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Senior Claims Representative Resume Example

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Jessica Claire
, , 100 Montgomery St. 10th Floor
Home: (555) 432-1000 - Cell: - resumesample@example.com - -
Websites, Portfolios, Profiles
  • www.linkedin.com/in/carlie-hershberger
Professional Summary

Multi-talented Analyst well-versed in due diligence, valuations and statistical analysis . Bringing 11 years of related experience as meticulous employee with quantitative excellence detailed in data analyses and reporting for audits, trend determination and reporting on budget areas such as procurement and labor. Well-coordinated in addressing problems, investigating root causes and implementing successful resolutions. Strategic adjudication and management of $150 million dollars claims and projects. Demonstrates leadership, influencing, and negotiating skills with an excellent eye for detail and expertise in defining scope with keen ability to build great rapport with a diverse workforce.

Skills
  • Analyze Data
  • Problem Solving
  • Resource Allocation
  • Implement Solutions
  • Management
  • Goal Attainment
  • Strong Communication Skills
  • Problem Solving Skills
  • Excel
  • Planning
  • Organizational Structure
  • Monitoring
Work History
08/2020 to Current
Senior Claims Representative Country Financial Chicago, IL,
  • Championed insurance claims process by investigating, negotiating and resolving 150 claims within first 70 days with organization. Demonstrating expert time management skills, providing transparent knowledge and building positive, trusting relationships to support clients during challenging times.
  • Analyzed key aspects of business to evaluate factors driving results and summarized into presentations.
  • Examined reports, accounts and evidence to determine integrity, accuracy of information to identify and resolve problems through root cause analysis and research
  • Selected and managed vendors involved in investigations, including expert witnesses and litigation managers.
  • Documented procedures and business processes and shared information with appropriate stakeholders.
05/2018 to 05/2020
Senior Claims Examiner Sedgwick Claims Management Services, Inc. South Portland, ME,
  • Responsible for analytical adjudication, communication with clients, customers, agents, attorneys and regulatory authorities while evaluating and negotiating settlements of intricate high value fine art, commercial ocean and inland marine claims exceeding $1M - investigating, and determining appropriate coverage and 3rd party liability claims based on policy provisions, individual state laws and regulations.
  • Managed thorough investigations to identify and classify damages of mid to complex claims, ensuring losses were properly reserved and fully prepared for evaluation, settlement and/or litigation.
  • Prepared and presented both oral and written reports of investigative findings on high value losses to executives, internal stakeholders, and leading reinsurance directors by leveraging clear communication of initiatives and action plans .
  • Directed claims negotiations within allowable limit of $100,000 and supported successful litigations for advanced issues.
08/2017 to 05/2018
Claims Analyst Freeport Health Network Savanna, IL,
  • Determined liability outlined in coverage by conducting agent and claimant interviews, examinations of claims documentation and related records from police and third party experts.
  • Successfully managed large caseload of property and commercial claims for both Admitted and Non Admitted lines to efficiently investigate and negotiate identifying fraud, denials, legal letters and reservations of rights letters in line with individual state law and support successful litigations for advance issues.
  • Substantiated validity and admissibility of evidence and preserved data integrity for court hearings.
  • Led Catastrophe Claims team of 8 senior claims personnel to research, negotiate, and settle high risk claims while improving and maintaining positive team morale and culture.
  • Met performance standard of 98% Compliance with Good Faith Claim Handling Best Practices and State DOI Regulations.
09/2015 to 08/2017
Property Adjuster Nationwide Gallipolis, OH,
  • Successfully prepared and organized file case summary and property caption reports for Domestic Carrier on all assigned losses, prepared statement of loss and final settlement letters within granted authority of $50k.
  • Achieved numerous high percentage contact and closures results relating to 24 hour contact and 30 day closure.
  • Trained and mentored 4 new hires and 3 summer interns successfully by creating and executing training and on boarding plan and timeline in accordance with company and Department of Insurance standards.
  • Received promotions during first 12 months from Associate Adjuster to Property Adjuster 1, and then within 6 months was promoted to Property Adjuster 2.
Education
Expected in
: Business Administration
Saginaw Valley State University - Bay City, MI
GPA:
Certifications
  • Licensed Independent Property & Casualty Insurance Adjuster - Active licenses held in all states except for HI

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Resume Strength

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  • Length
  • Measurable Results
  • Personalization
  • Strong Summary
  • Target Job
  • Typos
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Resume Overview

School Attended
  • Saginaw Valley State University
Job Titles Held:
  • Senior Claims Representative
  • Senior Claims Examiner
  • Claims Analyst
  • Property Adjuster
Degrees
  • Some College (No Degree)

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