Post Job Free

Resume

Sign in

Customer Service Claims Adjuster

Location:
Katy, TX
Posted:
November 17, 2023

Contact this candidate

Resume:

Cotrina Sanders

Cypress, TX *****

ad08f7@r.postjobfree.com

+1-225-***-****

Work Experience

Claims Adjuster File Reviewer

Alacrity Solutions - Houston, TX

Present

• Reviews claim submissions from the field staff and audits work product for accuracy, professionalism, and adherence to Elevate, carrier, and industry requirements.

• Packages and provides interim and finished work product to the carriers and advances diaries and / or invoices and closes files as necessary.

• Alerts management of developing or potential issues on claim files as observed.

• Alerts management to exceptional performance on claim files as observed.

• Provides direction and guidance to staff to ensure that they have sufficient knowledge and skill to provide exemplary customer service and resolve claims timely and equitably across all lines of business.

• Reviews client guidelines in order to ensure adherence to client requirements and policyholder expectations.

• Conducts closed file audits as assigned to ensure that claims are handled according to company policies and procedures.

• Assists in design of workflows, processes, and techniques with a focus on continual process development.

SWPPP Inspector

Environmental Allies - Houston, TX

July 2023 to Present

• monitoring and record issues related to storm water pollution prevention noting any and all deficiencies and communicating those issues to the field contact and office personnel Field Inspector/ Format Reviewer/QAQC

ICF

September 2022 to Present

• Package and provide interim and finished work product to the carriers and advances diaries and / closes files as necessary.

• Provides direction and guidance to staff to ensure that they have sufficient knowledge and skill to provide exemplary customer service and resolve claims timely and equitably across all lines of business.

• Assists in design of workflows, processes, and techniques with a focus on continual process development.

• Inspection of home systems and recommendation of needed repairs. Notation of all needed repair and/ or replacements; including roofs, electrical, plumbing, foundation, interior/exterior wall and flooring, and cabinetry. additional new/updated electrical and plumbing work. Provide additional reports Recruiter

DLM Pro - Houston, TX

January 2019 to May 2023

Interview, search appropriate candidates for various positions with different companies Matching qualifications and experience to the clients needs. Onboarding, trainings Disaster Response Specialist III

IEM - Chicago, IL

October 2022 to February 2023

• Developed state and local response and pre- and post-disaster recovery plans, procedures, checklists, and guidance documents

• Provided recovery programmatic assistance to clients and maintain currency of and compliance with applicable state and federal policies, procedures, and guidance documents relating to recovery

• Served in a response capacity in a state or local Emergency Operations Center

• Provide response and recovery related training to state and local government clients

• Developed Disaster Recovery Frameworks for clients, if needed to include job descriptions and job aids

• Conducted needs assessment and gap analysis as it relates to response and recovery planning, the client’s emergency operations plan, and mitigation planning (where applicable)

• Facilitated recovery stakeholder meetings to include developing meeting agendas, handouts, and PowerPoint presentations

• Identified potential impacts / implications of policy changes to Federal/State/local programs and provide briefings as required

• Conducted meetings and briefings with clients

• Provided technical guidance and recommendations to management

• Developed maintained and implemented plans and procedures associated with the effective and efficient delivery of a response and recovery program

• Performed quality control review procedures over work performed by other Disaster Recovery Specialists and over client-provided documents as requested

• Identified and elevated administrative issues for resolution QA/QC Inspector

JA Eubanks Construction - Houston, TX

July 2018 to November 2022

Inspection of home systems and recommendation of needed repairs. Notation of all needed repair and/ or replacements; including roofs, electrical, plumbing, foundation, interior/exterior wall and flooring, and cabinetry. additional new/updated electrical and plumbing work. Provide additional reports to superiors. Rapid Responder Rapid Responder

CTEH CTEH Center for Toxicology and Environmental Health - Little Rock, AR March 2017 to October 2022

- Little Rock, AR

March 2017 to Present

• read instruments and record measurements on standard forms;

• Translate data on paper forms to computer-based forms;

• Participate on projects related to industrial hygiene, risk assessment, toxicology or emergency response;

• prepare chain-of-custody for environmental samples;

• assemble technical reports for equipment, procedures, etc.; Chart Abstractor

ReMedi Health Solutions - Houston, TX

March 2022 to September 2022

Medical Chart Abstraction reviewed physician and clinical documentation in scanned reports and acquired practices medical record to identify pertinent patient information. Independently review, analyze, and identify significant patient health information from provider notes, lab results, surgical reports, inpatient and/or outpatient notes, and discharge summaries. Interprets and documents clinical information from the patient chart such as medications, allergies, procedures, family history and immunizations into discrete fields in the electronic medical record.

Monitors and maintains charts requiring abstraction for additional data elements after initial encounter is complete. Accurately enters health maintenance components into the electronic medical record utilizing appropriate diagnosis and procedure codes.

HHA/Caregiver

VARIOUS MEDICAL PRACTICES - Baton Rouge, LA

February 1996 to August 2022

19+ years experience Various Employers

Hospice Care(Inpatient/Homecare)

Long Term Care Facilities

Rehabilitation Centers

Private Duty Care

Liaison Vaccination Site Surveying

All Hands Consulting - Chicago, IL

February 2021 to January 2022

Vax site set-up, observations, case management, training deployed from the EOC out to different locations throughout the State of Illinois scout sites and to monitor the set up and execution of new or existing sites. Excel spreadsheets. PowerPoint presentations, scoping, Management Field Inspector

TELACU Construction Management - St Croix, VI

July 2018 to December 2019

Field Inspector

Disaster Assistance

Inspectorate & Xactimate skilled In various types of inspections including Flood & wind damage Residential and Commercial properties

Foundation inspection, Wiring, HVAC, Drywall, plumbing, Insulation, Roofing, Structural stability, Exterior wall measurements interior/Exterior of Resident or Commercial property Identifying problems and finding a solution

Building reports on cost of the repairs working with Contractors to agree on a settlement for the work being performed assessment of permits required for worked performed Xactimate 28 Experienced

Sketching and measurements included in Daily detailed reports about damages and repair amounts, Photographed documentation Final inspections of properties when work is complete Experienced In Mobile Home placement

Surveying for placement

Final inspections after placement, assessment of plumbing, electrical lines Public Assistance Specialist various types (debris removal and emergency protective measures), and permanent work (roads, bridges, buildings and structures, water control facilities, utilities, and parks and recreation areas) planning, analysis, review and public involvement

• Worked with local, state and federal officials to identify and report disaster related damages.

• Complete damage site visits to determine disaster related damages, project scope and cost. • Complete project list and assign project categories.

• Develop project scopes and costs for project worksheets.

• Reconcile, review and prepare documentation to develop Project worksheets including FAL and FAE. • Review damage assessments to develop projects for category A-G.

• Develop projects according to the Stafford Act section 428-Public Assistance Alternative Procedures.

• Assist applicants in obtaining reimbursement for rebuilding infrastructure after a declared disaster. • Meet with applicants to obtain details, collect documentation to prepare project worksheets.

• Consolidate and preserve project records.

QA/QC Construction Manager

Jacobs

February 2018 to August 2019

Roofing, Structural stability, Management of crew PPE standards Exterior wall measurements interior/ Exterior of Resident or Commercial property Identifying problems and finding a solution Building reports on cost of the repairs working with Contractors to agree on a settlement for the work being performed assessment of permits required for worked performed Xactimate Experienced

Case Manager

KBG Logistics

March 2018 to October 2018

Handle complex problems through effective and efficient resolutions compliant with policies such as FEMA, HUD, or

Federal Acquisition Regulations and policies.

• Makes and receives a high volume of phone calls and emails on a daily basis.

• Answers incoming calls from homeowners in a prompt, attentive, and friendly manner.

• Monitoring cases through to completion obtaining additional resources, intervening in crises, providing personal support to cases as needed

• Develop and execute comprehensive closeout process and supervise daily activities of project closeout

• Explains program policy and procedures to clients.

• Navigate efficiently through multiple system screens in a customized database to find and convey information.

• Data Entry including transcripts and summaries of client interaction.

• Provides periodic reports to the center manager.

• Attends periodic internal training sessions and meetings.

• Conducts outreach services to clients reviewing their claims, offering support with empathy, being the liaison for clients receiving construction services, ensuring the other entities are aware of client and their issues, etc.

• Developed reports and prepared support documentation.

• Reconciled contract funding obligations and expenditures with final voucher amounts and determine de-obligated amounts.

Field Inspector

Witt O'Brien's - Houston, TX

December 2016 to April 2018

Home restoration program

Flood/Wind damage I have experience in various types of inspections Residential and Commercial properties

Foundation inspection, Wiring, HVAC, Drywall, plumbing, Insulation, Roofing, Structural stability, Exterior wall measurements interior/Exterior of Resident or Commercial property Identifying problems and finding a solution

Building reports on cost of the repairs working with Contractors to agree on a settlement for the work being performed assessment of permits required for worked performed Xactimate Experienced

Sketching and measurements included in Daily detailed reports about damages and repair amounts, Photographed documentation Final inspections of properties when work is complete Experienced In Mobile Home placement

Surveying for placement

Final inspections after placement, assessment of plumbing, electrical lines Field Inspector

MPACT Strategic Consulting - Houston, TX

May 2015 to February 2018

Home restoration inspections

Wind & Floor damage homes

I have experience in various types of inspections

Residential and Commercial properties

Foundation inspection, Wiring, HVAC, Drywall, plumbing, Insulation, Roofing, Structural stability, Exterior wall measurements interior/Exterior of Resident or Commercial property Identifying problems and finding a solution

Building reports on cost of the repairs working with Contractors to agree on a settlement for the work being performed assessment of permits required for worked performed Xactimate Experienced

Sketching and measurements included in Daily detailed reports about damages and repair amounts, Photographed documentation Final inspections of properties when work is complete Experienced In Mobile Home placement

Surveying for placement

Final inspections after placement, assessment of plumbing, electrical lines Team Lead Team Lead Individual Assistance- Applicant Program Specialist

Researched, reviewed, and verified client's information and activities to determine eligibility of applicants for disaster assistance.

Requested and distributed information received from cases and re-certification of files.

Assured implementation of program policies and guidelines for efficient and expeditious processing of individual assistance

Education

Istrouma High School - Baton Rouge, LA

August 1996 to May 2000

Skills

• Quality assurance

• ERP systems

• Haitian Creole

• Computer Networking

• Microsoft SQL Server

• Volunteer management

• SharePoint

• Sales

• Drywall

• Linux

• Leadership

• Time management

• Computer literacy

• Computer operation

• Help Desk

• Negotiation

• Grant writing

• VMWare

• Water Damage Restoration

• Bookkeeping

• Program Management Supervisory Skills: Directing Others -- Completed October 2019 Motivating others through feedback to identify improvements or corrective actions. Full results: https://share.indeedassessments.com/share_to_profile/ 6d0d0f65bfd9ce47be13f27a7e647a4aeed53dc074545cb7 Call Center Customer Service

-- Proficient November 2019 Measures a candidate's ability to demonstrate customer service skills in a call center setting. Full results: https://share.indeedassessments.com/ share_to_profile/ b72f3fb86f24ad213e15d744633fd1adeed53dc074545cb7 Filing & Organization -- Highly Proficient January 2020 Arranging and managing information or materials using a set of rules. Full results: https://share.indeedassessments.com/share_to_profile/ 5a13057d5cd5a7cbe8912f3d42bb1308eed53dc074545cb7 Basic Computer Skills: PC -- Familiar January 2020 Performing basic computer operations, navigating a Windows OS, and troubleshooting common computer problems. Full results: https://share.indeedassessments.com/ share_to_profile/ 1c9205a79c9c1f5d309c872de7269cc8eed53dc074545cb7 Customer Focus

& Orientation -- Highly Proficient January 2020 Measures a candidate's ability to respond to customer situations with sensitivity. Full results: https://share.indeedassessments.com/ share_to_profile/ 5f301033036ae7b5c061fa53cd79e97feed53dc074545cb7 Customer Focus & Orientation -- Highly Proficient January 2020 Responding to customer situations with sensitivity. Full results: https://share.indeedassessments.com/share_to_profile/ 22da170ac02866f815d2db94494cff34eed53dc074545cb7 Indeed Assessments provides skills tests that are not indicative of a license or certification, or continued development in any professional field. Customer Service, Computer programs (10+ years), Certified Inspector Health & Safety (3 years), Certified Rapid Damage Assessment (5 years), Certified Inspecting, Assessment, Recording Mobile Homes, Travel trailers (5 years), Certified Recording Complaint Flood inspection (2 years), Certified Home Inspections (5 years), CPR (10+ years), Published Author (7 years), Public Assistance Specialist (PA) (2 years), Quality Control Accounting Skills: Bookkeeping

• English

• Budgeting

• Documentation review

• Adobe InDesign

• Enterprise software

• Hospice care

• Program management

• Microsoft Windows Server

• Accounting

• Disaster Recovery

• Contract management

• QA/QC

• Adobe Illustrator

• Restoration industry experience

• Cost accounting

• Adobe Photoshop

• Public speaking

• Oracle

• Mold Remediation

• CPR

• Operating Systems

• Fire Restoration

• Strategic Planning

• Quality control

• Windows

• Caregiving

• Technical Support

• Emergency management

• Customer service

• Cooking

• Illustration

• Construction Experience

• Active Directory

• Quality control

• Construction

• Quality assurance

• Water damage restoration

• Crew management

• Supervising experience

• Typing

• Document management

• Interviewing

• Customer relationship management

• Customer service

• Leadership

Certifications and Licenses

PMP

CPR Certification



Contact this candidate