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claims specialist resume example with 19+ years of experience

Jessica Claire
  • Montgomery Street, San Francisco, CA 94105 609 Johnson Ave., 49204, Tulsa, OK
  • H: (555) 432-1000
  • C:
  • resumesample@example.com
  • Date of Birth:
  • India:
  • :
  • single:
  • :
Summary

Dynamic insurance professional bringing 28 years in the field of insurance with an emphasis on commercial casualty claims.

Highlights
  • Claims file management processes
  • Strong interpersonal and communication skills
  • Property claims
  • Workers’ compensation claims
  • Customer advocate
  • Report writing
  • Analytical
  • Team player
  • Critical thinker
  • Casualty auto insurance
  • Active Property and Casualty Insurance License with the New Mexico Department of Insurance
Accomplishments
  • New Mexico Insurance Agent License Obtained in 2014, Vale National Certified for Dwelling Damage Estimating, INS 23 Casualty Insurance; Alliance of American Insurers Lesson Homeowners Insurance and Forms and Endorsements; AIC 33 The Claims Person and the Public; Focused Interview Workshop and Labor and Employment Law - Week Seminar; Seminar by O'Hagan, Smith & Amundsen - Clamp Down on Damage Claims Psychological Claims, Biomechanical Engineering Analysis, TMJ Syndrome; Pictorial Legal Concepts and Doctrines 2nd Edition; Seminar by Bair & Fountain P.C.
Experience
Claims Specialist, 01/2014 - 01/2015
Crst International Dunbar, WV,
  • Work with accounts to ensure efficient, prompt and smooth flow of handling of all claims,ensuring that established processes are followed.
  • Provide guidance to client as to claim process along with direction regarding likely outcome and timelines.
  • Review and contact claims representatives regularly.
  • Answer basic coverage questions.
Claims Examiner, 07/2008 - 05/2010
Aaa Of Southern California Shawnee, KS,
  • Third party administrator-Risk Management liaison for Albuquerque Public Schools.
  • Efficient management of incoming claims and monitoring claims.
  • All cases of moderate to high exposure claims.
  • Organizing and monitoring reconstruction companies and various departments within APS.
Property Consultant, 10/2005 - 02/2006
Sedgwick Claims Management Services, Inc. Pasadena, CA,
  • Case Manager for Zurich / Empire for Hurricane Wilma Claims in the Miami Florida.
  • Completed complex coverage analysis and prepared reservation of rights letters where appropriate.
  • Obtain proper policy information from underwriting department for proper claim coverage to complete coverage investigation.
Senior Claims Examiner, 03/2003 - 10/2005
Country Financial Centralia, IL,
  • Key liaison for high profile accounts in Wisconsin Dells, Chicago area supermarkets, and assisted living facilities.
  • Responsible for efficient management, disposition of manuscript policies, executing waivers, reservations of rights and disclaimers.
  • Handle moderate to high exposure bodily injury litigated and non-litigated files.
  • Assisting Spanish speaking customers and translating letters to customers or from customers for various units within the company.
Senior Claims Representative, 01/2001 - 03/2003
Country Financial Channahon, IL,
  • Familiarity of manuscript policies, review of coverage, issuing waivers, reservation of rights and disclaimers.
  • Identify and resolve cases that can /could be settled without litigation and coordinate effective defense strategy of files in litigation.
  • Prepare timely reports to managers when high exposure claims are involved.
  • Participated in the Group Focus Committee.
Claims Manager/Supervisor, 04/1997 - 08/1998
Farm Bureau Financial Services IA, State,
  • Guided weekly Pictorial Training sessions for automobiles first level, to claim representatives.
  • One Field Appraiser each week was invited to explain the mechanics, structure and repairs of vehicles and how body shops functioned.
  • Designed workflow and trained adjusters successfully, reducing time average claim open from 36 days to 22 days.
Senior Claims Representative, 07/1992 - 10/1995
Farm Bureau Financial Services Las Cruces, NM,
  • Training and supervised beginning claims adjusters and clerical assistants while personally handling a significant claim workload.
Casualty Claims Representative, 08/1990 - 07/1992
Colonial Penn Insurance City, STATE,
  • Managed all cases through the full claims cycle for Illinois and Minnesota, handled a 180+ unit general claim workload, designed and implemented insurance forms written in Spanish.
Casualty Claims Representative, 04/1985 - 07/1990
Metropolitan Property & Casualty City, STATE,
  • Handled a claim workload consisting of both physical and property damages and all aspects of no fault and bodily injury claims.
Education
Business Administration : Business , Expected in 2016
-
Brown Mackie College - Albuquerque, NM
GPA:
Status -

Currently attending night classes to complete my associates degree in Business Administration. Once obtained, continuing to pursue a Bachelors in Business Administration will be the next step.

Languages
Fluent in Spanish oral and written.
Skills

Casualty commercial insurance, basic clerical functions and equipment, client customer service, direction, familiarity with forms, insurance letters, litigation process, organizing policies, and processes, risk management.

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Resume Overview

School Attended

  • Brown Mackie College

Job Titles Held:

  • Claims Specialist
  • Claims Examiner
  • Property Consultant
  • Senior Claims Examiner
  • Senior Claims Representative
  • Claims Manager/Supervisor
  • Senior Claims Representative
  • Casualty Claims Representative
  • Casualty Claims Representative

Degrees

  • Business Administration

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