Amber Lane Email and Phone Number

• Makes timely contacts and completes appropriate investigation to make determination of coverage for complex and specialized claims.• Determines coverage, prepares coverage correspondence on claims, responds to coverage questions raised by insureds and others.• Calculates exposure and sets proper reserving for the life of the claim.• Identifies questionable claims and consults with SIU for further direction as appropriate.• Documents clearly and concisely all relevant activity on assigned files and makes recommendations for additional activity as appropriate.• Assesses medical/physical condition and prior injuries of claimant, obtaining and analyzing medical bills and wage loss reviews in determining reasonableness of charges and relation of injuries to accident and detect duplicate billing.• Determines settlement value of the loss and negotiates proper settlement of claims within authority. Provides recommendations for settlement and disposition of claims exceeding authority level.

• Made and maintained a connection with the customer by understanding and meeting their needs with empathy. • Summarized documents and entered documents into claim system notes, including evaluations and decision-making process.• Processed medical bills and recognized medical management opportunities.• Conducted first party file processing/fact gathering, including interviewing claimant, witnesses, medical providers, etc.• Evaluated medical records and treatment plan of claimant and determined if continued treatment was reasonable.• Determined appropriate benefit and settled basic claims, including resolution of basic usual and customary billings.• Monitored treatment and benefit payments for excessive, unreasonable, or abusive claims.• Handled specialized claims under guidance on an as needed basis.