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Skills

  • Insurance policy coverage knowledge
  • CCC Pathways
  • Customer retention strategies
  • Federal and state insurance regulations
  • Claims Cost Containment
  • Claims Cycle Time Optimization
  • Microsoft Word
  • ClaimsPro
  • Automated Work Distributor (AWD)
  • Accident scene investigations

Work Experiences

  • Verified the accuracy of category records to maintain the accuracy of the records database.
  • Conducted in-depth interviews with witnesses and claimants to gather facts and information.
  • Achieved a 85% improvement in SLA adherence.
  • Was in charge of maintaining claims data in initiative systems.
  • Achieved a flawless internal audit.
  • Advised senior officers on potential exposures.
  • Analyzed the data gathered during the investigation and wrote a report with my findings and recommendations.
  • Investigated and analyzed insurance claims that appeared to be suspicious or potentially fraudulent.
  • Looked into and assessed property damage, as well as reviewing property damage estimates.
  • Fixed procedure codes so that process claims could be properly classified.

Summaries

  • Boosted claim resolution efficiency by 62%.
  • Negotiates fair and thorough resolutions to all claims in a peaceful manner.
  • Recognized on a regular basis for outstanding performance and contributions to the Insurance industry's success.
  • Complete knowledge of the claims process and strategic planning.
  • Claims Adjuster with a passion for helping others and a knack for coming up with novel solutions to problems.
  • Strong conflict resolution and negotiation skills, as well as excellent reporting and research abilities.
  • Adept at collaborating with legal professionals.
  • Achieved a 82% decrease in legal expenses.
  • Accomplished negotiator, regularly spearheading complex settlements that reduce litigation exposure and contribute to favorable claim outcomes.
  • Collaborated with legal teams.

Accomplishments

  • Documented and resolved category which led to process.
  • Investigated and resolved complex third-party liability claims, lowering the reversal rate of denied claims from 63% to just 78%.
  • Led cross-functional collaboration with legal and underwriting teams to address complex coverage denials, resulting in savings of $15 in reserves.
  • Analyzed root causes of repetitive claims trends, recommending policy changes that reduced recurring claim submissions by 57% over a 12-month period.
  • Devised and implemented a comprehensive claims analysis tool, improving the accuracy of casualty loss projections by 17% over 17 months.
  • Collaborated with internal actuarial teams to develop more accurate reserve setting practices, reducing overestimations by $13 across 16 claims.
  • Reviewed 11 casualty claims per month, ensuring compliance with state, federal, and internal guidelines, contributing to a 57% reduction in compliance issues.
  • Led the integration of HubSpot with claims handling procedures, enhancing assessment accuracy and reducing manual claims processing by 69% hours weekly.
  • Designed and implemented a mentorship program for new casualty adjusters, reducing onboarding times by 34% and improving first-year retention rates.
  • Co-led the adoption of Asana into claims adjustment processes, improving operational efficiency and reducing error rates by 19% within 15 months.

Affiliations

  • Freemason
  • Certified Claims Professional Accreditation Council (CCPAC)
  • International Council of Nurses
  • Society of Claims Law Associates (SCLA)
  • International Risk Management Institute (IRMI)
  • American Bar Association - Tort Trial and Insurance Practice Section (ABA-TIPS)
  • American Association of Insurance Services (AAIS)
  • National Association of Professional Insurance Agents (PIA)
  • Rotary International
  • Society of Women Engineers

Certifications

  • Fraud Claim Law Specialist (FCLS)
  • Cyber Liability Insurance Coverage Specialist (CLICS)
  • Arson Investigating for Claims Professionals Certification – Lean
  • Associate in Claims (AIC) - Vantage
  • Insurance Data Analytics Certificate – procedure
  • Certified Environmental Claims Professional (CECP)
  • Apple Certified Associate (ACA)
  • Senior Claim Law Associate (SCLA) – Vantage
  • Insurance Account Management Professional Certification (IAMP)
  • Certified Property & Casualty Claims Professional (CPCP)

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