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Skills

  • Advanced documentation and record-keeping skills
  • Statistical analysis of claims trends
  • Cross-functional communication with legal, medical, and rehabilitation teams
  • Negotiation with insured parties and third-parties
  • Effective communication with insured parties
  • Accident benefits claim management
  • Problem resolution
  • First Aid/CPR
  • Statutory compliance in accident benefits legislation
  • Business operations

Work Experiences

  • Conducted agent and claimant interviews to review questionable claims to correct omissions and errors.
  • Avoided company exposure to compliance risks.
  • Gathered and tracked evidence in support of legal processes.
  • Accomplished in 2024.
  • Had an excellent attendance record and was always on time for work.
  • Collaborated with medical providers.
  • Boosted overall efficiency.
  • Arranged independent medical examinations (IMEs).
  • Achieved a 39% customer satisfaction rate.
  • Analyzed claimant history for patterns of repetitive injuries, contributing to a 81% decrease in chronic repeat claims.

Summaries

  • Within Miscellaneous, senior Accident Benefits Adjuster and outstanding performer in vendor management and quality assurance.
  • Avoided litigation through effective resolution.
  • Astute insurance professional with 16+ years of experience assessing properties, determining liabilities, and negotiating settlements.
  • Recognized on a regular basis for outstanding performance and contributions to the Miscellaneous industry's success.
  • Accident Benefits Adjuster with a sharp eye for detail.
  • Review documentation and assess properties efficiently to determine damage levels, complete cost estimates, and maintain liability control.
  • Accident Benefits Adjuster is a multi-talented Accident Benefits Adjuster who is consistently rewarded for planning and operational improvements.
  • Proven leadership, operational excellence, and organizational development skills, as well as a thorough understanding of the metric business.
  • Accident benefits expert.
  • Excellent communication skills as evidenced by 8 years of experience interviewing experts, witnesses, and claimants in order to compile data.

Accomplishments

  • Maintained claims closure rate of 11% above industry benchmark, ensuring top-tier operational efficiency.
  • Documented and resolved method which led to category.
  • Reduced vendor turnaround times by 81%, enhancing claimant access to third-party medical assessments.
  • Monitored and adjusted reserves on high-value cases, minimizing claim leakage by 62%.
  • Conducted regular claim file audits, ensuring compliance with regulatory standards and minimizing litigation risks by 47%.
  • Implemented an enhanced case review process, resulting in a 55% acceleration in return-to-work timelines.
  • Effectively managed accident benefit claims with exposure limits over category, maintaining a loss ratio below 75%.
  • Achieved PMP that enhanced analytical and evaluative skills, leading to a 42% improvement in claim budget accuracy.
  • Successfully managed cases with 7% more claims volume without compromising claimant experience or service level agreements.
  • Conducted detailed diagnostic and severity analysis using QuickBooks, resulting in optimized claimant recovery timelines and cost controls.

Affiliations

  • National Association of Social Workers
  • Member, Society of Claim Law Associates (SCLA)
  • Affiliate of the American Academy of Insurance Medicine (AAIM)
  • Accredited Member, Insurance Industry Arbitration Forum of 2024
  • Participant in Continuing Education Programs in Insurance Adjusting with Brightline
  • Health and Disability Insurance Section of the International Claim Association (ICA)
  • Association of Information Technology Professionals
  • Licensed Adjuster with 5 years of relevant state certifications
  • Certified Arbitrator through the Financial Services Commission of Phoenix
  • Participant, American Educational Institute (AEI) for Senior Claims Law Associate (SCLA)

Certifications

  • Professional Liability Insurance Adjuster Certification
  • Accident Benefits Adjuster Continuing Education – the Southwest
  • Cisco Certified Network Associate (CCNA)
  • Life and Health Insurance Certification – CLHIA recognized
  • SHRM Certified Professional (SHRM-CP)
  • Advanced Accident Benefits Adjuster Training – framework
  • Apple Certified Associate (ACA)
  • CompTIA Security+
  • Expert Medical Terms and Disability Analysis for Adjusters – standard
  • Fundamentals of Accident Benefits Claims – Meridian

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