Evelyn J. Hampton19999 Fleming St., Detroit, MI 48234313-551-9355, evelyn.hampton01@gmail.com

Summary

10+ years in customer service field of insurance, and consistent interaction with experience working in corporate office settings

5+ years managing $60,000 + accounts, financials documentation, forecasting expenditures based on individual customer need

Work Experience

The Auto Club Group (AAA) 10/2011-presentCasualty (PIP) Claim Representative, Southfield, Michigan

Manage medical claims including fast track, catastrophic, lifetime, and litigated claims; negotiate, settle, and resolve claims, manage and negotiate budgets and expenses of $60,000 and above.

Address and document customer contact and correspondence while addressing questions and concerns from customers and clientele

Develop strategies to maximize companywide profit & file handling responsibilities while aiding in the successful development of the team

Create plans to address reducing interest payments and excess spending & costs on claim settlements

Develop work processes to ensure a positive work environment and better customer service

Progressive Auto Insurance 03/2004-10/2011PIP Claims Adjuster, Sterling Heights, MI

Daily interaction with customers taking statements related to motor vehicle accidents and injuries.

Research medical records for current and past medical conditions Identify wage loss expenses and wage exposures on medical claims. Identify and handle wage loss expenses Evaluate medical claims for potential issues and make sure the Michigan no-fault law is applied

when making file decisions. Maintain communication monthly with customers for updates and claim resolution. Make approval or denial decisions on claims based on information received and reviewed. Schedule independent medical exams when appropriate. Maintain proper file organization

Evelyn J. Hampton

313-551-9355, evelyn.hampton01@gmail.com

Progressive Auto Insurance 03/2004-10/2011Medical Coder I & II, Plymouth, MI

Enter bills into the internal system and Mitchell Decision Point Evaluate diagnosis and procedure codes Read and evaluate medical records to ensure proper diagnosis and procedure codes billed Pay or deny medical bills Update reserve analysis for the claims representative Make phone calls to health care providers for billing and/or settlement information Draft and send letters to healthcare providers and insureds Train new and existing employees Organize the medical file room Assist claim representatives maintain proper file quality Data entry

Education Wayne County Community College District, Liberal Arts, Associate’s Degree, Detroit, MI Martin Luther King Jr., Sr. High School, High School Diploma, Graduation date 06/2001

Detroit, MI

References Available Upon Request

19999 Fleming St., Detroit, MI 48234