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Bodily Injury Complex Claims Adjuster resume example with 10+ years of experience

Jessica Claire
Montgomery Street, San Francisco, CA 94105 609 Johnson Ave., 49204, Tulsa, OK
Home: (555) 432-1000 - Cell: - resumesample@example.com - -
Professional Summary
Experienced Bodily Injury/Liability Claims Adjuster with a demonstrated history of working in the insurance industry.  Skilled in Human Resources, Customer Service, Workers Compensation Claims, and Property/Casualty Claims.  Strong professional with a Bachelor's degree focused in Business Management/Human Resources.
Skills
  • Florida, North Carolina and West Virginia Claims Adjuster License
  • Personal, casualty and property loss
  • Skilled investigator/negotiator
  • Customer service-oriented
  • Highly motivated
  • Organized
  • Easily adjusts to fast paced environments
Work History
10/2013 to
Bodily Injury/Complex Claims Adjuster Risk Strategies Company Oviedo, FL,
  • Work independently to perform detailed and highly complex claim functions.
  • Investigate, evaluate and settle Auto Bodily Injury claims.
  • Reviews the status of open and closed reserves and makes adjustments consistent with exposures.
  • Authorize settlements within current authority level.
  • Assists less experienced claim representatives with claims that are more complicated and complex.
  • Assume responsibility for complex files that were previously assigned to other claim representatives.
  • Compared data from surveillance footage to data on medical reports.
  • Drafted investigative reports covering all phases of the investigation in each case.
  • Reviewed new files to determine current status of injury claim and to develop a plan of action.
  • Answered questions posed by insured, claimant and attorneys.
  • Answered customer questions regarding deductibles.
  • Maintained contact with claimants and attorneys to determine treatment status.
  • Trained other claims staff members on proper handling and evaluation of injury claims.
  • Documented all investigation activity and presented reports to management.
  • Substantiated legitimate claims and denied unjustified claims.
  • Partnered with legal counsel on litigation cases.
  • Evaluated insurance policies and analyzed damages to determine coverage.

05/2010 to 10/2013
Property & Casualty Representative State Farm Insurance Company City, STATE,
  • Review assignments to determine severity, coverage and appropriate action.
  • Conduct phone interviews and take recorded statements from all parties possessing facts regarding the claim. 
  • Review and interpret the policy coverage to determine the claim is payable under the policy.
  • Write reports for the claim file to document all activity related to the loss.
  • Evaluate the loss/damages.



05/2008 to 05/2010
Workers Compensation Claims Adjuster State Farm Insurance Company City, STATE,
  • Investigate and adjust works compensation claims in accordance with established claims handling procedures.
  • Review medical, legal and miscellaneous invoices to determine if reasonable and or related to the ongoing workers compensation claims.
  • Authorize and make payment of workers compensation claims.
  • Negotiate settlements with claimants and attorneys.
  • Assist is selection and supervision of defense attorneys. 
  • Prepare reports detailing claims, payments and reserves.


05/2007 to 05/2008
Workers Compensation Claims Service Assistant State Farm Insurance Company City, STATE,
  • Provide clerical assistance as needed
  • Answer phones, prepare and mail letters, and balance payment logs.

03/2001 to 05/2005
Human Resources / Underwriting Service Assistant State Farm Insurance Company City, STATE,
  • Review resumes, select candidates for pre employment testing
  • Contact candidates to schedule pre employment testing
  • Facilitate mass testing
  • Extend and process job offers
  • Organize and maintain in office Job Opportunity Program
  • Schedule interviews

Education
Expected in 2014
Bachelor of Science: Business / Human Resources
Warner Southern University - Lake Wales, FL
GPA:

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Resume Overview

School Attended

  • Warner Southern University

Job Titles Held:

  • Bodily Injury/Complex Claims Adjuster
  • Property & Casualty Representative
  • Workers Compensation Claims Adjuster
  • Workers Compensation Claims Service Assistant
  • Human Resources / Underwriting Service Assistant

Degrees

  • Bachelor of Science

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