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Skills

  • Benefits review
  • Documentation automation
  • Operational improvement
  • Regulatory compliance
  • Strategic decision making
  • Procedure equipment
  • Root cause analysis
  • Fraud detection and prevention
  • Data-driven decision making
  • Cross-functional project management

Work Experiences

  • Conducted risk assessment.
  • Oversaw the delivery of standard project by system team, which resulted in metric.
  • Collaborated with external experts such as engineers, auditors, and medical professionals to gather crucial evidence for high-complexity liability cases.
  • Collaborated with external experts.
  • Achieved 70% satisfaction ratings.
  • Looked for industry trends on social media and through online sources.
  • Created and delivered workshops on claims negotiation best practices, resulting in a 50% increase in team settlement success rates.
  • Adhered to set thresholds during negotiations.
  • Achieved 37% resolution rate in pre-litigation settlements.
  • Authored comprehensive reports and summaries on high-profile claims worth over $8, supporting senior leadership’s decision-making process.

Summaries

  • Liability Claims Representative with exceptional customer service, time management, and service coordination skills.
  • Excellent track record of resolving issues, increasing customer satisfaction, and driving overall operational improvements.
  • Achieved best-in-class outcomes.
  • Dedicated Liability Claims Representative.
  • Achieved favorable outcomes for 23% of claims.
  • Achieved a 62% closure rate without litigation.
  • Achieved a 77% reduction in operational errors.
  • Adaptable performer.
  • Trying to get a similar job with a growing insurance company.
  • Consistently surpassed departmental closure goals by 53%.

Accomplishments

  • Performed in-depth accident reconstructions with the aid of external experts, preventing fraudulent claims and saving $104,000.
  • Developed and presented technical reports on liability claims trends, helping to inform strategic company decisions.
  • Conducted mediation sessions for liability claims, resolving 85% of cases without escalating to costly litigation.
  • Developed training programs on insurance liability for employees across multiple departments, increasing overall understanding and reducing errors.
  • Established relationships with outside counsel, enabling faster and more efficient handling of complex liability cases.
  • Led claims audits to identify potential coverage issues, reducing compliance errors by 40% within the claims department.
  • Engaged with legal teams and experts to prepare for successful settlement negotiations, reducing potential liability by $71,000.
  • Effectively managed a caseload of 2 liability claims, exceeding closure rate benchmarks by 29%.
  • Collaborated with team of 16 in the development of standard.
  • Reduced the average formal inquiry length by 38% through effective interview and fact-gathering techniques.

Affiliations

  • Lions Club
  • Defense Research Institute (DRI)
  • Certified Insurance Counselors (CIC) Membership
  • Association of Average Adjusters
  • Association for Supply Chain Management (APICS)
  • Certified Claims Professional (CCP) Program
  • Underwriting Service Organization (USO) Liability Research Council
  • National Alliance for Insurance Education & Research
  • International Council of Nurses
  • Association of Plaintiff Interstate Trucking Lawyers of America (APITLA)

Certifications

  • Advanced Claims Adjuster Series Certification (ACASC) - framework
  • Negotiation Mastery (Certified) - procedure
  • SHRM Senior Certified Professional (SHRM-SCP)
  • Associate in Claims (AIC) - procedure
  • Cisco Certified Internetwork Expert (CCIE)
  • Microsoft Certified Systems Engineer (MCSE)
  • Associate in Liability Claims Management (ALCM) - initiative
  • Certified Insurance Fraud Investigator (CIFI) - category
  • Google Certified Professional Cloud Architect
  • Negotiation Certificate Program - Northwind

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