Homeslice213 User
@homeslice213user
Highly motivated claims professional with 15+ years of experience
What I'm looking for
As a seasoned claims professional with over 15 years of experience in the insurance field, I have consistently exceeded expectations and demonstrated a strong ability to adapt to new challenges. With a strong background in property claims, liability investigations, and payment negotiations, I have honed my skills in claims processing, coverages, and liabilities. My expertise extends to managing claims according to state laws in Ohio, Kentucky, and Tennessee.
Throughout my career, I have demonstrated a commitment to growth and development, providing timely and critical feedback to improve claim process systems and training. I have also invested in the growth and development of colleagues, providing frequent training and mentorship to teammates and new employees. My strong communication skills have enabled me to conduct professional and productive conversations with policyholders, claimants, and external vendors.
I am now seeking a new opportunity to apply my skills and experience in a new endeavor, where I can continue to grow and develop as a professional.
Experience
Work history, roles, and key accomplishments
Care Coordinator
Quantum Health
Jan 2024 - Present (1 year 4 months)
Assists members in navigating the health insurance space by explaining benefits, claims status, and negotiating billing issues. Works with providers to obtain preauthorization for procedures and confirm benefits.
Claims Adjuster
Hagerty Insurance
Feb 2020 - Oct 2023 (3 years 8 months)
Processed claims in a team-centered environment, handling coverage questions and liability investigations. Negotiated payments and settlements while managing claims according to state laws.
Claim Representative II
Mapfre Insurance/American Commerce Insurance
Jun 2016 - Apr 2020 (3 years 10 months)
Managed property claims and handled payments while conducting liability investigations. Actively improved departmental processes and monitored for fraudulent activity.
Claims Experience Specialist
Safeware Insurance
Apr 2018 - Mar 2020 (1 year 11 months)
Processed claims and investigated coverage issues while maintaining service level agreements. Provided feedback to improve claims processing workflows.
Fraud Loss Prevention Representative
Discover Financial Services
Jan 2016 - Feb 2016 (1 month)
Handled card member accounts, addressing concerns related to fraudulent activity and customer service. Conducted effective research to identify potential fraud.
Claims Representative
State Farm Insurance
Jan 2003 - Jan 2016 (13 years)
Processed claims and managed property claims while handling coverage questions and liability investigations. Provided training and mentorship to colleagues.
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Homeslice213 hasn't added their education
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