Experience

Bankers Financial Corporation

• United States
• Financial Services
• 100 - 200 Employee

• Independent Claims Adjuster

  • Jun 2016 - Present

  Investigate and handle auto liability claims to disposition in a team environment Review 1st and 3rd party property damage and handled reserves and payments accordingly Examine policies to aid in coverage investigations Identify subrogation potential and negotiated settlements with third party carriers. Investigate and analyze auto liability and unrepresented bodily injury claims. Review and establish values on submitted estimates for payment or denial up to authority limit of $50,000. Show less



NueMD

• United States
• Information Technology & Services
• 1 - 100 Employee

• Electronic Data Interchange (EDI) Claims Specialist

  • Feb 2012 - Jun 2016

  Resolved and satisfied client requests and internal operational issues. Investigated claim rejections issues to identify discrepancies and determine appropriate solutions. Negotiated claim settlement with claimant carriers to recover funds paid on healthcare claims.

• Contract Medical Billing Services Representative

  • Jan 2013 - Nov 2015

  Evaluated organized and generated patient statements. Executed various collection actions such as, resubmitting claims to third party payers. Managed healthcare practice Accounts/Receivable reports



ACS A Xerox Company

• Tallahassee, FL

• Workers Compensation Claims Examiner

  • Jan 2005 - Jun 2011

  Evaluated and adjusted lost time claims for Federal Workers Comp employees. Calculated and maintained proper monetary reserves on claims, and recognized and pursued recoveries through subrogation or the Special Disability Trust Fund. Audited the handling of claims to ensure adherence to quality and compliance Submitted claims within assigned limits for payment Submitted letters of appeal to claimants district office Supplied coding and fee schedule updates to healthcare providers and medical staff Cross-trained and provided back-up for other Customer Service Representative when needed. Show less