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Claims Specialist Resume Germantown, MD
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Title Claims Specialist
Target Location US-MD-Germantown
Email Available with paid plan
Phone Available with paid plan
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Candidate's Name
Street Address  Wanegarden Dr.Germantown, MD Street Address
EMAIL AVAILABLEPHONE NUMBER AVAILABLEEDUCATIONBachelor of Science in Architecture, Concentration in Construction Management, May 2002The Catholic University of America, Washington, DC.Associate in applied science in Architectural Engineering Technology, May 1999University of the District of Columbia, Washington, DC.EMPLOYMENTManaged Care Advisors/Sedgwick Government Solutions, Bethesda, MD 8/2020- PresentoIntake of new Workers Compensation claims, evaluate for accuracy and timelines, submit to Dept. of Labor for processing following Federal workers Compensation GuidelinesoProvide guidance of the Workers Compensation processes to injured workers, including submitting federal forms online, response letters from Department of labor and assist navigating online portal.oSupport Agency Personnel, assist Nurses with administrative tasks and provide support to any stakeholders for efficient collaboration to the claims process.oCompute, tabulate and verify continuation of pay for the injured worker, verify accuracy of federal forms, and contact regional supervisors to process claims.Wells Fargo, Commercial Mortgage Insurance Department Analyst, Mclean, VA 9/2019-8/2020oEnsure compliance with loan documents, Servicing Agreements, and Investor Guidelines.oInitiating and responding to written and verbal communication from customers, insurance agents, and internal personnel regarding the insurance coverage on loans.oInitiating customer contacts to resolve insurance non-compliance.oCoordinating discrepancies & system updates, in accordance with loan documentationEnsuring all procedures are in compliance with agency, internal controls, and company policiesExperient, Customer Service Representative, Frederick, MD, 12/2018-5/2019oAssist callers with event registration, search database for customers information and process registration payments.oBook hotel accommodations using industry software.oAssists exhibitors, vendors with any event related questions.oAssist and explain the registration process to Spanish-Speaking customers.State Farm Insurance, Claims Specialist, Charlottesville, VA 2/2004 - 1/ 2018oNegotiate and settle with attorneys on customers bodily injury claims.oServes as a mentor to less experienced claims associates and assists with training as assigned by claim management.oClosely monitor defense counsels work product, adjust reserves and manage litigation when appropriate.oApplication of laws of jurisdiction to investigation facts, application of policy exclusions and exceptions.oReach out to body shops, rental companies, investigative agencies, and other insurance companies to evaluate the personal lines property damage portion of received claimsoListen and communicate clearly policy coverages and make liability decisions to English-speaking and Spanish-speaking customersoWorking in a collaborative team environment while meeting quality standardsLANGUAGESNative Spanish-speaker, fluent English

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