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Skills

  • Cross-functional team collaboration
  • Risk management
  • Employee Engagement and Retention Strategies
  • Claims reserve recalibration
  • BCCORP W5 for Adjusters
  • Hail and wind damage specialist
  • Data-driven decision making
  • Microsoft Publisher
  • Claims reserve system auditing
  • Insurance policy coverage knowledge

Work Experiences

  • Fixed process codes so that framework claims could be properly classified.
  • Examined claim forms and other records to determine insurance coverage.
  • Achieved favorable settlements for the company.
  • Developed positive working relationships with government officials and police officers.
  • Achieved favorable outcomes.
  • Reviewed new files to determine the current status of an injury claim and devise a strategy.
  • Authored technical claims guidelines used by 17 regional offices, standardizing responses to complex cases and reducing variance by 41%.
  • Applied Lean methodologies to operational workflows.
  • Administered a claims reserve system audit.
  • Was in charge of maintaining information files and processing paperwork on a daily basis.

Summaries

  • Negotiates fair and thorough resolutions to all claims in a peaceful manner.
  • Strong conflict resolution and negotiation skills, as well as excellent reporting and research abilities.
  • Claims Examiner with extensive experience in the process claims industry.
  • Insurance adjuster who investigates and analyzes liability in the event of a personal, casualty, or property loss.
  • Award-winning Claims Leader recognized with Innovation Award in 2024 for designing performance-based incentives that enhanced team output and morale.
  • Complete knowledge of the claims process and performance reporting.
  • Claims Service Leader with 12 years of successful stakeholder engagement and team leadership experience.
  • Recognized on a regular basis for outstanding performance and contributions to the Miscellaneous industry's success.
  • Clear understanding of client relations and risk assessment as well as process improvement training.
  • For several months, I've been a member of the National Society of Professional Insurance Investigators.

Accomplishments

  • Negotiated settlements in high-value claims totalling $132,000, maintaining a high success rate in minimizing escalations to litigation.
  • Coordinated with underwriting to review and adjust policies in complex cases, leading to a 84% decrease in rejected claims.
  • Reduced legal costs by $49,000 annually through early intervention strategies and effective pre-litigation dispute resolution.
  • Managed the adherence to compliance guidelines, enabling the team to pass Scrum Master audits with zero critical findings.
  • Resolved product issue through consumer testing.
  • Led the development of a cross-functional training platform that reduced time to proficiency for new claims adjusters by 15 days.
  • Reduced complex claims backlog by 18% within several months through team leadership and process improvements.
  • Analyzed claims data to recommend policyholder incentives, increasing retention and reducing dispute frequency by 44%.
  • Collaborated directly with IT teams to automate claims operations, achieving a 66% reduction in manual errors.
  • Developed and executed an internal audit protocol that identified and reduced operational inefficiencies, resulting in savings of $91,000.

Affiliations

  • National Association of Public Insurance Adjusters (NAPIA)
  • American Property Casualty Insurance Association (APCIA)
  • Property Loss Research Bureau (PLRB)
  • Chartered Property Casualty Underwriters (CPCU) Society
  • Toastmasters
  • International Federation of Adjusting Associations (IFAA)
  • International Association of Insurance Professionals (IAIP)
  • Casualty Actuarial Society (CAS)
  • Chartered Insurance Institute (CII)
  • Accredited Claims Adjusters Institute

Certifications

  • Six Sigma Green Belt Certification
  • CompTIA Security+
  • Leadership and Management Certificate by procedure
  • CompTIA A+ Technician
  • Advanced Claims Law Specialist (ACLS) by Ironclad Systems
  • Certified Financial Services Auditor (CFSA) by The IIA
  • Cisco Certified Network Associate (CCNA)
  • ServSafe
  • ISO 22301 Lead Auditor Certification for Business Continuity Management Systems
  • Google Certified Professional Cloud Architect

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