Claims Adjuster/Customer Service Representative
Resume:
Kayla Fisher
Professional Summary
Experienced claims adjuster specializing in Workers Compensation and Casualty/Bodily Injury claims. I negotiate peaceful resolutions of all claims with an emphasis on fairness and thoroughness, Trustworthy and dependable.
License #18486834:
Arkansas Insurance/Worker's Compensation Adjuster – Active
Certificates:
AED/CPR – April 19, 2018
Casualty & Loss Adjusting - November 30, 2018
HIPPA - February 22, 2019
Work History:
January 2020 – Present, Arkansas Blue Cross & Blue Shield – Little Rock, Arkansas
Customer Service Representative
Demonstrate proficiency in products and services.
Provide exceptional customer service by listening, understanding and, when necessary, demonstrate empathy for the caller’s needs and situation.
Review and proficiently explain coverage provisions, claims statuses and claims decisions as related to general medical diagnostic terminology.
Navigate multiple systems as sources of customer information to answer inquiries and correspondence.
Effectively work with team lead and supervisor to resolve service requests in an accurate and timely manner.
Maintain well written notes/documentation on all service interactions in a Customer Service Management System so that team members can quickly and accurately understand and follow up if necessary.
Manage all self-reporting related to productivity as required.
June 2020 – October 2020, Independent Adjuster/Contractor – Austin, Arkansas
Worker’s Compensation Adjuster
• Review and analyze suspicious and potentially fraudulent insurance claims.
• Conduct thorough investigations including obtaining necessary documents/forms from claimants and
Insureds; conduct recorded statements.
• Evaluate policy coverage, liability and damages/injuries.
• Evaluate all evidence with the goal of creating positive outcome for client’s claims.
• Prepare prosecution packages and restitution proposals.
• Establish productive working relationships with public officials and law enforcement officers.
• Review new files to determine status of injury and develop a plan of action.
• Answer questions posed by insured & maintain contact with claimants to determine treatment status.
• Document all investigative activity and present reports to management.
• Sustain legitimate claims and deny unjustified claims
August 2010 – June 2019, Arkansas Municipal League – North Little Rock, Arkansas
Workers' Compensation and Liability/Casualty Adjuster
• Review and analyze suspicious and potentially fraudulent insurance claims.
• Conduct thorough investigations including obtaining necessary documents/forms from claimants and
Insureds; conduct recorded statements.
• Evaluate policy coverage, liability and damages/injuries.
• Evaluate all evidence with the goal of creating positive outcome for client’s claims.
• Prepare prosecution packages and restitution proposals.
• Establish productive working relationships with public officials and law enforcement officers.
• Review new files to determine status of injury and develop a plan of action.
• Answer questions posed by insured & maintain contact with claimants to determine treatment status.
• Document all investigative activity and present reports to management.
• Sustain legitimate claims and deny unjustified claims
Education
Pulaski Technical College – Early Childhood Education – North Little Rock, Arkansas
Calvary Academy – High School -North Little Rock, Arkansas
Skills
Arkansas Worker’s Compensation Insurance
Subrogation
Restitution Proposals
Insurance policy coverage knowledge
Data analysis/entry
Microsoft Word, Excel and advanced computer skills
Skilled multi-tasker
Advanced oral and written communication skills
Strong Organization Skills
Contact this candidate