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Customer Service Insurance

Location:
Brandon, FL, 33511
Salary:
16.25 to 18.00
Posted:
January 12, 2020

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Resume:

ELIZABETH JONES

**** **** ****** ****** *** *** Brandon, FL 33511 813-***-**** ada96i@r.postjobfree.com

Profile

Key Skills

Insurance Claims Analyst – All Lines Specialty

Dedicated Licensed Insurance Professional with more than 10 years of experience investigating and processing Workers Compensation and health insurance claims. Excel in analyzing damages/causes, interpreting policies and negotiating payment solutions. Effectively manage multiple, high-priority projects and take pride in providing exemplary customer service.

Claims Handling and Claims Reports and Documentation

Investigations Policy Interpretation

Risk Assessment and Mitigation Confidential Records Management

Damage Assessment FL Auto Insurance Regulations

Evaluation of Liability Exposure

US Imaging Network– Tampa, FL

Accounts Receivable Clerk, 6/2018 to 10/2018

To prepare bank deposits to ensure that all accounts are processed and received to meet company’s needs and to follow all policies and procedures

Experience

Cognizant Technologies, Inc. – Tampa, FL

Claims Examiner, 5/2016 to 8/11/2017

Processing claims, research and review of claims, coordination of benefits, answering client inquiries, status of claims, adjustment of claims, answering inquiries as to company policy.

Jaimeson Lee Realty – Tampa, FL

Mortgage Review Specialist, 7/2011 to 8/2013

Prepare and review mortgage loan files for an initial screening to validate the accuracy of files for fees and or penalties assessed, whether or not loss mitigation procedures were correctly executed within the applicable state and federal Laws. (Temporary employment)

Florida Healthcare Plus – Tampa, FL

Claims Examiner, 12/2013 to 4/2014

Processing claims, research and review of claims, coordination of benefits, answering client inquiries, status of claims, adjustment of claims, answering inquiries as to company policy.

Travelers Property Casualty – Tampa, FL

Medical Appeals/Claims Analyst, 8/1999 to 4/8/2011

Analyze claims to determine extent of company’s liability, make approval or denial decisions and negotiate settlements with claimants in accordance with policy provisions. Collaborate with insurance agents and interview claimants to correct errors, rectify omissions and investigate questionable issues.

Outcomes:

Completed more than 2,500 claims throughout tenure. Provided optimum service to policyholders, negotiated fair settlements and identified fraudulent claims.

Achieved the highest number of inspection appointments (out of 162 colleagues) in 2009. Surpassed goal by averaging 45 appointments monthly (33% above quota).

Selected by supervisor to assist with file closures; resolve complex claims-processing issues; participate in quality-control audits; and monitor claim status updates.

Maintained a superior quality rating of 94% in file handling and claims resolution from 2007 to 2010, exceeding the 85% departmental goal.

Received Peak Performer Awards (2008, 2007) and Service Excellence Award (2007).

Brooklyn College – Brooklyn, NY

Training: Completed extensive training in All lines claims adjuster (parts, repair and medical procedures), Florida regulations; and customer service delivery.

Computers

Microsoft Excel, Word, Access, Outlook

References

Will be provided upon request



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