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Skills

  • Microsoft Word
  • High-Value Claims Handling
  • Policy investigations
  • Auto claims expertise
  • Interior water damage background
  • Report writing and documentation
  • Cost-saving repair coordination
  • Complex claims analysis
  • Automated Work Distributor (AWD)
  • Empathetic Customer Communication

Work Experiences

  • Collaborated with legal and medical professionals.
  • Achieved a 44% reduction in claim errors.
  • Handled method calls about category processes from customers and other stakeholders.
  • Achieved a 15% reduction in escalated claims through effective conflict resolution techniques with policyholders and vendors.
  • Analyzed the data gathered during the investigation and wrote a report with my findings and recommendations.
  • Ensured that all filed hazard and special hazard claims were properly managed.
  • Examined claim forms and other records to determine insurance coverage.
  • Collaboratively analyzed accident reports and expert assessments to successfully close 7 bodily injury claims without legal intervention.
  • Achieved 69% improvement in processing.
  • Analyzed customer feedback and implemented workflow improvements, reducing average call handling time by 31% minutes.

Summaries

  • Excellent track record of resolving issues, increasing customer satisfaction, and driving overall operational improvements.
  • Excellent communication skills as evidenced by 3 years of experience interviewing experts, witnesses, and claimants in order to compile data.
  • Accomplished Insurance Claims Adjuster with hands-on experience in claims investigation, saving $3 in annual payouts by efficiently detecting fraudulent claims. Expertise in collaborating with legal teams for favorable case outcomes.
  • Criminal investigation, insurance fraud, and surveillance are all part of his background.
  • Expert at creating profitable and high-quality processes.
  • Adept at vendor relationship management.
  • Dedicated to learning, growing, and succeeding in Insurance.
  • Collaborated effectively with third-party vendors.
  • Within Insurance, senior Insurance Claims Adjuster and outstanding performer in workflow optimization and stakeholder engagement.
  • Accomplished Insurance Claims Adjuster.

Accomplishments

  • Investigated and resolved 12 insurance claims per month, maintaining a customer satisfaction rating of 20% throughout the process.
  • Handled large-scale, specialized claims, such as cyber-insurance or procedure, resolving claims efficiently within two years.
  • Reduced total claim processing time by 78% by implementing streamlined procedures for documentation and vendor coordination.
  • Successfully handled liability claims involving multiple parties, reducing overall liability exposure for the company by 73%.
  • Developed and maintained a documentation system for procedure insurance claims, enhancing regulatory compliance and decreasing processing delays by 48%.
  • Authored and delivered training materials that improved junior adjuster teams' accuracy by 43%, reducing total errors in claim assessment.
  • Led a team in resolving 3 complex disaster claims related to initiative, while keeping adjuster overtime to less than 26% %.
  • Collaborated with attorneys and external vendors in settling claims, reducing legal expenses by 26% through effective negotiation strategies.
  • Documented and resolved initiative which led to program.
  • Collaborated with team of 12 in the development of procedure.

Affiliations

  • Rotary International
  • International Risk Management Institute (IRMI)
  • Property & Liability Resource Bureau (PLRB)
  • Membership in State Adjuster Licensing Bodies (Oregon Licensing Board)
  • National Association of Mutual Insurance Companies (NAMIC)
  • International Council of Nurses
  • International Association of Special Investigation Units (IASIU)
  • Casualty Actuarial Society (CAS)
  • Institute for Business & Home Safety (IBHS)
  • Society of Human Resource Management

Certifications

  • Associate in General Insurance (AINS)
  • National Flood Insurance Program (NFIP) Adjuster Certification
  • Certified in Customer Service for Insurance Professionals (CCSIP)
  • Microsoft Certified Systems Engineer (MCSE)
  • Certified Medicare Secondary Payer Professional (CMSP)
  • Associate in Insurance Services (AIS)
  • Associate in Risk Management (ARM)
  • Certified Public Accountant (CPA)
  • Society of Claim Law Associates Designation (SCLA)
  • Certified Insurance Fraud Investigator (CIFI)

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