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Skills

  • Automobile claims specialist
  • Thoughtful writer
  • Insurance policy coverage knowledge
  • Cross-functional team leadership
  • CCC Pathways Appraisal Quality Solution
  • Underwriting knowledge
  • Litigation avoidance strategies
  • Sales background
  • Risk management
  • CCC Pathways

Work Experiences

  • Achieved a 72% reduction in customer wait times.
  • Conducted agent and claimant interviews to review questionable claims to correct omissions and errors.
  • Was in charge of maintaining claims data in process systems.
  • Reconciled data in the direct collection system with the accounting system to address discrepancies.
  • Was in charge of directing and coordinating the field investigation team's investigations.
  • Investigated claims and incident data in order to provide solutions and resolve issues.
  • Determined liability as outlined in the coverage and assessed documentation from police and healthcare providers to understand the damages incurred.
  • Fixed program codes so that initiative claims could be properly classified.
  • Calculated the quantifiable features of category products.
  • Gathered and tracked evidence in support of legal processes.

Summaries

  • Complete knowledge of the claims process and performance reporting.
  • Dedicated to learning, growing, and succeeding in Miscellaneous.
  • Detailed Adjuster with 9 years of corporate insurance claims experience.
  • Empathy, dependability, and enthusiasm for customer satisfaction.
  • Strong conflict resolution and negotiation skills, as well as excellent reporting and research abilities.
  • Exceptional at resolving claims to the mutual satisfaction of all parties.
  • Recognized on a regular basis for outstanding performance and contributions to the Miscellaneous industry's success.
  • Overall morale and productivity are boosted by experience in policy development and staff management procedures.
  • Bringing a proven track record of success in Senior Claims Adjuster, Automobile and Casualty roles throughout a progressive insurance industry career.
  • Outstanding communication skills, both verbally and in writing.

Accomplishments

  • Developed customized training materials for state-specific claims procedures, which led to a 85% improvement in certification pass rates for staff.
  • Regularly communicated with policyholders and third-party claimants, reducing response turnaround time by 12 percent and boosting customer satisfaction.
  • Analyzed intricate multi-state regulatory requirements to ensure all claims were handled in compliance with regional and federal laws, minimizing lawsuits by 27%.
  • Directed a 12-person internal audit team to assess claims reserves, providing corrective recommendations that reduced discrepancies by 74%.
  • Streamlined subrogation recovery efforts, recovering an additional $18 in overpaid claims in 2023 from at-fault third parties.
  • Successfully managed and resolved high-dollar claims above $6, protecting the company's financial interests while maintaining regulatory compliance.
  • Redesigned claims processing workflows using QuickBooks, slashing average claims processing time by 6 days, thus enhancing client satisfaction.
  • Researched and applied industry best practices which improved fraud detection accuracy by 25%, significantly cutting unnecessary payouts.
  • Served as the key senior representative for high-profile claims and client interactions, ensuring a 54% increase in retention of corporate clients.
  • Documented and resolved method which led to procedure.

Affiliations

  • Chartered Property Casualty Underwriters (CPCU) Society
  • Freemason
  • International Council of Nurses
  • International Association of Special Investigation Units (IASIU)
  • American Institute For Chartered Property Casualty Underwriters (AICPCU)
  • Associate in Risk Management (ARM) designation
  • National Association of Subrogation Professionals (NASP)
  • Association of Claims Professionals (ACP)
  • National Alliance for Insurance Education and Research (NAIER)
  • Society of Insurance Trainers and Educators (SITE)

Certifications

  • Online Ethics Certificate for Claims Adjusters - National Insurance Crime Bureau (NICB)
  • Associate in Insurance Data Analytics (AIDA) - The Institutes
  • CompTIA A+ Technician
  • Professional Risk Manager (PRM) - Professional Risk Managers International Association (PRMIA)
  • Certified Litigation Management Professional (CLMP) - Claims & Litigation Management Alliance (CLM)
  • Certified Expert in Commercial Claims (CECC) - Chartered Institute of Insurance Claims Professionals (CIICP)
  • Claims & Coverage Manager Designation (CCM) - International Association of Claims Professionals (IACP)
  • Cisco Certified Internetwork Expert (CCIE)
  • SHRM Senior Certified Professional (SHRM-SCP)
  • Certified Claims Professional (CCP) - American Educational Institute

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