Service Representative Claims Adjuster
Resume:
PROFESSIONAL PROFILE
Results-oriented and resourceful Independent Adjuster having 15+ years’ experience in streamlining claims in a most efficient manner. Adept at leveraging knowledge in evaluating losses and property damages, examining estimates, and determining policy coverages. Streamlines claims designated and diligently communicates with Insured, Agents, Vendors, and other third parties while handling multiple assignments. Currently seeking an Property Field Adjuster position to effectively inspect, facilitate solutions, create estimates, and implement positive changes to achieve sustainability and growth in challenging Adjusting conditions.
Whitestown, IN
WORK EXPERIENCES
Auto Claims Adjuster Mar 2022 to Current
The Littleton Group Austin, TX
• Streamlined settlements with customers and lien holders paid out total loss settlements and obtained necessary documents to process titles for branding.
• Determined cause and extent of damages by investigating claims with underwriters and insurance agents in field.
• Delivered exceptional customer support to members, providers, billing departments and other insurance agency's regarding claims, appeals and eligibility.
• Effectively scrutinized extent of damage and documented findings.
• Researched and verified insurance policy coverage.
• Explained complex regulations and policy guidelines to clarify claims process for insured parties.
• Evaluated and investigated over 30 auto claims in one week and decided whether insurer should pay claim.
Patient Service Representative Oct 2008 to Feb 2022 St Vincent Hospital Worcester, MA
• Warmly ushered inpatients and visitors, checks patients in and out and obtains necessary documentation.
• Authenticated and entered demographic information.
• Obtained and verified insurance authorizations/precertification.
• Completed medical record release requests and schedules/confirms patient appointments.
• Entered reviews and submitted changes for patient procedures and services.
• Reviewed and corrected claim errors to facilitate smooth processing.
• Rendered excellent assistance to patients in filling out check-in and payment paperwork.
Customer Service, AIU Claims Adjuster Feb 2006 to Feb 2022 Farmers Insurance Exchange
• Gained and employed strengths in policy adherence, team building, and training.
• Diligently applied knowledge of auto insurance contracts, state laws and regulations, automotive repair experience, medical and anatomical knowledge while interviewing all parties to determine facts of claims.
• Organized and processed approximately 1500 auto claims annually utilizing appropriate procedures to include medical summary preparation for auto injury claims.
**************@*****.***
LICENSES
• CT 11465531
• AZ 11465531
• OR 11465531
• NH 11465531
• NC 11465531
• SC 11465531
• WA 1163699
• DE 1084126
• FL W371226
• OK 300*******
• IN 170831
• KY Doi-970519
• RI 2089180
• VT 3279005
CERTIFICATIONS
• State Farm Auto
CORE COMPETENCIES
• Strong Communication Skills
• Great Interpersonal Skills
• Research Skills
• Service Orientation
• Conflict Resolution
• Team Player/Management
• Customer Service
• Claims Handling and
Investigations
• Risk Assessment & Mitigation
• Liability Exposure Evaluation
• Policy Management
• Confidential Records
Management
• Insurance Regulations
• Damage Estimating
• Auto Claims
https://www.linkedin.com/in
/genia-mcclain-a0218649/
E U G E N I A L . M C C L A I N
Experienced & Result-Oriented Independent Adjuster WORK EXPERIENCES (CONT’D)
• Accomplished full investigations to determine claim liability.
• Liaised with designated litigation teams to ensure all documentations were in order and lawfully recorded.
• Participated as a member employee satisfaction committee.
• Current champion of Care Concierge for repair shops.
• Responded to customer requests for products, services, and company information.
• Offered advice and assistance to customers, paying attention to special needs or wants. EDUCATION
• Certificate, Medical Billing
Parkland Community College
• Diploma
Douglas MacArthur High School
References Available Upon Request
Contact this candidate