Experience

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  Carespot urgent care

  Mar 2014 - Jul 2015

  Claims adjuster

  • Provide employees and supervisors with information regarding workers compensation claims.• Communicating with workers compensation insurance companies to verify if the claim has been reported. • Communicating with adjusters who denied claims that were not related to workers compensation.• Mailing out claims,• Updating CPT codes. • Submitting appeals for denied claims. • Confirmed or denied coverage based on facts obtained during the investigation and advises policyholders as to proper course of action. Show less

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  One call

  Aug 2015 - Aug 2016

  Claims adjudicator

  • Performed matching referrals to claims for workers compensation dealing with physical therapy, occupational therapy, chiropractic therapy and Aquatic therapy.• Researched for preauthorization from providers, adjusters or case managers.• Worked over authorized visits by denying or obtaining a new prescription from the Doctor.• Denied any claims that were not authorized after protocol was completed.• Reviewed claims to make sure ICD 10 codes and CPT codes were valid.• Reviewed and researched policy contracts, regulations, and cause of injury to make coverage decisions Show less

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  Geico

  Sept 2016 - Aug 2017

  Claims adjuster

  • First point of contact with policyholders after they experienced a boating accident.• Collected all facts and data• Reviewed policy coverages and endorsements. • Reviewed reports, estimates and photos for settlement.• Drafted coverage decision letters to insured.• Negotiated with repair facilities and vendors on their estimates.

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  State farm

  Sept 2017 - Jul 2019

  Claims adjuster

  Member of the ECR Auto Weather Catastrophe team responsible for processing claims involving flood/hail/hurricane damages.• Reviewed and settled non-weather related claims for sump pump, pipes, and other non-weather related damages.• Calculate injury/reserves evaluations• Conduct thorough investigations• Actively created and implemented file strategies, management of litigation and appropriate resolution of claims.• Experience evaluating claims in a number of jurisdictions.• Worked on multi-peril claims.• Handled AWC Total Loss Claims Show less

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  Allstate

  Jul 2019 - Jun 2022

  Property claims adjuster

  Handled a claim count of 70 or more• Worked CAT and daily claims• Re-ran and reviewed Xactimate when needed• Reviewed and settled Hurricane Irma, Hurricane Michael, Hurricane Sally, and Tropical Storm Eta claims.• Reviewed and settled non weather water claims according to the policy• Worked on multi-peril claims• Negotiated settlements with attorney’s, public adjuster, and insureds.• Negotiated invoices with third party contractors, AOB companies and borrowers• Well versed in coverages including but not limited to coverage A, B, C, and D with the ability to explain the covered and non-covered items based on the policy and the covered peril.• Reviewed polices to determine coverage and issued payment accordingly. Show less

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  Citizens property insurance corporation

  Jul 2022 - Oct 2022

  Policy services

  • Effectively respond via telephone to concerns of both internal and external customers. • Process basic underwriting endorsement and/or policy changes within approved authority level.• Perform transactions according to latest corporate standards, manual rates, guidelines, and procedures.• Review various supporting documents for compliance with departmental guidelines, which may include gathering and forwarding information to other areas for handling or consideration.• Perform specialized functions and projects in accordance with departmental rules and regulations. Show less

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  International programs group

  Sept 2023 - now

  Claims examiner/ litigation

  Conduct thorough and fair investigations by obtaining facts to determine coverage, origin and extent of property losses and commercial losses.Worked on CAT and daily claims.Liaison for Handling Hurricane Ida Litigation files in suit.Handled a claim count of 70 or more.Reviewed and settled Hurricane Ida files.Reviewed Answer and affirmative defenses, Jury orders, signed dismissal and executed release documents, case management order, dealing with special masters to conduct mediation.Worked directly with defense attorneys and clients regarding preliminary reports with settlement authorities for Indemnity reserves and legal reserves.Reviewed IA’s report and estimates.Negotiated settlements with attorney’s public adjuster, and insureds. Show less