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field claims representative resume example with 11 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:
Professional Summary

Business-minded Property & Casualty Adjuster with exemplary skills in customer service, time management and service coordination. Bringing over 10 years of related experience combined with superior evaluation and negotiation abilities. Experienced in building and maintaining clientele relationships in order to achieve company goals.

Work History
Field Claims Representative, 02/2018 - Current
Farm Bureau Financial Services Gilbert, AZ,
  • Evaluates unrepresented and represented third-party bodily injury claims, as well as first-party UM/UIM bodily injury claims.
  • Handles multiple levels of bodily injury claims from low-velocity impacts to fractures.
  • Negotiates and settles claims with attorneys, as well as direct claimants, in accordance with business unit best practices.
  • Conducts in-person and virtual contact with unrepresented claimants in order to gather injury info and assess witness qualifications at onset of claim.
  • Conducts scene investigations for accurate liability determination.
  • Trained arbitrator for Arbitration Forums.
  • Reviews new files to determine current status of injury claim and to develop plan of action.
  • Directs claims negotiations within allowable limit of $20,000.
  • Works toward claim resolution by maintaining regulatory compliance and fair claims practices within authority.
  • Summarizes claims in excess of authority and submitted to manager for approval.
  • Reviews police reports, medical treatment records and physical property damage to establish extent of liability.
  • Maintains contact with claimants and attorneys to determine treatment status.
  • Resolves complex, severe exposure claims using high service oriented file handling.
Independent Travel Agent, 02/2017 - Current
Outside Agents City, STATE,
  • Arranges travel accommodations for groups, couples and weddings.
  • Maintains operational proficiency in coordinating both international and domestic travel accommodations for customers, arranging for airfare as well as hotel and rental car reservations.
  • Provides customers with best deals and well-researched travel options, successfully negotiating rates while improving customer satisfaction ratings.
  • Provides exemplary customer service to new and existing clients, which helped build lasting relationships and secure new travel assignments.
  • Supervises payments via credit and debit cards and handled sensitive information with professionalism and discreteness.
  • Responds to clients' questions, issues, and complaints and found appropriate solutions when needed.
  • Developed loyal clientele base due to excellent listening and research skills and keen understanding of travel budgets.
  • Maintained currency on airline policies, tariff regulations and travel laws to maximize effectiveness.
Coverage Adjuster, 03/2015 - 12/2016
Allstate Insurance Company City, STATE,
  • Investigated policy coverage in moderately complex issues and Errors and Omissions claims by conducting customer and agent interviews.
  • Researched and reviewed auto policy and other contractual wording, while analyzing loss facts and damages.
  • Approved or denied coverage, based on outcome of investigation, for an average of 60 claims a month.
  • Communicated regularly with agents, outside legal counsel and home office attorneys as part of investigations.
  • Provided coverage explanation to customers including detailed explanation of benefits and/or reason for denial.
  • Examined claims forms and other records to determine insurance coverage.
Senior Claims Service Analyst, 12/2010 - 01/2018
Allstate Insurance Company City, STATE,
  • Maintained caseload of an average of 120 automobile claims monthly
  • Determined and explained minimum coverage limits in moderately complex claims involving single or multiple claimants.
  • Set and updated reserves, documented rationale and claim summary notes for bodily injury claims.
  • Obtained photos and/or conducted scene investigations for accurate and thorough claim handling.
  • Gathered medical bills and records from providers and claimants; reviewed medical reports in preparation for settlement.
  • Evaluated minor to moderate bodily injury claims and determined claim value based on loss facts and damage severity.
  • Negotiated and settled claims with unrepresented claimants.
  • Followed up with insured individuals regarding premium and deductibles payments.
  • Researched and gathered relevant information; obtained recorded statements and scheduled inspections; analyzed police reports, diagrams, scene and damage photos to determine the degree of fault for each involved party.
  • Acted as advocate for customer throughout claims process, as well as liaison between policyholders, body shops, and rental agencies.
  • Assisted in training new employees through desk sits and mentor program.
  • Negotiated settlements with policyholder and claimants, as well as attorneys and third-party insurance carriers to ensure equitable and timely settlements.
  • Served as unit representative for monthly advisory council meetings with upper management.
Skills
  • Personal, casualty and property loss
  • Policy investigations
  • Negotiation and mediation skills
  • Insurance policy coverage expert
  • Travel Research
  • Conflict Resolution
  • Marketing
  • Risk management
  • Medicare and Medicaid process
  • Medical and CPT coding knowledge
Education
BBA: Marketing, Expected in 08/2009
-
Prairie View A & M University - Prairie View, TX,
GPA:
Status -

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Resume Overview

School Attended

  • Prairie View A & M University

Job Titles Held:

  • Field Claims Representative
  • Independent Travel Agent
  • Coverage Adjuster
  • Senior Claims Service Analyst

Degrees

  • BBA

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