Amanda Reynolds
Indianapolis,IN
Summary
Analytical problem-solver with excellent communication skills. Effective at interviewing claimants, compiling records and documenting findings. Well-versed in insurance policies, practices and standards.
Overview
13
13
years of professional experience
Work History
Claims Representative Associate
Nationwide Insurance Company
04.2022 - Current
- Successfully Maintained 95% claim closure ratio
- Collaborated with internal departments and external vendors to achieve fast resolution of claims.
- Followed up with customers on unresolved issues.
- Monitored compliance with regulations and industry best practices to promote fair and proper treatment for insured customers.
- Reviewed insurance and claims documents to verify required information and secure any missing data for settlements.
- Performed administrative duties by verifying documentation, researching facts ,contacting other parties involved to determine fault percentages and minimize potential losses.
- Understood requirements for disputes, gathered evidence to support claims and prepared customer cases to handle appeals.
- Conducted full claim investigations reported updates and legal actions.
- Escalated files with significant indemnity exposure to supervisor for further investigation.
- Negotiated with other involved parties to arrange settlements for maximum results.
- Drafted and reviewed legal documents utilizing knowledge of relevant clauses to minimize incurred liability.
- Conducted risk evaluations on claims settlement proposals to encourage sound decision-making regarding settlement offers.
- Collaborated with legal counsel to make organizational claims decisions aligning with governing laws.
- Checked documentation for accuracy and validity on updated systems.
- Posted payments to accounts and maintained records.
- Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
- Verified client information by analyzing existing evidence on file.
- Vast knowledge of property policies
- Writing disclaimers
- Modified, updated and processed existing policies.
- Reviewed outstanding requests and redirected workloads to complete projects on time.
- Worked closely with Public Adjuster and Attorney's to resolve claims and Litigated files
- Prepared estimates with Xactimate ( Xactimate II Certified)
- Worked productively in fast-moving work environment to process large volumes of claims
Senior Casualty Adjuster
Founders Insurance Company
04.2017 - 03.2022
- Delivered exceptional customer service to policyholders by communicating important information patiently listening to issues.
- Examined claims forms other records to determine insurance coverage.
- Read over insurance policies to ascertain levels of coverage and determine whether claims would receive approvals or denials.
- Conducted day-to-day administrative tasks to maintain information files and process paperwork.
- Reviewed police reports, medical treatment records, and physical property damage to determine extent of liability.
- Analyzed suspicious and potentially fraudulent insurance claims.
- Investigated and assessed damage to property and reviewed property damage estimates.
- Researched claims information to deliver solutions and resolve problems.
- Identified insurance coverage limitations with thorough examinations of claims documentation related records.
- Settled Bodily Injury and Medical Payments Losses
- Resolved complex, severe exposure claims using high service oriented file handling.
- Worked with private investigators and attorneys on preparation of evidence, witness statements and other documentation in preparation for trial.
- Established productive working relationships with public officials and law enforcement officers.
- E-Hub /Arbitration Forum Experience
- Successfully Managed a pending of 100+
Claims Adjuster
Allstate Insurance Company
09.2010 - 12.2016
- Examined claims forms and other records to determine insurance coverage.
- Reviewed police reports, medical treatment records, and physical property damage to determine extent of liability.
- Prepared summaries of damage, payments, and policy coverage.
- Researched and analyzed policy contracts to verify proper payment of claims.
- Successfully analyzed loss of business claims and was recognized for identifying certain risk and preventing over payments
- Evaluated insurance policies and analyzed damages to determine coverage.
- Conducted comprehensive interviews of witnesses and claimants to gather facts and information.
- Negotiated with policyholders and claimants to reach mutually satisfactory resolutions.
- Documented all investigation activity and presented reports to management.
- Mitigated risks and increased profitability with well-developed strategies for reducing future claims and costs.
- Delivered exceptional customer service to policyholders 50+ customer calls per day
- Conducted day-to-day administrative tasks to maintain information files and process paperwork.
- Researched claims and incident information to deliver solutions and resolve problems.
- Determined liability outlined in coverage and assessed documentation such from police and healthcare providers to understand damages incurred.
Education
MBA - Hospitality Administration And Management
Schiller International University
Largo, FL05.2019
BBA - Marketing / Hospitality Mgmt
Central State University
Wilberforce, OH05.2010
High School Diploma -
Warren Central Highschool
Indianapolis, IN05.2003
Skills
- Xactimate
- Employee Feedback and Recognition
- Complaint Management
- Active Listening
- Liability Denials
- Negotiation Leadership
- Settlement Management
- Microsoft Office
- Claims Preparation
- Negotiation
- Complex Coverage Issues
- Critical Thinking
Additional Information
Professional Certificates
Completed and successfully Passed Wyoming Department of Insurance Exam DHS Wyoming (non-resident Adjuster)
Currently hold 12 Active Licenses
Timeline
Claims Representative Associate
Nationwide Insurance Company
04.2022 - Current
Senior Casualty Adjuster
Founders Insurance Company
04.2017 - 03.2022
Claims Adjuster
Allstate Insurance Company
09.2010 - 12.2016
MBA - Hospitality Administration And Management
Schiller International University
BBA - Marketing / Hospitality Mgmt
Central State University
High School Diploma -
Warren Central Highschool
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