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Skills

  • Client-oriented communication
  • Exceptional attention to detail in case files
  • Insurance policy coverage knowledge
  • CCC EZNet
  • Advanced claims reporting and documentation
  • Expertise in casualty claim reserves management
  • Effective high-stakes case negotiation
  • Personal, casualty and property loss
  • Establishing and managing case reserves
  • Advanced negotiation and settlement techniques

Work Experiences

  • Investigated and analyzed insurance claims that appeared to be suspicious or potentially fraudulent.
  • Achieved results over 18 months.
  • Achieved a Employee of the Year award for customer satisfaction.
  • Achieved a resolution satisfaction rate of 43%.
  • Fixed initiative codes so that process claims could be properly classified.
  • Achieved over 81% policyholder retention.
  • Looked into and assessed property damage, as well as reviewing property damage estimates.
  • Investigated potentially fraudulent claims that claims representatives had initiated.
  • Conducted in-depth interviews with witnesses and claimants to gather facts and information.
  • Achieved results through effective negotiation.

Summaries

  • Casualty Claims Adjuster with a passion for personal, property, and casualty losses and damages.
  • Overall morale and productivity are boosted by experience in policy development and staff management procedures.
  • Avoided litigation whenever possible.
  • Adept at handling high-exposure casualty claims.
  • Strong understanding of claimant intake processes, record documentation, and fraud investigation protocols.
  • Strengths in stakeholder engagement and project management backed up by Miscellaneous training.
  • Achieved a 32% decrease in insurer payouts.
  • Proven track record of using excellent negotiating skills to speed up settlements.
  • Negotiates fair and thorough resolutions to all claims in a peaceful manner.
  • Achieved a 69% drop in bodily injury settlement payouts.

Accomplishments

  • Evaluated expert witness depositions in litigation cases, influencing court outcomes and minimizing client liability by $2.
  • Collaborated with attorneys and outside counsel to reduce financial exposure for clients, resulting in a 45% reduction in claim payouts over the past year.
  • Collaborated with team of 16 in the development of procedure.
  • Maintained up-to-date knowledge of insurance industry, including regulatory changes, which contributed to 35% compliance audit success rate.
  • Enhanced internal processing procedures resulting in a 65% improvement in both timeliness and accuracy of injury assessments.
  • Ensured regulatory compliance with state and federal laws on injury claims, maintaining a 54% error-free rate during annual audits.
  • Suggested process improvements that resulted in streamlined claims adjudication and decreased pending caseload by 29% over the past year.
  • Secured Outstanding Service Award for excellence in claims processing after exceeding key performance metrics for the past year.
  • Drafted comprehensive evaluation reports for complex casualty cases, increasing resolution accuracy by 83%.
  • Handled high-severity bodily injury cases, resolving 15% of cases through negotiation, mediation, or arbitration.

Affiliations

  • Lions Club
  • Jaycees
  • American Adjuster Association (AAA)
  • Property and Casualty Claims Professionals (PCCP)
  • Public Risk Management Association (PRIMA)
  • Certified Claims Professional Accreditation Council (CCPAC)
  • Claims and Litigation Management Alliance (CLM)
  • Society of Insurance Trainers and Educators (SITE)
  • National Insurance Crime Bureau (NICB)
  • International Risk Management Institute (IRMI)

Certifications

  • Certified Casualty Adjuster (CCA) 2019
  • Certificate in Casualty and Property Adjusting
  • CompTIA Security+
  • Certified Professional in Management (CPM) Ironclad Systems, 2017
  • Salesforce
  • SHRM Senior Certified Professional (SHRM-SCP)
  • ServSafe
  • Certified Adjuster Professional Bootcamp Beacon Labs, Denver, 2015
  • Google Certified Professional Cloud Architect
  • Associate in Reinsurance (ARe)

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