Customer Service Total Loss

LAMONICA BROWN

Texarkana, AR ***** 972-***-**** ***********@*****.***

Summary

Dynamic PD/Total Loss Adjuster with Sea Harbor Insurance, adept at settlement negotiation and claims assessment. Proven track record in streamlining documentation management and enhancing customer service. Recognized for effective communication and conflict resolution skills, ensuring fair compensation and timely processing of claims while maintaining compliance with insurance regulations. Core Competencies

Strong Communication Skills

Settlement negotiation

Documentation management

Liability evaluation

Payment processing

Repair coordination

Customer service

Great Interpersonal Skills

Conflict Resolution

Policy Management

Claims Handling/Investigations

Insurance Regulations

Property/Auto Claims

Time Management

Professional Experience

PD/TOTAL LOSS ADJUSTER 01/2023 - 12/2024

Sea Harbor Insurance - Dallas, TX

Streamlined settlements with vehicle owners following the determination of their vehicle as a total loss, presenting various options to ensure fair compensation in accordance with policy terms and regulations. Compiled and attached all necessary documentation to the claims file, including Power of Attorney (POA), evaluation documents, salvage documentation, offer letters, Total Loss (TL) calculator documents, Texas Department of Transportation (TxDOT) documents, and others as required. Initiated contact with vehicle owners to review and discuss settlement documents, ensuring clarity and understanding of the proposed settlement terms.

Verified representation status by checking for attorney representation letters before engaging in claim discussions with represented parties.

Coordinated with lien holders to obtain payoff amounts and letters of guarantee as needed for settlements involving financed vehicles.

Facilitated payment processing upon completion of required documentation, ensuring timely disbursement to vehicle owners or lien holders in accordance with settlement agreements. CLAIMS HANDLER PROPERTY DAMAGE/TOTAL LOSS 01/2022 - 09/2022 Liberty Mutual - PLANO, TX

Provided support and assistance to customers involved in automobile accidents, guiding them through the claims process with empathy and professionalism.

Conducted interviews with both the insured party and the claimant, capturing pertinent details through recorded or written statements to facilitate accurate claim assessment. Gathered and compiled essential evidence, including photos, videos, police reports, and witness statements, to establish the facts of the accident and determine coverage and liability. Collaborated with internal and external stakeholders to assess coverage and liability, ensuring fair and prompt resolution of claims.

Initiated the repair process by identifying reputable repair shops and arranging for vehicle repairs, as well as coordinating rental car reservations, if necessary, to minimize inconvenience for the insured party. Communicated clearly and effectively with the insured party or claimant, providing comprehensive explanations of the repair process.

Facilitated payment for repairs conducted on behalf of the insured party or claimant directly to the repair shop, streamlining the reimbursement process.

SUBROGATION CASEWORKER 09/2015 - 01/2022

Health Management Systems/Gainwell Technologies - Irving, TX Negotiated settlements with responsible parties to maximize subrogation recoveries. Reviewed and evaluated subrogation claims to determine potential recovery opportunities. Analyzed medical records, bills, and other related documents to identify liability issues. Adhered strictly to company policies regarding confidentiality and data security measures. Maintained accurate records of all activities related to assigned cases including correspondence, negotiations, payments, and settlements.

Provided support services such as document preparation or filing paperwork with courts or government agencies when necessary.

WAREHOUSE PACKAGE HANDLER PART/TIME 09/2019 - 02/2020 FedEx - Coppell, Texas

Ensured compliance with company policies regarding safety, security and cleanliness of the warehouse premises. Assisted with loading and unloading heavier objects using hand-trucks or pallet jacks. Picked, packed and prepared items for shipment according to customer specifications. Utilized scanning equipment to track movement of items throughout the facility. Unloaded incoming packages from delivery trucks and verified contents against shipping documents. Loaded outgoing packages onto delivery trucks according to customer orders. Followed safety protocols when handling hazardous materials such as chemicals or inflammable liquids. Sealed boxes securely with tape for safe transport of goods to customers. Loaded completed orders on pallets according to delivery numbers. Provided customer service by answering queries regarding package status and delivery. Worked flexible hours, including weekends and holidays, to meet business needs. INSURANCE VERIFICATION SPECIALIST 12/2012 - 10/2014 TMI Sports Medicine & Orthopedics - Arlington, TX

Reviewed medical records to ensure accuracy of required information needed for pre-authorization requests. Verified patient eligibility for insurance coverage by contacting insurance carriers and obtaining the necessary authorization numbers.

Conducted regular audits of patient accounts for accuracy of demographic data. Monitored changes in government regulations affecting healthcare reimbursement systems. Collaborated with internal staff members such as Billing Specialists, Medical Coders to resolve any discrepancies in patients' insurance information.

Researched third party payer guidelines related to prior authorizations, coding and billing processes. Maintained confidentiality of patient information in accordance with HIPAA regulations. Maintained accurate documentation on all pre-authorization requests, denials and appeals. Licenses

Texas, 2272863

State Farm Property certification

State Farm Estimatics certification

State Farm Auto certification

References

References available upon request.

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