Claim Adjuster

Interprets basic policy coverages and determines if coverages apply to claims submitted escalating issues as needed.
Explain policy coverage to policyholders and third parties.
Complete thorough investigations and document facts relating to claims.
Communicates claim action/processing with claimant, client and appropriate medical contact.
Ensures claim files are properly documented and claims coding is correct.
Follow and adhere to established processes that support organizational goals.
Cross-service existing clients to add needed coverage, increase limits and
reduce E & O exposure for agency.

Processed appeals, motions, and pretrial agreements.
Answered and directed calls using the multi-line switchboard.
Organized envelopes, postage, and mail correspondence for all clients.
Worked directly with specific lawyers, legal assistants, and secretaries to provide records management services, including Creating and organizing folders, general filing, court document indexing, prepare.
Sorted all papers alphabetically and according to content, dates, significance, etc.
Created or update records with new files and information.
Opened files and created the respective folders. Closed files and sent them to storage.

Highly effective at handling confidential information and identifying system
improvements with ease.
Verified and logged in deadlines for responding to daily inquires Developed a more effective filing system to accelerate the paperwork process.
Verified that information in the computer system was up to date and accurate.
Filing and data archiving, multitasker, Microsoft Office proficiency and
resourceful.
Managed office supplies, vendors, organization, and upkeep.
Answered and managed incoming and outgoing calls while recording accurate messages.
Opened and properly distributed incoming mail.
Helped distribute employee notices and mail around the office.
Maintained patient confidentiality in accordance with HIPAA regulations and company practices

Prepared source data for computer entry by compiling and sorting information; establishing entry priorities.
Processed customer and account source documents by reviewing data for
deficiencies, resolving discrepancies by using standard procedures or returning incomplete documents to the team leader and/or supervisor for resolution.
Entered customer and account data by inputting alphabetic and numeric
information on the keyboard according to screen format.
Supported data entry requirements by following data program techniques and procedures.
Verified entered customer and account data by reviewing, correcting, deleting, or reentering data; combining data from when account information is incomplete; purging files to eliminate duplication of data.
Abetted operations by following policies and procedures; reporting needed
changes.
Maintained customer confidence and protects operations by keeping information confidential.