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Senior Claims Adjuster Resume Example

Resume Score: 60%

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SENIOR CLAIMS ADJUSTER
Professional Summary
Licensed Claims Adjuster emphasizing effective time management, cost control, and mediation. Self-motivated and customer-focused.
Skills
  • 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
Work History
Senior Claims Adjuster09/2015 to Current
THE BEST IRS - TEMPORARY STAFFING – Huntington Beach, CA
  • 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 Adjuster11/2013 to 02/2015
GALLAGHER BASSETT SERVICES INC – Aliso Viejo, CA
  • 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 Adjuster02/2013 to 11/2013
PROFESSIONAL STAFFING SERVICE – Aliso Viejo, CA
  • Handled complex General Liability claims.
  • Handled "stage diver," claims.
  • Handled "dram shop," claims.
Claims Adjuster08/2005 to 12/2011
SUPERVALU INC. / NEW ALBERTSONS INC – Fullerton, CA
  • 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 Specialist04/2001 to 07/2005
BROADSPIRE / KEMPER INSURANCE COMPANIES – Anaheim, CA
  • 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.
Recruiter09/1995 to 06/1999
CALIFORNIA STATE UNIVERSITY FULLERTON OUTREACH / RECRUITER – Fullerton, CA
  • 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.
Education
Bachelor of Arts: Pre-LawJune 1997- Pre-Law
Additional Information
  • CSU Fullerton Fullerton, CA, US CSU (FULLERTON), FULLERTON, CALIFORNIA UNITED STATES Accomplishments Licensed in CA, NY and OK
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Resume Overview

Companies Worked For:

  • THE BEST IRS - TEMPORARY STAFFING
  • GALLAGHER BASSETT SERVICES INC
  • PROFESSIONAL STAFFING SERVICE
  • SUPERVALU INC. / NEW ALBERTSONS INC
  • BROADSPIRE / KEMPER INSURANCE COMPANIES
  • CALIFORNIA STATE UNIVERSITY FULLERTON OUTREACH / RECRUITER

Job Titles Held:

  • Senior Claims Adjuster
  • Claims Adjuster
  • Claims Specialist
  • Recruiter

Degrees

  • Bachelor of Arts : Pre-Law June 1997

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