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commercial casualty and general liability claims specialist resume example with 20+ 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 - -
Summary

Result driven professional with over a decade of customer service and claims handling experience. Unwavering commitment to providing exceptional service in a fast pace environment. Needs little to no direction in day-to-day functions and a self-starter. Excellent and effective communicator with strong interpersonal skills with the ability to work independently and collaboratively in a team environment.

Highlights
  • Critical thinker
  • Creative Problem Solver
  • Strong organizational skills
  • Skilled Negotiator
  • Leadership/communication skills
  • Project management
  • Self-motivated
  • Management Experience
Accomplishments

Lean Management based projects: Participated in the Value Stream Mapping Event in Farmingdale, NY focusing on current & future state business processes in addition to developing standard work within the No Fault line of business and litigation platform presenting results to senior leadership.

Participated in the No Fault Kaizen in Ft.Lauderdale; creating the Standard of Work for FL No Fault litigation.

Mentored and trained employees on the implementation of Lean Management tools.

Actively leads Root Cause Problem Solving Sessions to continuously improve business functions and work flows.

Project Management: works as a liaison between PAL practices and Commercial Insurance developing standard work and focusing on process improvement. Works actively with management and the standard work committee on the implementation of lean concepts and process improvement within Commercial Insurance.

Recipient of the Variable Incentive Plan (VIP) Top 10% Award in 2011 & 2012

Successfully managed a department of 15-20 employees.

Experience
07/2014 to Current
Commercial Casualty and General Liability Claims Specialist Liberty Mutual Anaheim, CA,

Reduced loss ratios through fair and prompt processing of claims.Obtained relevant evidence and information regarding suspicious claims.Interviewed claimants, medical specialists and employers to determine pertinent claim information. Attended anti-fraud trainings, conferences, client SIU trainings and industry seminars.Conducted interviews, gathered detailed information. Investigated any potentially fraudulent claims with a focus on thoroughness, quality and cost control.Mentored new members of the claim staff. Identified and collected evidence and determined its value to a specific claim.Served as subject matter expert on the Standard Work Committee focusing on business work flow and improvement. Contacted injured parties and legal representatives to negotiate final settlements for claims.Recommended settlement offers and negotiated payment arrangements.Kept up-to-date on changes in regulations for deductibles and collections.Obtained all necessary information to complete proper evaluation of injury claims.Completed required investigations on referred files in a timely manner.

07/2004 to 07/2014
Senior Claims Specialist I Upgrade Inc. San Francisco, CA,
  • Handling all aspects of the claims process including coverage analysis, investigation, taking statements, bill processing, medical management, handling demands submitted by attorneys and medical providers, negotiations, reviewing/explaining contracts, and customer service.Lead in the Litigation Department resolving all incoming lawsuits. Training and development of employees. Current on all aspects of Florida's Legislative changes, implementing new changes and offering resolutions/legal strategies to these issues as they arise. Works actively with senior management in facilitating and executing training of staff in areas of work flow, customer service, production, SIU, litigation strategies and business best practices.
1997 to 2004
Customer Service Manager Winn-Dixie City, STATE,
  • Interviewed, hired and trained new team members.Delegated tasks to team members to optimize productivity.Supervised 10-20 employees per shift.Handled products and equipment in accordance with safety and sanitation guidelines.Served shoppers in a prompt, courteous and friendly manner.Evaluated department conditions and operations to determine strengths and areas for improvement.Emphasized fast, friendly customer service.Rewarded and disciplined associates.
Education
Expected in 2003
B.A: Interpersonal Communications
University of Central Florida - Orlando, FL
GPA:
Skills

Communication Skills, Management, Customer service, Leadership, Problem Resolution, Process Redesign, Project Management, Careful and active listener, Multi-tasking,Project Planning, Staff Motivation, Staff Training, Change Implementation, Managing, Team Building, Team Leadership, Team Player, Training and Development, Negotiations, Litigation

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Resume Overview

School Attended

  • University of Central Florida

Job Titles Held:

  • Commercial Casualty and General Liability Claims Specialist
  • Senior Claims Specialist I
  • Customer Service Manager

Degrees

  • B.A

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