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Skills

  • Legal and regulatory compliance
  • Multi-state regulatory compliance
  • MS Office
  • Business operations
  • Claims Investigation
  • Loss valuation strategies
  • Operational improvement
  • Cross-functional team leadership
  • Communications
  • Project management for claims reviews

Work Experiences

  • Had an excellent attendance record and was always on time for work.
  • Conducted agent and claimant interviews to review questionable claims to correct omissions and errors.
  • Audited claims filed by junior representatives.
  • Achieved a 83% case approval rate improvement.
  • Achieved a 62% win rate on disputed claims.
  • Achieved 52% more than previous estimates.
  • Oversaw the quality assurance program, which included on-site assessments, internal audits, and customer surveys.
  • Reviewed police reports, medical treatment records, and physical property damage to determine the extent of liability.
  • Examined claim forms and other records to determine insurance coverage.
  • Achieved savings over a three years period.

Summaries

  • Proven track record of using excellent negotiating skills to speed up settlements.
  • Hardworking Field Claims Representative with 17 years of telecommuting experience meeting customer needs.
  • Recognized on a regular basis for outstanding performance and contributions to the Miscellaneous industry's success.
  • Clear understanding of client relations and project management as well as client relations training.
  • Excellent communication skills as evidenced by 15 years of experience interviewing experts, witnesses, and claimants in order to compile data.
  • Award-winning Field Claims Representative.
  • Adept at navigating high-volume caseloads.
  • Achieved accurate results through effective negotiation.
  • Adept at navigating high-volume caseloads while consistently achieving faster resolution times than industry benchmarks. Successfully recovered 69% more than predicted through settlement disputes in the past one year.
  • Overall morale and productivity are boosted by experience in policy development and staff management procedures.

Accomplishments

  • Investigated and resolved 12 high-complexity claims per month, improving settlement accuracy by 82%.
  • Led cross-functional teams of up to 15 adjusters to ensure timely and accurate claim resolutions in compliance with state and federal regulations.
  • Conducted in-depth legal compliance audits on 6 closed claims, leading to corrections that reduced audit infractions by 50%.
  • Trained and mentored 7 junior adjusters in claims best practices which resulted in a 37% performance improvement.
  • Resolved product issue through consumer testing.
  • Achieved 45% customer retention amidst disputes through successful mediation and conflict resolution strategies.
  • Implemented a digital claims processing system, reducing paperwork error rates by 38% and increasing claims workflow efficiency by 6 months.
  • Bilingual claim resolutions handled in both English and German, improving communication across diverse client bases.
  • Trained 8 new claims representatives in effective field investigation and report writing, improving team competence by 65%.
  • Identified and prevented fraud in 7 high-risk claims, saving 8 in potential losses.

Affiliations

  • Professional Liability Underwriting Society (PLUS)
  • Certified Professional Insurance Agent (CPIA) Certification Program
  • Claims & Litigation Management Alliance (CLM)
  • American Institute for Chartered Property Casualty Underwriters (CPCU Society)
  • Further Education Programs in Insurance and Risk Management at program
  • National Association of Social Workers
  • American Bar Association Litigation Section
  • Association of Certified Fraud Examiners (ACFE)
  • Property Loss Research Bureau (PLRB)
  • Lions Club

Certifications

  • Certified Insurance Counselor (CIC)
  • Chartered Property Casualty Underwriter (CPCU)
  • Google Certified Professional Cloud Architect
  • Construction Claims Professional (CCP)
  • SHRM Certified Professional (SHRM-CP)
  • CompTIA Network+
  • Associate in Reinsurance (ARe)
  • Certified Subrogation Recovery Specialist (CSRS)
  • Adjuster Licensing - All Lines Oregon
  • Accredited Insurance Examiner

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