015 - Current
Freelance Medical Claims Analyst
Healthcare Financial Resources
04.2015
Claims Adjuster
American Access Casualty Company
06.2013 - 06.2014
Claims Adjuster III
GEICO
07.2010 - 05.2013
Associate of Science - Criminal Justice
Colorado Technical University
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