insurance claims adjuster resume example with 10+ years of experience
JessicaClaire
Montgomery Street, San Francisco, CA94105609 Johnson Ave., 49204, Tulsa, OK Home: (555) 432-1000 - Cell: - resumesample@example.com - : - -
Professional Summary
Claims Adjuster skilled in investigating and analyzing liability concerning auto, casualty or property loss. Proven history of leveraging excellent negotiation skills to facilitate settlements. Independent problem-solver who also coordinates well with management and other company employees. Excellent communication skills demonstrated through several years of experience interviewing specialists, witnesses and claimants to compile information.
Skills
Multi State Claims Adjuster License; can obtain additional as needed
Advanced computer skills
Insurance policy coverage knowledge
Subrogation expert
Personal, casualty and property loss
Underwriting knowledge
Excellent written and oral communication
Medical terminology knowledge
Reporting skills
Documentation abilities
Proficient in Microsoft Office applications - Word, Excel, PowerPoint
Teamwork and Collaboration
Negotiation
Policy Investigations
Claims Management
Insurance Policy Coverage Knowledge
Computer Skills
Work History
09/2021 to 01/2023
Insurance Claims AdjusterMejuri – San Francisco, CA,
Analyze files to determine likelihood of subrogation recovery, identify and outline information necessary for subrogation recovery, and relay information to appropriate claims manager.
Demonstrated respect, friendliness and willingness to help wherever needed.
Communicate with external parties including but not limited to claimants, insureds, witnesses, attorneys, and other insurance carriers regarding subrogation recoveries or investigations into claims.
Conduct investigations into 30+ assigned claims, including ordering police reports; completing ISO filings; and retaining appraisers, independent adjusters, and other outside vendors.
Identify potentially responsible parties and prepare appropriate demands.
Represent company in meetings, arbitrations, mediations, legal proceedings or other forums concerning subrogation matters or assigned claims.
Negotiate settlements of subrogation claims within authority and make recommendations for approval when required.
Assure proper crediting of subrogation payments received
10/2015 to 09/2021
Insurance AdjusterAAA Texas – City, STATE,
Examined claims forms and other records to determine insurance coverage.
Reviewed police reports, medical treatment records, and physical property damage to determine extent of liability.
Directed claims negotiations within allowable limit of $10,000 and supported successful litigations for advanced issues.
Determined liability outlined in coverage and assessed documentation such from police and healthcare providers to understand damages incurred.
Conducted thorough property investigations to identify and classify damages for customer claims.
Conducted comprehensive interviews of witnesses and claimants to gather facts and information.
Prepared summaries of damage, payments, and policy coverage.
Negotiated with policyholders and claimants to reach mutually satisfactory resolutions.
Mitigated risks and increased profitability with well-developed strategies for reducing future claims and costs.
Trained other claims staff members on proper handling and evaluation of injury claims.
Consulted police and hospital records when needed.
Substantiated legitimate claims and denied unjustified claims.
Negotiated terms and handled settlements and adjustments with attorneys, claimants and co-defenders.
Prepared and presented complex cases to management, in-house legal team and Claims Committee.
Reviewed over 100 medical treatment reports, police reports and medical bills in 2020 for AAA Texas.
Documented and tracked claims approval process and communicated status monthly with claimants, attorneys and in-house personnel.
Carried and managed consistently heavy project workload through exemplary organizational, time management and collaboration talents.
Enhanced customer satisfaction by delivering honest advice to policyholders in regards to repair work and body shop processes.
Assessed complex claims and accurately determined value of damages.
Successfully negotiated settlements with claimants and insurers.
02/2012 to 10/2015
Assistant Store ManagerKroger – City, STATE,
Interviewed, hired, and trained staff associates and equipped to comply with company policies and procedures.
Supervised and evaluated over 100 staff members to help improve skills, achieve daily objectives, and attain advancement.
Responded to customer concerns, working with manager to significantly raise customer satisfaction ratings.
Maintained positive customer relationships by responding quickly to customer service inquiries.
Provided weekly work schedules to employees to accommodate business demands and vacation requests.
Managed opening and closing procedures and recommended changes to enhance efficiency of daily activities.
Walked through store areas to identify and proactively resolve issues negatively impacting operations.
Rotated merchandise and displays to feature new products and promotions.
Tracked employee attendance and punctuality, addressing repeat problems quickly to prevent long-term habits.
Scheduled employees for shifts, taking into account customer traffic and employee strengths.
Supervised creation of exciting merchandise displays to catch attention of store customers.
Monitored daily cash discrepancies, inventory shrinkage and drive-off.
Reported issues to higher management with great detail.
Education
Expected in 07/2012 to to
MBA: Business Administration And Management University of Phoenix - Tempe, AZ GPA:
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