Senior Claims Adjuster Resume Example Portland General Electric

SENIOR CLAIMS ADJUSTER

Professional Summary

Licensed Claims Adjuster emphasizing effective time management, cost control, and mediation. Self-motivated and customer-focused.

Skills

Work History

Senior Claims Adjuster09/2015 to Current
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 Adjuster11/2013 to 02/2015
Portland General Electric – Wilsonville , OR

Senior Claims Adjuster02/2013 to 11/2013
Portland General Electric – Rainier , OR

Claims Adjuster08/2005 to 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 Specialist04/2001 to 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.

Recruiter09/1995 to 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.

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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