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Summary
Talented Claims Adjuster emphasizing effective time management, cost control andmediation. Self-motivated and customer focused. Detail-oriented Property Claims Adjusterwith over 3 years of experience investigating property claims in accordance with federaland state regulations. Personable and understanding with exceptional organizationalskills. Adept at obtaining evidence and information regarding claims.
Skills
Strong interpersonal and communication skills
Claims file management processes
Interviewing techniques
Problem-solving abilities
Settlement determinations
Coverage assessments
Regulatory compliance understanding
Documentation skills
Policy knowledge
Fraud identification
Decision-making skills
Issue and conflict resolution
Decision-making
Critical thinking
Experience
03/2021 to CurrentAuto Claims Handler IISedgwick Claims Management Services, Inc. | Muskegon, MI,
Evaluate and investigate policy coverage, liability and damages in a timely manner while following a set of general claims and statutory guidelines
Assist internal and external customers with problems or questions regarding claims by phone or through written correspondence while providing a high level of customer service
Establish initial reserves for all potential exposures and adjust as appropriate throughout the claim
Establish and maintain appropriate management of assigned inventory following company guidelines
Conduct thorough investigations including obtaining necessary documents and forms from claimants and insureds; conducting recorded statements
Ensure timely completion of appraisals and determine accident related damages
Communicate with involved parties and negotiate appropriate settlements with claimants, insureds and attorneys within approved payment authority
Recognize recovery opportunities in regards to subrogation and salvage
10/2018 to 03/2021Claim AdjusterKemper Corp. | Downers Grove, IL,
Evaluate and investigate policy coverage, liability and damages in a timely manner following a set of general claim and statutory guidelines
Assists internal and external customers with problems or questions regarding claims by phone or through written correspondence while providing a high level of customer service
Establish initial reserves for all potential exposures and adjust as appropriate throughout the claim
Evaluate policy coverage, contact insureds, claimants, attorneys, body shops while determining and establishing reserve requirements
Document computer log with results of review and intentions for handling
Plan and conduct investigations (including but not limited to interviewing parties involved, collecting and evaluating documentation and securing evidence and protecting the chain-of-custody, determine inspection needs, order police reports, scene investigation, take witness statements, review material damage photos, etc.) to analyze coverage, determine liability, compensability, and extent of damages
Compile information for decision making with discussion of claims committee where appropriate
Maintain accurate records and handle administrative responsibilities associated with processing and payment of claims
Record and update status notes, and document results of contacts per Best Practices
Determine need for independent adjusters, cause and origin experts, economists, accident re-constructionists, and engineers
Respond timely and appropriately to all settlement demands
Keep internal and external customers advised of file status and other matters as required
Evaluate claim for potential fraud and work with Special Investigations Unit as required
Assess actual damages associated with claims and conduct negotiations to settle claims
Determine if subrogation exists and take steps necessary to initiate recovery efforts
05/2018 to 10/2018Claims AdjusterFirst Acceptance Insurance | City, STATE,
Handle low to moderately complex cases., Obtain facts to evaluate coverage, liability, mechanics, and causation/damages
Take focused and thorough recorded statements from appropriate parties
Identify subrogation and salvage opportunities and complete required referral timely
Establish and maintain appropriate claim reserves
Provide timely contact with all required parties
Provide excellent customer service including keeping appropriate parties updated throughout the claim's adjustment process
Assure cost-effective resolution
Coordinate potential fraud investigations with SIU
Comply with state specific regulations and state fair claim practices requirements
Represent the claim department to our customers, retail agents, regulatory authorities, and other contacts to promote the Company's image and mission
Maintain quality claim files in accordance with appropriate best practices and claim handling file expectations
Participate in individual and department training as needed
Work effectively with team members and other departments
Education and Training
Expected in 08/2010Bachelor of Arts | Business AdministrationFlorida Atlantic University, Boca Raton, FLGPA:
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