image/svg+xmlSenior Claims Representative - Nationwide Mutual Insurance ..., Raleigh, NC
June 2018 - January 2020
Senior Claims Analyst - Nationwide Mutual Insurance ..., Raleigh, NC
January 2011 - May 2018
Subrogation Specialist (Part-Time) - Mercury General, Citrus Heights, CA
September 2004 - July 2005
Bachelor's Degree In Education
2002 - 2005
Subrogation Potential
Liability Claims
Customer Service
Insurance Companies
Medical Records
Policy Coverage
PIP
Pursue Recovery
Special Projects
Potential Recovery
William Miller
William Miller
Senior Claims Representative
(790) 555-0675 | wmiller@example.com | 28659 S. Oak Rd., Raleigh, NC 77204
Experience
Evaluated Personal Injury Protection (PIP) and Medpay claims for eligibility and medical necessity.
Worked with programs such as CLASS, Xactimate, and ISO to assist with property and auto adjusting.
Identified and addressed fraud and/or misrepresentation.
Maintained open lines of communication with management to ensure swift handling of claims-related
concerns.
Utilized Xactimate estimating system during field inspection to properly evaluate commercial property
damages.
Entered data, CPT, ICD-9-CM and HCPCS medical codes from Medicare claims into computer system.
Utilized Xactimate estimating system during field inspection to properly evaluate commercial property
damages.
Partnered with Special Investigation Unit (SIU) and Subrogation to identify fraud and subrogation
opportunities.
Identified and addressed fraud and/or misrepresentation.
Operated Xactimate at a proficient level in presenting claim settlements to policyholders.
Partnered with SIU Department in identifying suspicious losses.
Facilitated SIU referrals as needed, assisted in investigation and deposition of claims.
Worked directly with defense counsel on litigated claims.
Engaged, and assisted, counsel in extreme impasse cases to procure recoveries.
Guided the claimant through the claims process following property damage or loss.
Education
The Academy - Citrus Heights, CA
Skills & Abilities