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Jessica Claire
, , 100 Montgomery St. 10th Floor (555) 432-1000, resumesample@example.com
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 Current Auto Claims Handler II Sedgwick 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 03/2021 Claim Adjuster Kemper 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 10/2018 Claims Adjuster First 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 08/2010 Bachelor of Arts | Business Administration Florida Atlantic University, Boca Raton, FL GPA:

Florida & Louisiana

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Resume Overview

School Attended

  • Florida Atlantic University

Job Titles Held:

  • Auto Claims Handler II
  • Claim Adjuster
  • Claims Adjuster

Degrees

  • Bachelor of Arts

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