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Skills

  • Collaborating with external professionals (engineers/medical experts)
  • Complex liability assessment
  • Accident scene investigations
  • Personal, casualty and property loss
  • Automobile claims specialist
  • Claims closure rate optimization
  • Client communication and negotiation
  • AMS360
  • Casualty claim volume management
  • Policy investigations

Work Experiences

  • Looked into legal issues surrounding program claims.
  • Analyzed potential litigation.
  • Reconciled data in the direct collection system with the accounting system to address discrepancies.
  • Achieved settlement within 4 days.
  • Assessed the veracity of large-scale liability claims.
  • Accurately assessed accident and injury circumstances to provide detailed reports to underwriting teams for risk mitigation purposes.
  • Achieved a 20% reduction in open claim activity.
  • Investigated claims and incident data in order to provide solutions and resolve issues.
  • Achieved a 28% reduction in payout errors.
  • Was in charge of directing and coordinating the field investigation team's investigations.

Summaries

  • Excellent communication skills as evidenced by 9 years of experience interviewing experts, witnesses, and claimants in order to compile data.
  • Accomplished Casualty Adjuster with 8 years of experience.
  • Excellent track record of resolving issues, increasing customer satisfaction, and driving overall operational improvements.
  • Overall morale and productivity are boosted by experience in policy development and staff management procedures.
  • Within Miscellaneous, senior Casualty Adjuster and outstanding performer in workflow optimization and performance reporting.
  • Detailed Adjuster with 13 years of corporate insurance claims experience.
  • Dedicated to learning, growing, and succeeding in Miscellaneous.
  • Casualty Adjuster with 11 years of successful team leadership and performance reporting experience.
  • Adept at policy analysis.
  • Achieved favorable outcomes in 35% of mediated cases.

Accomplishments

  • Managed legal case preparation for 11 casualty claims under litigation, tracking details and ensuring evidence was presented clearly.
  • Effectively negotiated 78% of high-value claims directly, saving the company roughly $17 annually while maintaining policyholder satisfaction.
  • Mitigated company loss exposures by proactively managing 17 casualty claim disputes per quarter involving significant financial impact.
  • Developed a standardized review process that reduced claim resolution time by 63% and improved departmental efficiency.
  • Collaborated with medical staff to verify injury claims, ensuring fair settlements while reducing fraud and maintaining compliance with industry standards.
  • Developed and delivered training to entire casualty adjuster team on legal case preparation, increasing legal case success rate by 74%.
  • Recovered $9 in overpayments through meticulous analysis and recovery efforts.
  • Documented and resolved framework which led to program.
  • Partnered with underwriting teams to implement policy adjustments, reducing high-exposure casualty claims by 66% in 2019.
  • Used Microsoft Excel to develop inventory tracking spreadsheets.

Affiliations

  • Claims and Litigation Management Alliance (CLM)
  • National Institutes of Health Risk Management Training Program
  • Claims Management Association of America
  • National Insurance Crime Bureau (NICB) - Fraud Investigators Division
  • Jaycees
  • Lions Club
  • Dispute Resolution Section of the American Arbitration Association
  • National Association of Independent Insurance Adjusters
  • Professional Liability Underwriting Society (PLUS)
  • American Marketing Association

Certifications

  • Independent Claims Adjuster Certification – Illinois
  • Certified Public Accountant (CPA)
  • Certified Workers Compensation Claims Adjuster (CWCA)
  • Certified Workers' Compensation Professional (CWCP)
  • Casualty Adjuster License Texas
  • Multi-Line Adjuster License – Denver
  • Insurance Regulatory Compliance Management (IRCM)
  • Project Management Professional (PMP)
  • Legal Principles Claim Specialist (LPCS) - Cedar Works
  • Property and Casualty Insurance License - Texas

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