Experience

Paragon Subrogation Services, LLC

• United States
• Insurance
• 1 - 100 Employee

• Arbitration Specialist

  • May 2018 - Present

  Subrogation Specialist Review collection files to verify claim amount, determine recovery potential and next steps in the collection process Subrogate against Uninsured Motorist and other Insurance Companies Review and respond to incoming correspondence Conduct negotiations within assigned authority to settle claims Arbitration Specialist Accept claim assignments electronically and review all pertinent documents, evidence and the adverse carriers liability position… Show more Subrogation Specialist Review collection files to verify claim amount, determine recovery potential and next steps in the collection process Subrogate against Uninsured Motorist and other Insurance Companies Review and respond to incoming correspondence Conduct negotiations within assigned authority to settle claims Arbitration Specialist Accept claim assignments electronically and review all pertinent documents, evidence and the adverse carriers liability position Evaluate the facts of loss of an auto claim and examine file materials that may be used as evidence to support liability theory and damages (police reports, recorded statements, photographs, etc) Communicate effectively with insured customers, general adjusters, claimants, witnesses, experts and attorneys in order to obtain any additional necessary information Determine each file for Arbitration viability Review the initial applicant Arb, counter and response/counter Arbitrations Write persuasive Contentions presenting our clients theory of liability while also creating a theme for the case and the clients request for damages Prepare persuasive arguments through written contentions and gathered evidence Prepare the arbitration and evidence and submit via Total Recovery Solution (TRS), via Arbitration Forum’s, Inc. website Handle and/or address challenge defenses, deferments, appeals and errors Maintain quality in claim documentation and arbitration filings in accordance with department expectations Respond professionally and promptly to telephone calls and emails Review files using a diary system in order to review and handle claims and correspondence within allotted time guidelines Show less Subrogation Specialist Review collection files to verify claim amount, determine recovery potential and next steps in the collection process Subrogate against Uninsured Motorist and other Insurance Companies Review and respond to incoming correspondence Conduct negotiations within assigned authority to settle claims Arbitration Specialist Accept claim assignments electronically and review all pertinent documents, evidence and the adverse carriers liability position… Show more Subrogation Specialist Review collection files to verify claim amount, determine recovery potential and next steps in the collection process Subrogate against Uninsured Motorist and other Insurance Companies Review and respond to incoming correspondence Conduct negotiations within assigned authority to settle claims Arbitration Specialist Accept claim assignments electronically and review all pertinent documents, evidence and the adverse carriers liability position Evaluate the facts of loss of an auto claim and examine file materials that may be used as evidence to support liability theory and damages (police reports, recorded statements, photographs, etc) Communicate effectively with insured customers, general adjusters, claimants, witnesses, experts and attorneys in order to obtain any additional necessary information Determine each file for Arbitration viability Review the initial applicant Arb, counter and response/counter Arbitrations Write persuasive Contentions presenting our clients theory of liability while also creating a theme for the case and the clients request for damages Prepare persuasive arguments through written contentions and gathered evidence Prepare the arbitration and evidence and submit via Total Recovery Solution (TRS), via Arbitration Forum’s, Inc. website Handle and/or address challenge defenses, deferments, appeals and errors Maintain quality in claim documentation and arbitration filings in accordance with department expectations Respond professionally and promptly to telephone calls and emails Review files using a diary system in order to review and handle claims and correspondence within allotted time guidelines Show less



Western General Insurance Company

• United States
• Insurance
• 1 - 100 Employee

• Subrogation Specialist

  • Feb 2016 - Nov 2017

  * Review collection files to determine recovery potential and approach in the collection process * Complete required investigations on referred files in a timely manner * Obtain relevant evidence and information regarding suspicious claims * Review Police Reports to ensure facts of losses are accurate * Conduct additional investigation into claims when necessary to expedite the Subrogation process * Prepare subrogation demands and documents against other carriers * Negotiate… Show more * Review collection files to determine recovery potential and approach in the collection process * Complete required investigations on referred files in a timely manner * Obtain relevant evidence and information regarding suspicious claims * Review Police Reports to ensure facts of losses are accurate * Conduct additional investigation into claims when necessary to expedite the Subrogation process * Prepare subrogation demands and documents against other carriers * Negotiate damage and liability disputes to resolve Subrogation Claims * Identify and recommend files for Inter-Company Arbitration * Identify and recommend files for Collections Vendors * Subrogate against Uninsured Motorists * Utilize ISO to locate Uninsured Motorists parties and search for valid insurance or assets * Negotiate and secure lump sum settlements when possible and * Manage accounts receivable and payable for auto related incidents * Serve as interpreter and translator; review, and respond to incoming and outgoing correspondence Show less * Review collection files to determine recovery potential and approach in the collection process * Complete required investigations on referred files in a timely manner * Obtain relevant evidence and information regarding suspicious claims * Review Police Reports to ensure facts of losses are accurate * Conduct additional investigation into claims when necessary to expedite the Subrogation process * Prepare subrogation demands and documents against other carriers * Negotiate… Show more * Review collection files to determine recovery potential and approach in the collection process * Complete required investigations on referred files in a timely manner * Obtain relevant evidence and information regarding suspicious claims * Review Police Reports to ensure facts of losses are accurate * Conduct additional investigation into claims when necessary to expedite the Subrogation process * Prepare subrogation demands and documents against other carriers * Negotiate damage and liability disputes to resolve Subrogation Claims * Identify and recommend files for Inter-Company Arbitration * Identify and recommend files for Collections Vendors * Subrogate against Uninsured Motorists * Utilize ISO to locate Uninsured Motorists parties and search for valid insurance or assets * Negotiate and secure lump sum settlements when possible and * Manage accounts receivable and payable for auto related incidents * Serve as interpreter and translator; review, and respond to incoming and outgoing correspondence Show less



Explorer

• Insurance
• 1 - 100 Employee

• Recovery Representative

  • Jan 2007 - Jul 2016

  * Review and analyze claim files to determine recovery potential * Prepare documents and compile subrogation demands * Negotiate damage and liability disputes to resolve Subrogation Claims * Analyze, prepare and file Inter-Company Arbitrations * Negotiate and secure Medical Payment Reimbursement * Negotiate and secure lump sum settlements when possible, or arranged monthly payments from uninsured motorists * Refer claims to Collections Vendors and prepare claims for… Show more * Review and analyze claim files to determine recovery potential * Prepare documents and compile subrogation demands * Negotiate damage and liability disputes to resolve Subrogation Claims * Analyze, prepare and file Inter-Company Arbitrations * Negotiate and secure Medical Payment Reimbursement * Negotiate and secure lump sum settlements when possible, or arranged monthly payments from uninsured motorists * Refer claims to Collections Vendors and prepare claims for litigation when deemed appropriate * Manage accounts receivable, and reimburse deductible accordingly * Member of Arbitration Forums: Volunteer as a Panelist, participate in arbitration hearings and decision determination for disputed claims Show less * Review and analyze claim files to determine recovery potential * Prepare documents and compile subrogation demands * Negotiate damage and liability disputes to resolve Subrogation Claims * Analyze, prepare and file Inter-Company Arbitrations * Negotiate and secure Medical Payment Reimbursement * Negotiate and secure lump sum settlements when possible, or arranged monthly payments from uninsured motorists * Refer claims to Collections Vendors and prepare claims for… Show more * Review and analyze claim files to determine recovery potential * Prepare documents and compile subrogation demands * Negotiate damage and liability disputes to resolve Subrogation Claims * Analyze, prepare and file Inter-Company Arbitrations * Negotiate and secure Medical Payment Reimbursement * Negotiate and secure lump sum settlements when possible, or arranged monthly payments from uninsured motorists * Refer claims to Collections Vendors and prepare claims for litigation when deemed appropriate * Manage accounts receivable, and reimburse deductible accordingly * Member of Arbitration Forums: Volunteer as a Panelist, participate in arbitration hearings and decision determination for disputed claims Show less



Farmers Insurance

• United States
• Insurance
• 700 & Above Employee

• Subrogation Specialist / Claims Associate / Clerical Supervisor

  • May 1990 - Dec 2006

  Clerical Supervisor - National Complex Large Loss / Suit Against the Exchange Organize workflow to ensure employees understand their duties and responsibilities Prepare and conduct performance evaluation reports and reviews Manage accounts receivable and payable Claims Associate - Automobile Claims / National Complex Large Loss Claims / Suit Against the Exchange First contact to explain… Show more Clerical Supervisor - National Complex Large Loss / Suit Against the Exchange Organize workflow to ensure employees understand their duties and responsibilities Prepare and conduct performance evaluation reports and reviews Manage accounts receivable and payable Claims Associate - Automobile Claims / National Complex Large Loss Claims / Suit Against the Exchange First contact to explain coverage and claim process Provide assistance to adjusters to arrange vehicle inspections and rental reservations Review repair estimate for accuracy and payment Settle Injury cash-out payments within authority Subrogation Specialist / Med Pay Reimbursement Review and analyze files to gather pertinent claim information to determine subrogation potential and collection approach Identify, collect and analyze evidence to determine its value to a specific claim Negotiate damage and liability disputes to settle within the scope of assigned financial authority Process Inter-Company Arbitration filings Follow up on recovery to ensure timely claim resolution Review medical bills to ensure correct coding and accurate charges Pursue Medical Payment reimbursement Review and respond to customer correspondence via e-mail, phone and face to face meetings Monitor claim inventory to ensure timely resolution of all claims Manage accounts receivable and payable for auto related incidents Show less Clerical Supervisor - National Complex Large Loss / Suit Against the Exchange Organize workflow to ensure employees understand their duties and responsibilities Prepare and conduct performance evaluation reports and reviews Manage accounts receivable and payable Claims Associate - Automobile Claims / National Complex Large Loss Claims / Suit Against the Exchange First contact to explain… Show more Clerical Supervisor - National Complex Large Loss / Suit Against the Exchange Organize workflow to ensure employees understand their duties and responsibilities Prepare and conduct performance evaluation reports and reviews Manage accounts receivable and payable Claims Associate - Automobile Claims / National Complex Large Loss Claims / Suit Against the Exchange First contact to explain coverage and claim process Provide assistance to adjusters to arrange vehicle inspections and rental reservations Review repair estimate for accuracy and payment Settle Injury cash-out payments within authority Subrogation Specialist / Med Pay Reimbursement Review and analyze files to gather pertinent claim information to determine subrogation potential and collection approach Identify, collect and analyze evidence to determine its value to a specific claim Negotiate damage and liability disputes to settle within the scope of assigned financial authority Process Inter-Company Arbitration filings Follow up on recovery to ensure timely claim resolution Review medical bills to ensure correct coding and accurate charges Pursue Medical Payment reimbursement Review and respond to customer correspondence via e-mail, phone and face to face meetings Monitor claim inventory to ensure timely resolution of all claims Manage accounts receivable and payable for auto related incidents Show less