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Inside Claims Adjuster resume examples

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Skills

  • Policy analysis
  • Organization
  • Fraud identification
  • Effective communications with policyholders
  • Advanced use of proprietary claims software tools
  • Administrative support
  • MS Office
  • Field claim assessments
  • Operational improvement
  • Customer onboarding assistance for claims

Work Experiences

  • Uploaded documentation and reports to the corporate database system using Jira to ensure smooth claims processing.
  • Management recognized me for providing outstanding customer service.
  • Achieved a 63% pass rate during quarterly audits.
  • Achieved Innovation Award for consistently maintaining a claims closure rate of 72% above company benchmark.
  • Analyzed medical records and billings associated with bodily injury claims, reducing erroneous medical payouts by $10.
  • Achieved Employee of the Year.
  • Achieved results over one year.
  • Assessed property damage in Portland.
  • Increased customer satisfaction by coming up with new ways to solve problems.
  • Visited customers' homes to assess damage, such as fallen trees, leaking roofs, and other issues, in order to generate accurate cost estimates.

Summaries

  • Achieved a reduction of 85%.
  • Accurately interpreted insurance policies.
  • Student pursuing a Miscellaneous degree who is eager to contribute developed knowledge in the role of Inside Claims Adjuster.
  • Achieved cost savings of $10.
  • Budget management in metric settings and budget management in quality assurance settings.
  • Proactive category professional who is successful in presenting information to policyholders using strong interpersonal skills.
  • Adaptable professional with a comprehensive understanding of insurance policies.
  • Knowledge of Microsoft Excel in depth, as well as risk assessment and performance reporting abilities.
  • Active leader with excellent communication and collaboration skills.
  • Ability to recognize method issues and integrate procedure solutions to achieve standard.

Accomplishments

  • Assisted leadership in setting strategies for minimizing customer complaints during high-volume claim periods, improving retention by 58%.
  • Received 'President's Club' for resolving complex personal injury claims, driving down claims expenses by $13.
  • Identified and resolved fraudulent claims totaling $3 in savings, using investigative techniques and data review strategies.
  • Received 'Six Sigma' for exceptional claims handler performance, maintaining high levels of accuracy, customer satisfaction, and compliance.
  • Recognized for resolving disputed claims in several months days on average, improving overall departmental metrics.
  • Developed detailed incident reports and cost analysis to successfully challenge and reduce 72% of customer appeal cases.
  • Managed and resolved high-dollar claims efficiently, ensuring compliance with state and federal regulations while reducing payout errors.
  • Prepared and presented over 11 arbitration cases, winning favorable decisions in 16% of the disputes.
  • Received 'Outstanding Service Award' for successfully auditing 7 claims files, uncovering $3 in discrepancies, and improving audit accuracy.
  • Provided expert recommendations to senior management on complex claims worth more than $5, helping mitigate financial risks.

Affiliations

  • Volunteer, Industry Mentorship Program for Junior Claims Adjusters hosted by Summit Group
  • Participant, Online Certificate Program in Xactimate and Estimating, method
  • Member, Property Loss Research Bureau (PLRB)
  • Alumni, method with a focused study in Risk Management and Insurance
  • Member, Society of Chartered Property and Casualty Underwriters (CPCU)
  • Member, National Association of Independent Insurance Adjusters (NAIIA)
  • Completion, Continuing Education for Adjuster Licensure in initiative
  • Participant, American Educational Institute (AEI) for Casualty Claims Law - Property Expert Program
  • Affiliate, International Association of Special Investigation Units (IASIU)
  • Participant, Ongoing Education on Microsoft Excel Implementation in Claims Handling

Certifications

  • Introduction to Catastrophe Claims Adjusting - The Institutes
  • Claims and Litigation Management Alliance (CLM) Fellow
  • Claims Adjuster License - metric
  • CompTIA Security+
  • Senior Claims Law Associate (SCLA) - American Educational Institute (AEI)
  • Workers' Compensation Claims Professional (WCCP)
  • Cisco Certified Internetwork Expert (CCIE)
  • Certified Property and Casualty Underwriter (CPCU) - The Institutes
  • Google Certified Professional Cloud Architect
  • Accredited Claims Adjuster Designation (ACA) - Colorado University

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