Claims Adjuster Compensation

Yeney Goginsky

813-***-**** ***********@*******.*** Brandon, FL 33511

SUMMARY

To acquire a long term position that will enable me to advance and grow within the company. Talented Claims Adjuster emphasizing effective time management, cost control and mediation. Self-motivated and customer-focused. Energetic and enthusiastic insurance professional motivated to succeed in fast-paced and deadline-driven professional environment. Comprehensive knowledge of claims adjustments with special knowledge of auto appraisals and CCC pathways estimations. Licensed Claims Adjuster focused on construction inspections and workers' compensation claims. Positive attitude and exceptional problem solving skills.

SKILLS

Bilingual

Microsoft Office

Excel

Power Point

40WPM

Outlook

HBOC

Workers' Compensation Claims

Automobile Appraisals

EXPERIENCE

Field Resolution Claims Adjuster Commercial Heavy Equipment/Represented BI, Soil Tech Distributor, January 2023-October 2023

Tampa, FL

Provide exceptional customer service to insured, claimant, witness and attorney to obtain necessary information to move the claim forward

Investigated loss detailed and determine liability

Investigated fraudulent claims and authorized surveillance on claimants

Reviewed medical bills and communicated with providers on claimed injuries

Negotiated with claimants, or their attorney to settle all property damage and bodily injury claims

Issued checks and secure releases and all required paperwork

Inspected and estimated commercial heavy equipment, commercial property, and personal property damages

Handled all inbound and outbound subrogation demands.

Case Manager, Trimed Billing Solutions, July 2019-January 2023

Brandon, FL

Responsible for handling specialty accounts

Act as a liaison between the patient/attorney and healthcare providers within the TriMed Provider Network

Responsible for accepting new referrals for timely contact, underwriting and assessing risks along with scheduling and confirming appointments from inception until bills/records have been received and reviewed.

NARBI Adjuster, Direct General, February 2012-July 2019

Tampa, FL

Handle all aspects of claims handling, including bodily injury settlements

Handle Florida, North Carolina, South Carolina, Virginia, and Georgia claims

Was able to use my negotiation skills to achieve desired results

Specifically, in 2014 I was second highest on the team with BI settlements within 0-30 days and was highest on the team in 2015 with BI settlements 0-90 days.

Trainee / Fast Track Adjuster, Direct General, September 2011-February 2012

Tampa, FL

Completed training and began taking claims in November

Was able to expand my claims knowledge and was promoted to NARBI team in February 2012

Sr. Workers' Compensation Claims Analysis, Select Staffing, January 2007-March 2011

Tampa, FL

Coordinate and facilitate the company's claims intervention and return to work for 37,000 temporary employees

Manage claims from 60 plus Branch locations across 6 Regions

Responsible for claims from initial report to closure, make recommendations on compensability and authority for settlement.

Administrative Assistant, Town Country Hospital, May 2006-January 2007

Tampa, FL

Assist with all administrative duties for the CNO and CFO of the facility

Liaison for the medical staff and the hospital senior administration

Also full responsibility of the handling of all patient complaints.

Workers' Comp. Coordinator, Town Country Hospital / Memorial Hospital, January 2004-May 2006

Tampa, FL

Overall responsibility for coordinating the Worker's Compensation Program including referral and follow-up care for injured employees

Monitor and document management related to the complete process for injured employees until released to work at full capacity

Maintain close contact with Workers Comp

Carrier for accurate follow up

Collaborated in the development of policies and procedures relevant to the Workers' Compensation Program

Responsible to inform the statistical data to the Safety Committee as well as any relevant changes in current policies and procedures

OSHA 300 yearly reporting and other reports as requested by the senior management

Together with Worker's Comp

Duties a 25% of Human Resources responsibilities such as support to applicants, hospital staff, management and administrative support to the HR Director, new hire processing, job advertising, employment verification, etc.

EDUCATION AND TRAINING

CNA, HHA, PCA and Surgical Tech.

Brewster Technical Center, Tampa FL

620 Adjuster License

Hillsborough Community College

LANGUAGES

English:

Full Professional

Spanish:

Native/ Bilingual

CERTIFICATIONS

620 Adjuster License

CNA, HHA, PCA and Surgical Tech

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