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Skills

  • Efficient prioritization and multi-tasking with sizable caseloads
  • Advanced computer skills
  • Insurance policy coverage knowledge
  • Microsoft Word
  • Expertise in bodily injury and liability claims
  • Legal proceedings knowledge
  • North Carolina Claims Adjuster License
  • Commercial claims handling
  • Data analysis
  • Types 3 wpm

Work Experiences

  • Made a proposal
  • Taught other claims staff members how to handle and evaluate injury claims properly.
  • Verified insurance claims and calculated a fair settlement amount.
  • Reconciled data in the direct collection system with the accounting system to address discrepancies.
  • Built relationships with local fraud bureaus, district attorneys' offices, and professional organizations.
  • Conducted in-depth interviews with witnesses and claimants to gather facts and information.
  • Was in charge of maintaining claims data in program systems.
  • Taught new employees how to spot external and internal fraud.
  • Punitive action against fraudulent claims was something I recommended.
  • Calculated the quantifiable features of category products.

Summaries

  • Bilingual Insurance Sales Agent with a knack for driving business development and customer base growth.
  • Motivated graduate looking to start a career in underwriting in team leadership.
  • Claims Adjuster with a passion for helping others and a knack for coming up with novel solutions to problems.
  • Claims Adjuster with 14 years of successful data analysis and team leadership experience.
  • Reliable and trustworthy.
  • Conducting in-depth trend, financial, and business analysis to mitigate risk and protect against financial loss has proven to be successful.
  • SUI Investigator was successful in gathering and compiling information in accordance with evidence rules.
  • With a high level of integrity, trained in local, state, and federal fraud statutes.
  • Pragmatic
  • Motivated individual.

Accomplishments

  • Implemented streamlined documentation processes that reduced communication delays by 79%, leading to faster claim resolutions.
  • Earned designations as method.
  • Approved policies up to $9.
  • Developed effective claims investigation processes that led to a 53% higher detection rate of falsified claims.
  • Provided expert witness testimony in litigation cases, resulting in a favorable outcome for the company in 77% of cases.
  • Analyzed and processed claims for accuracy and liability, resulting in a 48% decrease in processing time within 6 months.
  • Resolved high-stake negotiations by demonstrating expert-level knowledge in liability claims, achieving a settlement agreement free of litigation.
  • Collaborated with medical professionals to substantiate injury claims, leading to a 40% reduction in unnecessary medical payouts.
  • Obtained and reviewed third-party medical submissions and police records, accelerating claim decisions by 4 business days.
  • Integrated risk management strategies that resulted in a 65% reduction in fraudulent or exaggerated claim payouts.

Affiliations

  • American Society of Safety Professionals
  • National Institute for Trial Advocacy (NITA) Programs
  • Project Management Institute
  • The Institutes - Risk and Insurance Knowledge Group
  • International Association of Special Investigation Units (IASIU)
  • Associate in Claims (AIC) designation
  • Chartered Property Casualty Underwriter (CPCU) Society
  • Certified Insurance Fraud Investigator (CIFI)
  • Auto Insurance Claims Investigators Network
  • International Association of Administrative Professionals

Certifications

  • Google Certified Professional Cloud Architect
  • Flood Adjuster Certification (NFIP) method
  • Certified Risk Manager (CRM) category
  • Cisco Certified Internetwork Expert (CCIE)
  • Property and Casualty Adjuster License standard
  • Chartered Property Casualty Underwriter (CPCU)
  • Collision Loss Adjuster Appraiser Certification system
  • Association for Project Management (APM)
  • Associate in Risk Management (ARM) - The Institutes
  • Associate in Surplus Lines Insurance (ASLI) - The Institutes

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