Aisha Anderson
Little Rock
Summary
Results oriented Property Claims Adjuster with expertise in coverage interpretation and negotiation. Demonstrated success in managing complex claims and ensuring compliance while enhancing customer communication. Proficient in data analysis and vendor oversight, consistently achieving fair settlements and building strong relationships.
Overview
13
13
years of professional experience
Work History
Remote Property Claims Adjuster
Alacrity Solutions
02.2023 - Current
- Apply policy language to determine coverage and communicate decisions clearly to insureds and interested parties.
- Investigate and evaluate property damage, engage experts as needed, and negotiate fair settlements in alignment with best practices.
- Maintain compliance with state-specific timelines, including timely contact, acknowledgments, and diary management.
- Oversee contractors, vendors, and field partners to ensure quality performance and cost-effective claim handling.
- Identify subrogation opportunities and refer potential fraud indicators to SIU.
- Document all claim activity thoroughly and maintain accurate reserves in accordance with company philosophy.
Remote Auto Claims Adjuster
Alacrity Solutions
09.2021 - 02.2023
- Conducted detailed investigations for auto claims, confirming coverage, assessing liability, and documenting findings in compliance with carrier guidelines.
- Communicated proactively with customers, claimants, and agents regarding claim status, coverage decisions, and settlement expectations.
- Managed medical-only and minor lost-time workers' compensation claims under supervision, ensuring timely and accurate resolution.
- Collaborated with senior adjusters on complex claims and participated in claim reviews to support continuous improvement.
Remote Quality Provider Liaison
Centene Corporation
11.2020 - 11.2021
- Analyzed and presented HEDIS, CAHPS, HOS, and Part D data to providers to support quality improvement initiatives.
- Built strong relationships with provider groups and communicated key performance indicators to drive compliance and service enhancements.
- Delivered reports, gap lists, and operational insights to support clinical documentation improvements.
Claims Examiner
The Hart Agency
07.2019 - 08.2021
- Investigated property and auto claims to determine liability, evaluate damages, and negotiate equitable settlements.
- Prepared subrogation and arbitration files, processed payments, and verified policy coverage while maintaining transparent communication with all parties.
- Ensured complete, compliant claim documentation, adhering to regulatory standards and internal best practices.
- Supported litigation efforts by coordinating with counsel and providing necessary claim file materials.
Senior Member Enrollment Analyst
Centene Corporation
11.2017 - 11.2020
- Interpreted and analyzed enrollment data, resolving complex eligibility issues and maintaining accuracy across systems.
- Reviewed and processed medical claims, ensuring complete member and provider information.
- Served as a Subject Matter Expert, mentoring new team members and supporting project implementation.
Enrollment Analyst
Centene Corporation
09.2016 - 11.2017
- Processed enrollment data with high accuracy, resolved membership inquiries, and conducted research to correct errors.
- Reviewed medical insurance claims for payment resolution and responded to carrier documentation requests.
Eligibility Specialist
Healthscope
05.2013 - 08.2016
- Responded to eligibility inquiries from internal departments, employer groups, and government agencies.
- Processed enrollment documents and maintained accurate eligibility records across multiple systems.
- Conducted eligibility screenings and coordinated case assignments to appropriate claims teams.
Education
Associate of Arts -
University of Arkansas - Pulaski Technical College
North Little Rock, AR05-2010
Skills
- 1st party property claims management
- Coverage interpretation and policy application
- Liability investigation
- Settlement evaluation and negotiation
- Subrogation and SIU referral
- Reserve accuracy and documentation
- Vendor oversight and cost control
- Customer and agent communication
- Litigation support
- Data analysis and reporting
- Best practices compliance
- Microsoft Office proficiency
- Claims systems expertise
Timeline
Remote Property Claims Adjuster
Alacrity Solutions
02.2023 - Current
Remote Auto Claims Adjuster
Alacrity Solutions
09.2021 - 02.2023
Remote Quality Provider Liaison
Centene Corporation
11.2020 - 11.2021
Claims Examiner
The Hart Agency
07.2019 - 08.2021
Senior Member Enrollment Analyst
Centene Corporation
11.2017 - 11.2020
Enrollment Analyst
Centene Corporation
09.2016 - 11.2017
Eligibility Specialist
Healthscope
05.2013 - 08.2016
Associate of Arts -
University of Arkansas - Pulaski Technical College