Enthusiastic insurance professional with fourteen years experience in claims handling with an emphasis on bodily injury claims. Exceptionally strong verbal and written communication skills
to resolve claims timely and accurately. Competent in the interpretation of insurance contracts to resolve claims for both the company as well as the insured by properly investigating all exposures and/ or perils to determine cause, scope, and extent of damages and/or determine liability and possible subrogation potential.
Claims file management processes
Medical terminology specialist
Strong interpersonal and communication skills
Bodily Injury Claims AdjusterJul 2005 to Sep 2017 The Hartford － Tampa, FL
Evaluate and investigate policy coverage, liability and damages in a
timely manner following a set of general claim and statutory guidelines.
Establish initial reserves for all potential exposures and adjust as
appropriate throughout the claim
Attend arbitration, meditations and other settlement conferences as needed.
Handled special level commercial claims for high profile insured's
Establish and maintain appropriate diary of open claims following
Determine an appropriate reasonable range of
value to negotiate fairly with attorneys and unrepresented claimants based on
the merits of their case.
Recommended settlement offers and negotiated payment arrangements with unrepresented claimants and attorneys.
Draft precisely accurate settlement agreements in compliance with state laws that also provided protection to policy holders and insurance carriers.
Claims ExaminerSep 2001 to Aug 2004 United Health Group － Oldsmar, FL
Mentored 5 new members of the claim staff.
Reviewed data to verify the validity of claims.
Processed medical claims pursuant to the group plan benefits and guidelines.
Determined member eligibility, handled pre- authorizations for medical procedures
Processed medical claims according to the policy contract both in and out of network
Education and Training
Business AdministrationPTC Institute － Tampa, FL, USA