Vanessa Holmes-Anderson

Richmond, CA *****

ad0m56@r.postjobfree.com

+1-510-***-****

Work Experience

Teacher Assistant Trainee

Contra costa county community service bureau - Martinez, CA September 2021 to Present

Teaching 3 to5 year old students to writing their names, ABC, manners, etc. Senior Claims Specialist/Examiner

Professional Temporary Services - San Rafael, CA

May 2018 to Present

Traveled to various insurance companies and public entities, handling bodily injury /slip/fall claims. Investigated and determined liability then handled the exposures as a results of auto accidents, general liability and commercial claims.

Senior Claims Representative

AC Transit Bus District - Oakland, CA

July 2017 to May 2018

Handled personal injury injury claims arising from auto accident, slip and fall claims, general liability. Evaluating and negotiating claims with attorneys and claimants in proper. Placing a monetary value on claims for settlement. Handle Small Claims Court action filed against the District. Personal Injury Claims Rep.

Municipal Pooling Authority c/o Pro-Temps - San Rafael, CA December 2016 to June 2017

Traveled to various insurance companies, public entities handling bodily injury claims, slip/falls liability claims, commercial lines of insurance claims

My recent position was with Municipal Pooling through June of 2017. This was a two week assignment Claims Examiner II

Insurance Overload Staffing Agency - Concord, CA

October 2016 to December 2016

Handled Liability claim, i.e. slip & falls and collision accident for the City of Oakland. Also, handled property damage claims

Claims Examiner II

Global Staffing Solutions - Walnut Creek, CA

August 2016 to October 2016

Handle general liability claims for Ross stores nationwide, which consisted of slip and falls, hard tag injury from sensor pin. . (TPA)

Personal Injury Claims Specialist

Renfroe Temp Agency - Alabama

June 2014 to August 2016

Responsibilities

Traveled to State Farm Ins. Co., only, which was located out-of-state. Handled personal injury and medical payment claims/grievances. Reviewed an abundance of medical record to determine diagnosis prognosis and prescribed disability when on assignment.

Skills Used

Negotiating skills Efficient in multi-task skills. Excellent verbal skills and interpretation of polices and statutes. Letter composition via Microsoft Word.

Liability Claims Representative

State Farm Insurance Co. - Emeryville, CA

May 2011 to May 2014

Investigating auto liability claims and handling exposures accordingly. Reviewing and evaluating medical records/ loss of earning to establish case values. Determined diagnosis, prognosis and disability periods. Honored and negotiated all liens including Medi-Cal . Negotiated bodily injury & medical claims grievances claims with attorney and claimants in pro per. Handled first party medical claims, wherein, I set up independent medical examination when warranted. Upon conclusion of my investigation, claim/grievance was submitted to our management team for final decision. Composed denial letters via Word application and incorporated policy language, policy exclusions and regulations. Monitored & questioned medical treatment which was reviewed with our management team and company doctors. Handled restitution/ subrogation interest. Attended Small Claims Ct. and Mediations. All Litigation matters was attended with company attorneys

Personal Injury Claim Rep.

Career Professional Agency. - Oakland, CA

September 2009 to May 2011

Responsibilities

Traveled to various insurance companies and public entities handling liability, general liability claims/ grievances. Handled medical claims/grievance,and bodily injury claim/grievances In addition, handled some property damage claims, total loss work up and subrogation/restitution interest. Benefit Authorizer

Social Security Administration - Richmond, CA

August 2007 to August 2009

Handled Retirement, Survivors, Widow(er), Disability and Workers Compensation, Railroad claims, and Annuities; managed heavy phone volume with public. Personal Injury Claim Rep.

Career Professional Agency. - Oakland, CA

March 2005 to July 2007

Responsibilities

Traveled to various insurance companies and public entities handling bodily injury, general liability/public entities, commercial claims and medical claims. Inspected vehicles and inlined estimates with body for remittance. Total Loss work-ups

Personal Injury Claims Representative

Viking Insurance Co - Walnut Creek, CA

October 2000 to January 2005

Investigated auto liability non standard claims/grievances; interviewed claimants, witnesses, police officers, and obtained statements both written or recorded; gathered medical records and wage information to evaluate and establish settlement range; Negotiated settlements either with claimants directly, or with attorneys of claimants; assisted in training peers; monitored work of independent adjusters and defense attorneys on litigated matters; attended small claims court hearings weekly and scheduled mediations; pursued reimbursement through subrogation; worked with claimants to pay restitution and monitored payment on accounts; issued settlement checks on settled cases. Cross trained in Workers Compensation claims. Inspected vehicles and performed total loss work-up for settlement. Handled first party Medical claims. or declined medical coverage. Monitored treatment and set up independent medical examinations when warranted. Reviewed medical records to determine diagnosis, prognosis and disability periods. Paid and denied medical coverage when warranted and send denial letter which incorporated policy language, exclusions and regulations. Personal Injury Claims Rep.

Career Professional Temp. Agency - Oakland, CA

February 1999 to October 2000

Traveled to various insurance companies to assist in times of excessive claims volume. Handing personal injury, medical claim grievances, general liability. In addition, some property damage & commercial casualty, medical claims. Inspected claimant's vehicle and inline estimate with shop for remittance. Performed total loss work-ups

Personal Injury Field Claims Specialist/Team Leader CSAA Insurance Co

August 1981 to December 1998

Investigated automobile liability claims and handled exposures independently; performed field work as part of investigation; directly assisted claimants with claims process; evaluated medical records and wage information to determine settlement value; interviewed claimants; witnesses, police officers, and secured written or recorded statements of facts; attended Small Claims Court weekly on fraudulent cases and Mediations hearings; handled subrogation and collections, and investigated to determine claimants ability to pay back restitution; monitored restitution payments monthly. Handled first party medical claims/grievances. Monitored medical treatment and set up independent medical examination when warranted. I was active in Special Investigation Unit for 3 years. I was a Team Leader for a group of 10 claims representatives; I extended settlement authority as Team Leader; coordinated for Independent Medical Examinations when necessary; Issued and signed checks up to authority level for myself and team members. Inspected claimant/insured vehicle, inline estimates with body shops for remittance. Also, completed total loss work-ups, i.e. contacted independent dealership, newspaper ads to ascertain a fair value. Negotiated & settled w/ legal owners. Receptionist/Legal

CSAA Insurance Co

June 1974 to August 1981

Responsibilities

Answered a Centrix telephone system for 14 corporate attorneys for CSAA. Greeted clients, other attorneys when setting up for depositions. Filed legal documents in Superior, Municipal and Court of Appeals. Research passages of law from the Court of Appeals. Education

Associate in Business

Contra Costa College

Skills

• Medicare

• Icd9

• Liability

• Icd-9

• Medical Billing

• ICD-10

• Auto Estimating

• CPT Coding

• Auto Estimating

• Workers' Compensation

• Auto Estimating

• Physiology Knowledge

• Insurance Verification

• Auto Estimating

• Medical Coding

• Medical Scheduling

• Documentation review

• Cash handling

• HIPAA

• Customer service

• Negotiation

• ICD Coding

• Medical Terminology

• Medical Records

• Anatomy Knowledge

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