Claims Adjuster

TOMMYGAI

Orlando,FL*****

407-***-****

********@*****.***

OBJECTIVE

Seekingachallenging,rewarding,careerfocusedopportunityinwhichIcaneffectivelyutilize myextensivemanagementskills,salesandcustomerserviceexperienceandloyalworkethic. EDUCATION

BachelorsofScienceinHealthCareAdministration

UniversityofPhoenix,2016

LICENSES

FloridaStateLicense/HealthInsurance-License#W489558 HealthLicense-0240

Adjuster,AllLines-0620

PROFESSIONALEXPERIENCE

ProgressiveFortLauderdale,FL/Hybrid Aug2022-Feb2025 PCS/CCUAdjuster

● Investigateclaimsinformation.

● Determinecoverageandliability.

● RunningreportssuchasAccurint,ADD123toconfirmownershipofvehicle.

● RunningISOreportstoconfirmifclaimwasreportedtoClaimantCarrier.

● Makingoutboundcallstoobtainstatementsfromallpartiesinvolvedinaccident.

● Reachingouttoattorneyifinsuredorclaimanthasobtainedone.

● ReachingouttoIAAandBodyshopsifvehicleisatotalorrepairable.

● ProvidingpaymenttoinsureforTotalloss,orreimbursementfortow,rental,etc.

● Providingexcellentcustomerservicetoallpartiesinvolvedintheclaim. EsuranceCoconutCreek,FL/Remote Sept2021-2022

LiabilityClaimsAdjuster

● Providingnecessarysupportforeffectreview,research,andinvestigationofclaims

● Answering/makingcallsto/fromdifferentindividuals,includingclaimants,insured,body shop,attorneys,andmedicalfacilities

● Reviewclaimsubmissions,obtainandverifyinformation,correspondwithinsurance agentsandbeneficiaries,aswellasprocessclaimpayments

● HavingEffectivetimemanagementtohaveorganizedfiles,documents,anddiaries

● Assistingcolleagueswithclaimsandbeingcollaborative PearlHoldingGroupParkland,FL May2019-Sept2020

SalvageProcessor

● Processingtotallosspaperworktoapprovepaymentamountforinsured

● ReachingouttolienholderstoobtaininsuredLetterofGuarantee(L.O.G.)

● WorkingdirectlywithAdjusterstoprovidethemosteffectivecustomerservice

● Maintainingandorganizinginsurefilesanddocuments

● Providingleadershiptoteammemberswheninformationisunknown. AffordableInsuranceGroup(AIG)FortLauderdale,FL May2018-April2019 LicensedCustomerServiceRepresentative

● Makingandreceivingcallsto/fromfromseniorsages65anduptoofferMedicare healthinsuranceplansthroughMutualofOmaha,Aetna,andCigna

● Guidingclientsthroughtheapplicationprocess

● Providinganoverviewofdifferentplanoptionsavailableinclients’area AutoAuctionAdvisorsDavie,FL February2017-March2018 ProcessingManager

● ManagedtheprocessingandfilingofimportantdocumentsrequiredbytheDepartment ofMotorVehiclestofacilitatecarsales

● Performedadministrativeduties,managedrecords,clientinvoicing,andaccounts receivable

● Interactedandassistedwithclienteledaily

● Updatedclientsonthecurrentstatusofvehiclesincludingvehicleinquiriesand documentationstatus

● ArrangedvehicledeliveriesfromvariousManheimAuctionlocations 2

IATInsuranceGroupCoralSprings,FL September2016-February2017 CSRAgent

● Receivedanddirectedcallstoappropriateadjusterbasedonclaim

● Opened/handledcollision,autoandpropertyinsuranceclaims

● Generatedaccidentreportsbasedonclient’sdescriptionofincident

● Contactedbodyshopsregardingcostandstatusofrepairs

● Updatedattorneysondamagesregardingsettlements

● Enteredclaimdataonpaymentprocessingsystem

PROFICIENCIES

ExtensiveKnowledgeofHIPPA

ProficientinMicrosoftOfficeandAdobeAcrobat

DetailedandOrganized

BilingualinEnglishandHaitianCreole

Extensiveinterpersonalskills

Referencesavailableuponrequest

2

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