Sharon Chavis
Claim Specialist II at Aon Affinity Travel Practice- Claim this Profile
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Topline Score
Bio
Credentials
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Notary Public
North Carolina Department of the Secretary of StateApr, 2021- Oct, 2024 -
Associate In Claims
The Institutes -
Certificate In General Insurance
The Institutes -
Fraud Claim Law Associate
American Educational Institute, Inc. -
NC Adjuster License
North Carolina Department of Insurance -
Senior Claim Law Associate
American Educational Institute, Inc.
Experience
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Aon Affinity Travel Practice
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United States
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Insurance
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1 - 100 Employee
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Claim Specialist II
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Mar 2023 - Present
Review and service claims according to plan provisions. Examine claim submissions to confirm coverage. Review and analyze medical records, itineraries, and other documentation to determine validity of claims. • Communicate effectively with customers and travel suppliers. • Proactively work to resolve claims in a timely manner. • Update claim reserves • Thoroughly document claim file with necessary details. Review and service claims according to plan provisions. Examine claim submissions to confirm coverage. Review and analyze medical records, itineraries, and other documentation to determine validity of claims. • Communicate effectively with customers and travel suppliers. • Proactively work to resolve claims in a timely manner. • Update claim reserves • Thoroughly document claim file with necessary details.
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Conduent
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United States
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IT Services and IT Consulting
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700 & Above Employee
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Subrogation Recovery Analyst
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Oct 2022 - Mar 2023
Negotiated reimbursements from third-party liability cases on behalf of various health plans. • Managed an inventory of cases for health plan reimbursement in third-party liability claims. • Responded to and made requests for information and documentation relating to healthcare recovery rights. • Made outbound calls and communicated with attorneys, insurance adjusters, health providers and health plan members. • Applied knowledge of applicable state and federal laws related to… Show more Negotiated reimbursements from third-party liability cases on behalf of various health plans. • Managed an inventory of cases for health plan reimbursement in third-party liability claims. • Responded to and made requests for information and documentation relating to healthcare recovery rights. • Made outbound calls and communicated with attorneys, insurance adjusters, health providers and health plan members. • Applied knowledge of applicable state and federal laws related to healthcare recovery rights. Show less Negotiated reimbursements from third-party liability cases on behalf of various health plans. • Managed an inventory of cases for health plan reimbursement in third-party liability claims. • Responded to and made requests for information and documentation relating to healthcare recovery rights. • Made outbound calls and communicated with attorneys, insurance adjusters, health providers and health plan members. • Applied knowledge of applicable state and federal laws related to… Show more Negotiated reimbursements from third-party liability cases on behalf of various health plans. • Managed an inventory of cases for health plan reimbursement in third-party liability claims. • Responded to and made requests for information and documentation relating to healthcare recovery rights. • Made outbound calls and communicated with attorneys, insurance adjusters, health providers and health plan members. • Applied knowledge of applicable state and federal laws related to healthcare recovery rights. Show less
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Builders Mutual
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Insurance
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200 - 300 Employee
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Agency Service Representative
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Feb 2022 - Sep 2022
Provided customer service support to agents and underwriters. Handled various inquiries and requests for commercial policies. • Determined timely and accurate premium charge for commercial lines using automated and manual methods. • Determined appropriate codes and classifications on commercial line policies. • Ordered and screened miscellaneous reports needed in the rating and underwriting processes, such as ISO rates, Motor Vehicle Reports, loss history reports, credit checks, loss… Show more Provided customer service support to agents and underwriters. Handled various inquiries and requests for commercial policies. • Determined timely and accurate premium charge for commercial lines using automated and manual methods. • Determined appropriate codes and classifications on commercial line policies. • Ordered and screened miscellaneous reports needed in the rating and underwriting processes, such as ISO rates, Motor Vehicle Reports, loss history reports, credit checks, loss control, etc. • Determined appropriate codes and classifications on commercial line policies. Show less Provided customer service support to agents and underwriters. Handled various inquiries and requests for commercial policies. • Determined timely and accurate premium charge for commercial lines using automated and manual methods. • Determined appropriate codes and classifications on commercial line policies. • Ordered and screened miscellaneous reports needed in the rating and underwriting processes, such as ISO rates, Motor Vehicle Reports, loss history reports, credit checks, loss… Show more Provided customer service support to agents and underwriters. Handled various inquiries and requests for commercial policies. • Determined timely and accurate premium charge for commercial lines using automated and manual methods. • Determined appropriate codes and classifications on commercial line policies. • Ordered and screened miscellaneous reports needed in the rating and underwriting processes, such as ISO rates, Motor Vehicle Reports, loss history reports, credit checks, loss control, etc. • Determined appropriate codes and classifications on commercial line policies. Show less
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Allstate
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United States
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Real Estate
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Casualty Claims Adjuster
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Mar 2020 - Oct 2021
In this job role, I determined liability and resolved claims with injured parties as well as enhanced service quality and consumer compliance to provide compassionate service. • Identified claim coverage on basis of all policy regulations. • Developed and maintained precise loss cost costs and reserved each claim. • Acknowledged and addressed clients' feedback and counseled them on coverage considerations. • Reviewed claims, including taking recorded statements, reviewed medical… Show more In this job role, I determined liability and resolved claims with injured parties as well as enhanced service quality and consumer compliance to provide compassionate service. • Identified claim coverage on basis of all policy regulations. • Developed and maintained precise loss cost costs and reserved each claim. • Acknowledged and addressed clients' feedback and counseled them on coverage considerations. • Reviewed claims, including taking recorded statements, reviewed medical reports/lost wage data, reporting claim files, along with preparing investigation summaries.
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Inside Liability Adjuster
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Dec 2018 - Mar 2020
In this position, I managed all aspects of the claim, including gathering statements and evaluating coverage. I communicated with customers for assessment and collected facts/reported complaints liability information. I performed non-injury responsibility inquiries and secured agreements. • Completed claim investigations within four days. • Insured contact 91.7% with a target rate of 85% - 90%. • Claimant contact 93.5% as compared to the goal of 85% - 90%.
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Casualty Processor
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Jan 2010 - Nov 2018
In this role I obtained medical bills, records, and other documentation. I verified that Medicare/Medicaid reporting was done timely. • File quality reviews 97.4% compared to the goal of 90%. • Resolved telephone inquiry calls with an average rate of 99.84%, compared to a goal of 96%. • Identified and managed risk in compliance with rules, internal controls, Sarbanes-Oxley, fraud detection and prevention.
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Education
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2022 - 2023
Vance-Granville Community College
Associate's degree, Paralegal Technology -
Franklinton High School
High School Diploma
Community
