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Skills

  • Analytics and Data-Driven Decision Making
  • Claims Cycle Time Optimization
  • Personal, casualty and property loss
  • Legal proceedings knowledge
  • CCC Pathways Appraisal Quality Solution
  • Litigation cost reduction strategies
  • Valuation knowledge
  • Automated Work Distributor (AWD)
  • CCC Pathways
  • Legal expense reduction

Work Experiences

  • Reconciled data in the direct collection system with the accounting system to address discrepancies.
  • Organized system data in order to finish method files.
  • Calculated the quantifiable features of process products.
  • Achieved total recoveries of $2 across Phoenix.
  • Looked into and assessed property damage, as well as reviewing property damage estimates.
  • Maintained a suspicious claims database and prepared supervisory reports on a several months basis.
  • Achieved Top Performer for innovation.
  • Reviewed police reports, medical treatment records, and physical property damage to determine the extent of liability.
  • Conducted in-depth interviews with witnesses and claimants to gather facts and information.
  • Investigated potentially fraudulent claims that claims representatives had initiated.

Summaries

  • Achieved results aligned with bottom-line objectives.
  • Reliable and trustworthy.
  • Advised on potential exposures.
  • Collaborative claims professional skilled in partnering with external medical experts for injury claims reviews, achieving a 35% reduction in liability assessments.
  • Accomplished negotiator.
  • Criminal investigation, insurance fraud, and surveillance are all part of his background.
  • Boosted claim resolution efficiency by 62%.
  • Overall morale and productivity are boosted by experience in policy development and staff management procedures.
  • Senior Casualty Claims Adjuster with 13 years of successful strategic planning and client relations experience.
  • Achieved industry-standard timelines.

Accomplishments

  • Achieved a claims settlement ratio above 31% by effectively negotiating fair and equitable resolutions, minimizing claim revisitation occurrences.
  • Reviewed 11 casualty claims per month, ensuring compliance with state, federal, and internal guidelines, contributing to a 57% reduction in compliance issues.
  • Received Top Performer for excellence in catastrophic loss management through quick, effective claims oversight following process.
  • Developed new data-driven metrics to assess case performance, reducing large-loss reserves by $6 and increasing accuracy by 73%.
  • Used Microsoft Excel to develop inventory tracking spreadsheets.
  • Documented and resolved category which led to process.
  • Devised and implemented a comprehensive claims analysis tool, improving the accuracy of casualty loss projections by 17% over 17 months.
  • Led cross-functional collaboration with legal and underwriting teams to address complex coverage denials, resulting in savings of $15 in reserves.
  • Cultivated and maintained relationships with industry-leading vendors, lowering medical service costs in casualty claims by $17 annually.
  • Mentored a team of 16 junior claims adjusters, fostering rapid skill development and reducing team attrition by 20%.

Affiliations

  • Association for Supply Chain Management (APICS)
  • National Association of Independent Insurance Adjusters (NAIIA)
  • International Risk Management Institute (IRMI)
  • American Society of Safety Professionals
  • Claim and Litigation Management Alliance (CLM)
  • National Association of Mutual Insurance Companies (NAMIC)
  • National Underwriter Company Continuing Education Programs
  • Workers' Compensation Institute (WCI)
  • International Association of Insurance Professionals (IAIP)
  • Women in Insurance Leadership (WIL) Program

Certifications

  • Conflict Resolution and Mediation Certification - initiative
  • Nationwide Multistate Licensing System (NMLS) Certification in Insurance Claims
  • Certified Public Accountant (CPA)
  • Certified Professional Insurance Adjuster (CPIA)
  • Certified Property & Casualty Claims Professional (CPCP)
  • Legal Principles Claim Specialist (LPCS) – standard
  • Associate in Risk Management (ARM)
  • Certified Litigation Management Professional (CLMP) – Tableau
  • Associate in Claims (AIC) - Vantage
  • First Aid/CPR Certified

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