Yomaira Reed
Dover
Summary
Detail-oriented claims professional with a solid background in investigating, evaluating, and resolving claims efficiently. Adept in handling high-volume inventory without compromising accuracy. Recognized for strong communication skills and with ability to navigate challenging situations with professionalism and empathy.
Overview
13
13
years of professional experience
Work History
Personal Injury Protection (PIP) Examiner
Progressive Insurance
10.2023 - Current
- Review and evaluate PIP claims for coverage, compliance, and medical necessity.
- Identifies involved parties eligible for coverage, analyzed medical bills, lost wages and other expense claims submitted for payment using a consistent and thorough review process.
- Determine the validity of claims by reviewing medical records, accident reports and policy coverage.
- Communicate with injured parties, attorneys, and medical providers to settle claims efficiently.
Claims Performance Analyst
GEICO
02.2020 - 10.2023
- Conducted audits of claim files and customer calls across multiple departments, including auto and commercial lines.
- Used Excel and SharePoint to track audit trends and performance metrics at individual, team, and location levels.
- Facilitated monthly calibration sessions to ensure alignment across QA analysts and operations.
- Created and presented audit summaries and improvement recommendations to leadership.
Claims Adjuster
GEICO
02.2018 - 02.2020
- Managed high-volume inventory of auto claims from investigation through resolution and communicated decisions to all parties involved.
- Conducted detailed fact-finding, evaluated policy coverage and liability, and made claim decisions.
- Investigate and resolve liability and coverage issues timely.
- Verify facts of loss and determine applicable coverages.
- Obtain recorded interviews and resolve complex coverage claims.
- Identify possible fraud indicators such as SIU or subrogation.
Copy Coordinator
Nexstar Media Group
01.2017 - 01.2017
Financial Foundations Specialist
USAA
01.2015 - 01.2017
Administrative Assistant
Entravision
01.2013 - 01.2014
Education
Bachelor of Arts - Communications
University of South Florida
Tampa, FLSkills
- Excellent written and verbal communication
- Conflict Resolution
- Collaborative
- Attention to detail
- Decision making
- Proficient computer skills (Microsoft Office Applications)
Timeline
Personal Injury Protection (PIP) Examiner
Progressive Insurance
10.2023 - Current
Claims Performance Analyst
GEICO
02.2020 - 10.2023
Claims Adjuster
GEICO
02.2018 - 02.2020
Copy Coordinator
Nexstar Media Group
01.2017 - 01.2017
Financial Foundations Specialist
USAA
01.2015 - 01.2017
Administrative Assistant
Entravision
01.2013 - 01.2014
Bachelor of Arts - Communications
University of South Florida