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Skills

  • Risk management
  • Interior water damage background
  • Microsoft Word
  • Expert testimony in arbitration
  • Familiar with fraud statutes
  • Legal proceedings knowledge
  • Commercial claims negotiations
  • Casualty claims investigations
  • Claims-cycle time reduction
  • Valuation knowledge

Work Experiences

  • Looked into legal issues surrounding initiative claims.
  • Verified the accuracy of metric records to maintain the accuracy of the records database.
  • Categorized and prioritized claims.
  • Developed positive working relationships with government officials and police officers.
  • Assessed claims involving complex contract law.
  • Testified on behalf of the agency in criminal and civil proceedings.
  • Reviewed police reports, medical treatment records, and physical property damage to determine the extent of liability.
  • Assessed claims involving complex contract law, winning a Employee of the Year for best legal outcomes in 2023.
  • Analyzed liability trends.
  • Kept track of 17-clients' caseload for each quarter.

Summaries

  • Commercial Claims Adjuster with 4 years of successful budget management and quality assurance experience.
  • Negotiates fair and thorough resolutions to all claims in a peaceful manner.
  • Criminal investigation, insurance fraud, and surveillance are all part of his background.
  • Achieved favorable decisions in 50% of coverage disputes.
  • Achieved 75% success rate in settlements.
  • Achieved reductions through strategic negotiations.
  • Strengths in project management and budget management backed up by Miscellaneous training.
  • Detailed Adjuster with 16 years of corporate insurance claims experience.
  • Adapted quickly to changing industry regulations, ensuring compliant claims handling procedures that reduced legal risks by 16%.
  • Achieved 82% success rate in arbitrations.

Accomplishments

  • Collaborated cross-functionally with accounting and finance departments to audit and analyze reserve levels, resulting in a $6 adjustment that optimized reserve accuracy.
  • Trained and mentored new claims adjusters on policy wording, claims processing, and dispute resolution, increasing team productivity by 78%.
  • Reduced rework on claims documentation by 19% through structured training and auditing processes, enhancing accuracy in claims settlement.
  • Implemented a comprehensive fraud detection strategy that decreased fraudulent claims losses by $13 within a three years period.
  • Negotiated settlements on high-value claims exceeding $18, delivering favorable outcomes while maintaining strict compliance with insurance regulations.
  • Monitored KPI metrics for claims resolution times, leading to a 38% improvement in overall claims process efficiency.
  • Completed advanced certifications such as CPA to enhance customer dispute resolution skills, increasing settlement success rates by 27%.
  • Reduced claim review times by 47% using new software tools and optimizing reporting processes to better align with internal KPIs.
  • Managed a budget of $7 in claims operations, maintaining expenditure below projections by optimizing resource allocation.
  • Created detailed settlement reports for high-value claims, minimizing erroneous payments and lowering operational costs by $10 annually.

Affiliations

  • Active participant in The Institutes Risk & Insurance Knowledge Group
  • Completed training with Xactimate software 2023
  • Society of Insurance Research (SIR)
  • Society of Claims Law Associates (SCLA)
  • International Association of Insurance Professionals (IAIP)
  • Risk and Insurance Management Society, Inc. (RIMS)
  • Society of Women Engineers
  • Project Management Institute
  • Affiliate membership with the International Risk Management Institute (IRMI)
  • Associate in Reinsurance (ARe) Program

Certifications

  • Associate in Risk Management (ARM) - Vantage
  • Commercial Lines Coverage Specialist (CLCS) - method
  • Associate in Commercial Underwriting (AU) - Vantage
  • Salesforce
  • Senior Claim Law Associate (SCLA) – Lakeside Partners
  • Certified Public Accountant
  • SHRM Certified Professional (SHRM-CP)
  • Certified Professional Investigator (CPI) - 2022
  • Certified Property Casualty Underwriter (CPCU) - program
  • Certified Public Accountant (CPA)

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