- 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:
Licensed Claims Adjuster emphasizing effective time management, cost control, and mediation. Self-motivated and customer-focused.
- Strong multi-task skills
- Coverage Analysis
- Litigation Management
- Critical thinker
- Strong multi-task skills
- Coverage Analysis
- Litigation Management
- Critical thinker
- Strong interpersonal and communication skills
- Strong Interviewer
- Claims file management processes
- Litigation resolution
- Team player
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Senior Claims Adjuster, 09/2015 - Present
Portland General Electric – Estacada, OR, - Handled "food borne illness," claims.
- Interview or correspond with claimant, witness, police, physicians, or other relevant parties to determine claim settlement, denial, or review.
Senior Claims Adjuster, 11/2013 - 02/2015
Portland General Electric – Wilsonville, OR, - Handled complex employment practices claims.
- Procured recoveries in excess of $1 million.
- Contested claims in court.
- Conducted recorded phone statements Maintained 1:1 closing ratio.
Senior Claims Adjuster, 02/2013 - 11/2013
Portland General Electric – Rainier, OR, - Handled complex General Liability claims.
- Handled "stage diver," claims.
- Handled "dram shop," claims.
Claims Adjuster, 08/2005 - 12/2011
Banner Health – Phoenix, AZ, - Review police reports, medical treatment records, medical bills, or physical property damage to determine the extent of the liability.
- Interview or correspond with claimants, witnesses, police, physicians, or other relevant parties to determine claim settlement, denial, or review.
- Negotiate claim settlements and recommend litigation when settlement cannot be negotiated.
- Collect evidence to support contested claims in court.
- Prepare report of findings of investigation.
Claims Specialist, 04/2001 - 07/2005
Markel Corporation – Pewaukee, WI, - Investigate, evaluate and settle claims, applying technical knowledge and human relations skills to effect fair and prompt disposal of cases and to contribute to a reduced loss ratio.
- Pay and process claims within designated authority level.
- Adjust reserves or provide reserve recommendations to ensure that reserve activities are consistent with corporate policies.
- Enter claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation.
- Resolve complex, severe exposure claims, using high service oriented file handling.
- Maintain claim files such as records of settled claims and an inventory of claims requiring detailed analysis.
- Verify and analyze data used in settling claims to ensure that claims are valid and that settlements are made according to company practices and procedures.
- Examine claims investigated by insurance adjusters, further investigating questionable claims to determine whether to authorize payments.
- Present cases and participate in their discussion at claim committee meetings.
- Contact or interview claimants, doctors, medical specialists, or employers to get additional information.
- Confer with legal counsel on claims requiring litigation.
- Report overpayments, underpayments, and other irregularities.
- Conduct detailed bill reviews to implement sound litigation management and expense control.
- Prepare reports to be submitted to company's data processing department.
Recruiter, 09/1995 - 06/1999
Nelnet – Denver Metro Area- Aurora, CO, - Represent institutions at community and campus events, in meetings with other institution personnel, and during accreditation processes.
- Participate in faculty and college committee activities.
- Provide assistance to faculty and staff in duties such as teaching classes, conducting orientation programs, issuing transcripts, and scheduling events.
- Participate in student recruitment, selection, and admission, making admissions recommendations when required to do so.
- Plan and promote sporting events and social, cultural, and recreational activities.
Bachelor of Arts: Pre-Law, Expected in June 1997
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- ,
GPA:
Pre-Law
- CSU Fullerton Fullerton, CA, US
CSU (FULLERTON), FULLERTON, CALIFORNIA UNITED STATES
Accomplishments
Licensed in CA, NY and OK
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