Claims Representative Service

AMBER STEMBRIDGE

Albuquerque, NM *****!"702-***-**** !"*.*.**********@*****.***

PROFESSIONAL SUMMARY

Hardworking bodily injury adjuster brining nine years of claims experience meeting customer needs via telecommuting roles. Skilled at listening to customers needs, maintaining communication and meeting productivity targets. Proven ability to build and maintain rapport with attorneys in order to facilitate a seamless negotiation process and bring the file to closure. Skilled at time management to ensure compliance within company standards. Offering empathy, reliability and a desire for growth. ACCOMPLISHMENTS

*asked to join the limited GEICO commercial team

*promoted to Performance Monitoring Technician

*quickly promote to Telephone Claims Representative I with commercial auto, handling and maintaining a diary of 19 states

*started handling third party injury claims at a TCRI level

*promote to TCRII

*graduation from Claims Liability School

Insurance Policy Coverage Knowledge

Liability Investigation

Problem resolution

Documentation Review

DE and NC Claims Adjuster License

Diary Maintenance

SKILLS

Oral and written communication skills

Relationship development

Knowledge of commercial auto

Settlement determinations

Time Management

WORK HISTORY

Legal Claim Representative, 09/2020-Current

Will Ferguson and Associates – Albuquerque, NM

Meet with and interview potential clients

Set up the claim with the respective inusrance company, draft and send Letter of Representation Interview witnesses, make contact with law enforcement if need be Order police reports

Help facilitate treatment

Review and confirm all applicable lines of coverage Maintain open lines of communication with insurance company and clients Order and review medical bills and records

Draft demand and settlement authority

Negotiate settlement with insurance company

Draft settlement statement

Request reduction from any applicable provider or health insurance carrier Disburse to client

Claims Service Rep/Telephone Claims Representative I/ Telephone Claims Representative II-Bodily Injury Adjuster, 12/2011 to 09/2020

GEICO – Fredericksburg, VA

Evaluated coverage, liability and damages and investigated suspicious claims. Interviewed policyholders, witnesses and third parties to gather information and details regarding injury event.

Interviewed relevant parties to determine claim denial or settlement. Interpreted policy details and recommended most favorable course of action. Examined forms to determine insurance coverage.

Prepared and presented complex cases to management, in-house legal team and Claims Committee Set and maintain reserves that are appropriate for level of injury and within company guidelines. Communicate entire claims process from start to finish with insured and relevant parties. Conducted claims investigations by obtaining written statements, preparing reports, researching public records and conducting personal interviews.

Evaluate, recommend authority and settle demands with both attorneys and unrepresented parties. Customer Service Representative, 08/2010 to 11/2011 Pediped Footwear – Las Vegas, NV

Responded to customer requests for products, services and company information. Communicated with vendors regarding back order availability, future inventory and special orders. Offered advice and assistance to customers, paying attention to special needs or wants. Health Advisor/Claims Representative, 09/2007 to 07/2010 United HealthCare – Chico, CA

Maintained full and current understanding of available plans, products and services. Provided information such as copay and premium details, pre-approval procedures and available products.

Helped members navigate enrollment process and choose appropriate options. Resolved problems related to benefits, eligibility and claims. Promoted available resources and connected individuals with services. Addressed and resolved problems with complex claims issues EDUCATION

Human Services

Germanna Community College - Fredericksburg, VA

Human Services

Yuba Community College - Yuba City, CA

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