Case Manager, Claims Adjuster
Resume:
Jody Daniels
****.*.*.*******@*****.*** • 410-***-**** • 3890 S. Luce, Fremont, MI 49412
SUMMARY
Resourceful and creative Case Manager with over 5 years of claims experience. Skilled at claim management, collaborating and working independently. Accustomed to facilitating repairs to completion, working with Subrogation and SIU. Proven track record of rapid advancement and compliance with industry standards and practices. Experience includes BI, PIP, Workers’ Compensation and Litigation.
EXPERIENCE
Newaygo County Commission on Aging (COA), Case Manager, Feb 2023 – Present
-Interview, collect and document information from various people such as clients, agencies, medical providers, attorneys, and police.
-Demonstrate ability to solve problems and coordinate cases that advocate for client care, managing a case load of 100+ clients.
-Engage with team and external providers to form a collaborative care network following independent client assessment.
Progressive Insurance Company, Commercial Claims Adjuster, Dec 2022 - Feb 2023
-Promoted after 3 months to a more challenging role in Heavy Equipment handling, demonstrating rapid advancement and capability.
-Applied claims management experience to execute decision-making to analyze claims exposure, plan the proper course of action, and appropriately resolve claims.
-Interacted extensively with various parties involved in the claim process to ensure effective communication and resolution.
-Provided exceptional customer service to our claimants on behalf of Progressive Insurance Company, exhibiting empathy through each step of the claims process.
-Handled claims consistent with clients' and corporate policies, procedures, and standard methodologies in accordance with statutory, regulatory, and ethical requirements.
-Documented and communicated claim activity timely and efficiently, supporting the outcome of the claim file.
Progressive Insurance Company, Claims Adjuster, Apr 2019 - Jul 2021
-Selected for pilot MD Total Loss Team because of expedient claim handling.
-Received Rep of the Quarter in 2020 and 2021.
-Applied claims management experience to execute decision-making to analyze claims exposure, plan the proper course of action, and appropriately resolve claims.
-Interacted extensively with various parties involved in the claim process to ensure effective communication and resolution.
-Provided exceptional customer service to our claimants on behalf of Progressive Insurance Company, exhibiting empathy through each step of the claims process.
-Handled claims consistent with clients' and corporate policies, procedures, and standard methodologies in accordance with statutory, regulatory, and ethical requirements.
-Documented and communicated claim activity timely and efficiently, supporting the outcome of the claim file.
Law Offices of Leo P. Hylan, P.A., Case Coordinator, Jul 2016 - Apr 2019
-Negotiated terms for Bodily Injury, Personal Injury, Workers Compensation, and assisted attorney with criminal defense cases.
-Estimated cost of treatment or compensation for those injured in accidents and presented to attorney.
-Analyzed and interpreted medical reports, followed up with no-fault parties, and managed claims process to ensure efficient resolution.
-Established action plan based on case facts, best practices, protocols, regulatory issues and available resources and presented to attorney.
-Conducted investigations of claims to confirm coverage and to determine liability, compensability and damages and presented to attorney.
SKILLS
-Insurance Principles: Liability Determination, Policy Analysis, Claims Adjustment, Risk Assessment, Coverage Verification, Settlement Negotiation
-Analytical Tools: MS Office, Claims Management Software, Automated Estimating Systems
-Regulatory Compliance: FAIR Claims Settlement Practices, Subrogation Principles, State-Specific Insurance Laws, Ethical Guidelines, Privacy Protections, Documentation Standards
-Administrative Skills: Data Entry Record Keeping, Claims File Management, Correspondence Handling, Workflow Scheduling, Documentation Review
EDUCATION
Bachelor of Science • Recreation Therapy/Speech Pathology
Western Michigan University
LICENSES & CERTIFICATIONS
Florida Property and Casualty Adjuster License
State of Florida Depart of Finance, Issued Mar 2022
Certified Michigan Medicare and Medicaid (MMAP) Counselor
Area Agency on Aging, Grand Rapids, MI, Issued June 2023-Present
Certified Navy Ombudsman Trainer
Department of Defense, United States Naval Academy, Annapolis, MD, Issued 2015
VOLUNTEER ACTIVITIES
Buddy, Night to Shine, Fremont, MI, Present
Leader, High School Youth Program, Light House Church, Glen Burnie, MD, 2020-2021
ESL (English as a Second Language) Teacher, Broadneck Evangelical Presbyterian Church, Arnold, MD, 2013-2019
Preschool Teacher, Broadneck Evangelical Presbyterian Church, Arnold, MD, 2012-2019
Contact this candidate