Melanie Da Camara
Fall River
Summary
Detail-oriented Senior Property Claims Representative with proven success in managing high-volume claims, ensuring compliance, and delivering exceptional customer service.
Overview
20
20
years of professional experience
1
1
Certification
Work History
Senior Property Claims Representative
Amica Insurance
Raynham, MA
07.2022 - Current
- Evaluate and process insurance claims to ensure compliance with policy guidelines.
- Collaborate with clients to gather necessary documentation for property claim resolution.
- Handle ocean marine claims
- Handle a large load of property claims
- Communicate effectively with internal teams to expedite claim investigations.
- Review claims for accuracy, identifying discrepancies and recommending adjustments.
- Assist in training new representatives on claims processing procedures and systems.
- Manage high-volume claims workload while maintaining attention to detail and deadlines.
- Work productively in fast-moving work environment to process large volumes of claims.
- Develop strong relationships with clients, facilitating trust and open communication during the claims process.
- Provided exceptional customer service, addressing concerns and resolving issues promptly.
Senior PIP Claims Representative
Amica Insurance
Raynham, MA
11.2015 - 07.2022
- Managed a caseload of an average 100 claims, ensuring timely handling in compliance with state regulations
- Reviewed and processed Personal Injury Protection (PIP) claims including medical bills, lost wages, and related expenses
- Verified coverage, policy limits, and eligibility for benefits under applicable no-fault insurance laws
- Investigated claims by obtaining medical records, accident reports, and provider documentation
- Assigned IME's as needed Independent Medical Examination
- Coordinated with medical providers, attorneys, and claimants to gather required documentation and resolve issues
- Identified potential fraud indicators and escalated suspicious claims for further review
- Maintained accurate claim file documentation and system updates in accordance with compliance standards
Auto Claims Handler
Amica Insurance
Raynham, MA
07.2010 - 11.2015
- Investigated accidents by reviewing police reports, photos, witness statements, and videos
- Determined liability and coverage based on policy terms and applicable state laws
- Evaluated vehicle damage estimates and coordinated with appraisers and repair shops
- Handled property damage claims
- Communicated with insureds, claimants and attorneys, to gather information and provide updates
- Negotiated and settled claims within authority limits
Account Executive
Neto Insurance
Fall River, MA
06.2006 - 07.2010
- Personal Lines book of business contains over 300 accounts
- Knowledge of Auto, Homeowner, Renters, Condo and Umbrella coverage
- Initiate, manage and follow through on all aspects of the renewal process
- Review policies upon receiving them
- Respond to client inquires, insurance company requests, billing, and assist with claims
- Work with Commerce, Preferred Mutual, Mass Property, Surplex, Harleysville and XS Brokers
- Handle incoming and outgoing mail
- Handle incoming calls
- Reconcile checking account
Education
High School Diploma -
Durfee High School
Fall River, MA06-2006
Skills
- Microsoft office
- Insurance claims review
- Claims investigation
- Time management
- Excel spreadsheets
Certification
CPR/First Aid Certified
Languages
English
Native or Bilingual
Portuguese
Full Professional
Timeline
Senior Property Claims Representative
Amica Insurance
07.2022 - Current
Senior PIP Claims Representative
Amica Insurance
11.2015 - 07.2022
Auto Claims Handler
Amica Insurance
07.2010 - 11.2015
Account Executive
Neto Insurance
06.2006 - 07.2010
High School Diploma -
Durfee High School