Reviews assignments to determine the nature of the claim and action required. Establishes phone contact with claimant and begins a field investigation by meeting with claimants, the insured and witnesses. Investigates losses by going to the scene of the accident, taking photos of the location and or the claimant Meeting with the injured employee and taking a written or recorded statement signed by him or her as well as a signed medical release. Submits timely reports for the claim file complying with company standards.
Analyzed claims to determine in covered , made approval or denial decisions and negotiated settlements with claimants in accordance with Florida statues. Collaborated with claims coordinators of various state agencies and interviewed claimants to correct errors, rectify omissions and investigate questionable issues. Handled over 300 workers compensation files both medical and loss time. Worked with Nurse Case Managers to get claimants medical portion of the file handled and followed up accordingly. Set up surveillance as needed.
Supported claims adjusters in processing hundreds of first- and third-party workers compensation, auto, homeowners and property insurance claims. Analyzed and determined validity of claims. Processed payments and paid medical and legal bills for adjusters. Assisted policyholders in a busy call-center environment. Assisted adjusters in investigating claims and determine cause and extent of damages and or injuries. This motivated me to pursue my adjuster license. Worked with hospital providers to get bills paid accordingly. Developed a strong understanding of insurance policies and legal issues through completion of a series of INS classes coupled with in-depth, claims.
Chipola College: Some classes 1994
FL. ALL LINES ADJUSTER 620 LIC# W114342 (2011)
CSR 440 LIC# W114342 (2010)
Tallahassee Chamber of Commerce
Workers Compensation Association
Claims, Compensation, Workers Compensation, Auto Insurance, Insurance Claims, Payments, Operations, Payroll, Staffing, Workers Compensation Claims, File, Field Investigations, Settlements, Accounts In, Customer Service, Detail Oriented, Fraud Investigation, Interviewing, New Accounts, Receptionist, Retail Sales, Self Directed, Assisted Living, Senior Residential Care
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