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Claims Adjuster Resume Example

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CLAIMS ADJUSTER
Experience
Claims Adjuster 03/2015 to Current TriMet Portland, Oregon
  • Investigate liability of 3rd party bodily injury and property damages claims made against TriMet.
  • Conduct on-site inspections of TriMet facilities, Park and Rides, platforms, Transit Centers and right-of-ways to determine if any hazards or liability exist.
  • Negotiate settlements within our SIR of $5million where liability exists for the Agency.
  • Identify recovery dollars for the Agency due to another party's negligence.
  • Work with our Safety Division and attend bus/rail accident reviews.
  • Work closely with our defense attorneys and attend mediations.
  • Knowledgeable in the Oregon Tort Claims Act.
  • Achievements:.
  • Current TEI Board of Directors- Co-treasurer.
  • Coordinated the development of a paperless environment for our department.
  • Provide education and training to the Agency on subrogation/recovery efforts.
  • Developed an updated Claim Reporting form and procedures to align with the Tort Claims Act.
  • Drafted claim forms and templates.
  • Implemented a paperless mail room.
  • Volunteered for Portland Rose Festival and First Ave Project.
  • Participated as a member of the Operations Safety Committee.
  • Working toward my PRIMA Risk Management Certification.
Commercial Claims Specialist III 12/2003 to 03/2015 Nationwide Insurance Portland, Oregon
  • Specialize in commercial claims involving moderate to serious injuries and property damage.
  • Met face-to-face with business owners to discuss their insurance coverages and investigate accidents relating to their business operations.
  • Met with injured parties and evaluated medical records to determine the value of their injury claim.
  • Worked with attorneys to settle claims.
  • Made decisions within delegated authority and proactively moved claims toward resolution.
  • Adhered to high standards of professional conduct and consistently provided superior customer service.
  • Achievements:.
  • Successfully negotiated a multi-claimant case in excess value of $800,000.
  • Continuously achieved an average closed-file ratio of over 100%.
  • Consistently a top performer with claim audit scores above 95%.
  • Appointed as council member of the Nationwide Rocky Mountain Diversity and Inclusion Business Council.
  • Co-chaired the Leadership Action Team to develop claim customer-focused material and letters.
  • Chosen to be in the 2005 Emerging Leaders Program from over 60 applicants Handpicked to be involved in the re-design of the New Hire Casualty program in Des Moines, Iowa.
Unit Claim Manager 01/1999 to 11/2003 Travelers Insurance St. Paul, Minnesota
  • Supervised a staff of seven commercial claim representatives.
  • Responsibilities included writing performance reviews and recommending merit increases.
  • Proactively addressed performance issues with employees and worked closely with HR.
  • Successfully serviced the needs of small, medium and large commercial lines client accounts.
  • Assisted with claim reviews and acted as a key contact for commercial accounts.
  • Worked as a liaison between underwriting and claims departments.
  • Developed and monitored the investigation, evaluation, negotiation and resolution of the claim handlers' files.
  • Implemented unit performance goals and measurements in connection with business objectives.
  • Achievements:.
  • Oversaw the management of 500 open claims year-to-date on average.
  • Supervised over $13 million dollar reserve portfolio.
  • Reduced unit vendor expenses by 9% from the previous year by developing the use of internal certification medical forms instead of using an outside vendor.
Senior Commercial Claim Representative 01/1994 to 01/1999 St. Paul Insurance Companies St. Paul, Minnesota
  • Negotiated Errors and Omission claims for real estate agents, appraisers, and title agents.
  • Met the special needs of accounts in relation to this customized insurance line of business.
  • Also handled more complex commercial liability claims including employment practice liability and litigation.
  • Covered a region involving Minnesota, North and South Dakota, Iowa, Wisconsin, Nebraska, and Colorado.
  • Investigated auto bodily injury, premise, and product liability claims.
  • Met face-to-face with insureds, claimants, and attorneys.
  • Inspected claim accident sites and reviewed other documents to evaluate, negotiate, and resolve claims.
  • Handled claims in litigation.
  • Proactively worked with defense counsel in the resolution of litigated files Handpicked to investigate international claims for the Global Claims Division.
  • Recognized as a "High Potential" Employee.
  • Employees with this designation are singled out for special projects and promotions when available.
Education and Training
B.A: International Relations 1993 University of Minnesota Minneapolis, Minnesota International Relations
Certifications
Minor- Spanish Accreditations Language Commercial Lines Coverage Specialist designation (CLCS) 2009 Completed three CPCU courses (510,552,530)
Languages
Conversational and written skills in Spanish
Skills
Agency, business operations, Council, client, customer service, forms, HR, insurance, Leadership, letters, litigation, mail, negotiation, performance reviews, real estate, Reporting, Risk Management, Safety, settlements, Spanish, underwriting, written skills
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Resume Overview

Companies Worked For:

  • TriMet
  • Nationwide Insurance
  • Travelers Insurance
  • St. Paul Insurance Companies

School Attended

  • University of Minnesota

Job Titles Held:

  • Claims Adjuster
  • Commercial Claims Specialist III
  • Unit Claim Manager
  • Senior Commercial Claim Representative

Degrees

  • B.A : International Relations 1993

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