Claims Adjuster

Phone

**@*******.***

Experience

**/**** - **/**** ******* Mutual Group

Claims Adjuster

Responsible for handling auto and property damage claims. Execute and obtain insured and claimants statements, police reports, photos, and witness statements. Complete liability decisions, setting reserves on claims, obtain estimates, and settle claims within my settlement authority. I currently possess my P&C adjuster's license.

12/2004 - 03/2008 Citigroup Financial Auto Division, Coppell, TX

Operations Specialist-1

Responsible for leading a team of six, delegating task as needed. Monitor department's daily productivity.

Assist in protecting the company from potential financial risk and loss. Provide weekly audits and quality on

employees along with tracking and updating daily productivity reports. Execute and Finalize special

projects from management including production coding, creating desktops, running new query reports, and management reporting.

12/2002 - 12/2004 Texas Medicaid & Health Care, TX

Medicaid Claims Rep

Maintain and analyze Medicaid claims. Execute determinations based upon claim criteria.

Reprocess telephone appeals. With Medicaid providers, researching and correcting any coding that was incorrect. Ensure that federal and state mandates are incorporated, as well as company policies and procedures. Maintained a high level of accuracy, for prompt processing of payments on Medicaid claims.

03/2002 - 10/2002 United Health Care, Plano, TX

Health Claims Processor

Maintain and analyze health care claims. Execute determinations based upon claim criteria.

Insure that federal and state mandates are incorporated, as well as company policies and procedures.

Maintain a high level of accuracy, and proficient knowledge of the industry.

09/1991 - 09/1999 U.S. Navy, Cubi Point, Philippines

Maintenance Bookkeeper.

Veteran of the Armed Forces, Active duty assignment, Aircraft, and Pilot

Bookkeeping.

Education:

City College, Norman, Oklahoma

Paralegal

Technical Software Programs:

Microsoft Office Word 2003, Microsoft Office Outlook, Microsoft Office PowerPoint 2003, Microsoft Office Excel, Word Perfect 6.0, Siebel System 6.0, 10 key by touch, Ascent Capture, Auto Pro, Adobe, Avaya, Right Fax.

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