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liability claim adjuster manger resume example with 7+ years of experience

Jessica Claire
  • , , 609 Johnson Ave., 49204, Tulsa, OK 100 Montgomery St. 10th Floor
  • Home: (555) 432-1000
  • Cell:
  • resumesample@example.com
Professional Summary

Results-oriented Claims Adjuster bringing hands-on law enforcement experience and exceptional leadership and communication skills. Background includes criminal investigation, insurance fraud and surveillance. Service-oriented Claims Adjuster skilled at applying creative approaches to solving complex problems. Adept at developing profitable and quality-focused processes.

Skills
  • Team Management Experience
  • Service Quality
  • Service Delivery
  • Insurance Claim Forms Review
  • Claim Amount Calculations
  • Customer Retention
  • Property Owner Representation
  • Insurance Policy Coverage Knowledge
  • Customer Relations
  • Correspondence Writing
  • Insurance Fraud Expertise
  • Client Interviewing
Work History
Liability Claim Adjuster Manger , 12/2021 to Current
Employers Holdings, Inc.Remote, OR,
  • Examined claims forms and other records to determine insurance coverage.
  • Followed up with insured individuals regarding premium and deductibles payments.
  • Testified on behalf of agency as part of criminal and civic proceedings.
  • Maintained suspicious claims database and prepared reports for supervisors.
  • Reviewed and analyzed suspicious and potentially fraudulent insurance claims.
  • Established productive working relationships with public officials and law enforcement officers.
  • Drafted investigative reports covering phases of investigation in each case.
  • Compared data from surveillance footage to data on medical reports.
  • Verified insurance claims and determined fair amount for settlement.
  • Analyzed information gathered by investigations to report findings and recommendations.
  • Answered questions posed by insured and attorneys.
  • Eliminated claimant, premium and provider fraud.
  • Conducted comprehensive interviews of witnesses and claimants to gather facts and information.
  • Maintained contact with claimants and attorneys to determine treatment status.
  • Expanded cross-functional organizational capacity by collaborating across departments on priorities, functions and common goals.
  • Resolved staff member conflicts, actively listening to concerns and finding appropriate middle ground.
  • Onboarded new employees with training and new hire documentation.
  • Performed statistical analyses to gather data for operational and forecast team needs.
Senior Claims Adjuster, 04/2018 to 12/2021
Sedgwick Claims Management Services, Inc.Roseville, CA,
  • Partnered with legal counsel on litigation cases.
  • Analyzed information gathered by investigations to report findings and recommendations.
  • Documented all investigation activity and presented reports to management.
  • Answered customer questions regarding deductibles.
  • Ran 15 special projects and initiatives at both local and regional level.
  • Eliminated claimant, premium and provider fraud.
  • Collaborated with claims department and industry anti-fraud organizations to resolve claims.
  • Trained other claims staff members on proper handling and evaluation of injury claims.
  • Evaluated insurance policies and analyzed damages to determine coverage.
  • Reconciled data in direct collection system with accounting system to address discrepancies.
  • Negotiated all settlement agreements to resolve disputes.
Liability Claims Adjuster, 10/2014 to 04/2018
All StateCity, STATE,
  • Interviewed agents and claimants to correct errors or omissions and investigate questionable claims.
  • Examined claims forms and other records to determine insurance coverage.
  • Directed and coordinated various investigations conducted by field investigation team.
  • Reviewed and analyzed suspicious and potentially fraudulent insurance claims.
  • Testified on behalf of agency as part of criminal and civic proceedings.
  • Established productive working relationships with public officials and law enforcement officers.
  • Maintained suspicious claims database and prepared reports for supervisors.
  • Synthesized data into comprehensive quarterly written reports for management.
  • Evaluated evidence with ultimate goal of creating positive outcomes for client's claims.
  • Followed up on potentially fraudulent claims initiated by claims representatives.
  • Reviewed police reports, medical treatment records and physical property damage to determine extent of liability.
  • Documented all investigation activity and presented reports to management.
  • Conducted comprehensive interviews of witnesses and claimants to gather facts and information.
  • Substantiated legitimate claims and denied unjustified claims.
  • Prepared summaries of damage, payments and policy coverage.
  • Developed company-wide quality assurance program.
  • Trained other claims staff members on proper handling and evaluation of injury claims.
  • Compared data from surveillance footage to data on medical reports.
  • Maintained contact with claimants and attorneys to determine treatment status.
  • Answered customer questions regarding deductibles.
  • Reported to management on customer problems, field conditions, safety issues and policy problems.
  • Investigated and assessed damage to property and reviewed property damage estimates.
  • Collaborated with claims department and industry anti-fraud organizations to resolve claims.
  • Collected premiums on all direct collection files.
  • Reviewed field inspections and coordinated all insurance claim audits.
  • Reconciled data in direct collection system with accounting system to address discrepancies.
  • Evaluated insurance policies and analyzed damages to determine coverage.
  • Eliminated claimant, premium and provider fraud.
  • Ran 20 special projects and initiatives at both local and regional level
  • Verified insurance claims and determined fair amount for settlement.
  • Followed up with insured individuals regarding premium and deductibles payments.
Education
Associate in Business : , Expected in 08/2026
University of Michigan - Ann Arbor - Ann Arbor, MI
GPA:
High School Diploma: , Expected in 07/2016
East Kentwood High School - Grand Rapids, MI
GPA:

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Resume Overview

School Attended

  • University of Michigan - Ann Arbor
  • East Kentwood High School

Job Titles Held:

  • Liability Claim Adjuster Manger
  • Senior Claims Adjuster
  • Liability Claims Adjuster

Degrees

  • Associate in Business
  • High School Diploma

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