Senior Claims Specialist Resume Example Metlife Auto And Casualty

SENIOR CLAIMS SPECIALIST

Professional Summary

Motivated Senior Casualty Adjuster specializing in personal, property and casualty loss and damages. Negotiates peaceful resolutions of all claims with an emphasis on fairness and thoroughness.

Skills

Accident scene investigations
Insurance policy coverage knowledge
Personal, casualty and property loss
Automobile claims specialist

Organized
Customer service-oriented
Advanced oral and written communication skills
Highly motivated
Skilled multi-tasker

Work History

10/2013 to Current

Senior Claims SpecialistMetLife Auto and Casualty – Henderson, NV

Investigate and determine coverage, liability and handle large loss exposure claims.
Negotiating settlements for first and third party claimants and resolving attorney represented files.
Assigning independent adjusters to do field investigations.
Review for subro potential.
Maintaining diary and reserves timely.
Reviewed and analyzed suspicious and potentially fraudulent insurance claims.
Evaluated all evidence with the ultimate goal of creating positive outcomes for client's claims.
Directed and coordinated various investigations conducted by field investigation team.
Reviewed new files to determine current status of injury claim and to develop a plan of action.

09/2011 to 10/2013

Senior Litigation SpecialistCSAA – Oklahoma City, OK

Determining liability, investigations, negotiations and litigated files.
Assigning to defense and working closely to resolve large loss claims.
Handling large loss claims.
Maintaining diary and reserves timely.
Investigated claims involving potential and suspected fraudulent activities.
Partnered with legal counsel on litigation cases.
Evaluated insurance policies and analyzed damages to determine coverage.
Maintained contact with claimants and attorneys to determine treatment status.

09/2005 to 06/2009

Senior Litigation SpecialistFARMERS INSURANCE – Fayetteville, AR

Determining if coverage is available and completing liability investigation.
Field rep that included meeting with claimants that have been injured.
Handle attorney represented files along with review of time demands and evaluations.
Negotiates for timely settlement.
Preparing files for arbitration, mediation, litigation and trial.
Referring any type of fraud potential to SIU.
Partnered with legal counsel on litigation cases.

03/2005 to 09/2005

Senior Claims AdjusterCLAIMS MANAGEMENT INC – Rogers, AR

Handling loss prevention claims for Wal-Mart, Sams and Neighborhood Market.
Investigate and handle claim appropriately.
Reviewing video tapes of incident.
Determining if loss was handled appropriately by Wal-Mart employee.
Upon determination would evaluate for appropriate settlement offer to resolve.
Senior Bodily Injury Adjuster.
Collaborated with the claims department and industry anti-fraud organizations to resolve claims.
Partnered with legal counsel on litigation cases.
Drafted investigative reports covering all phases of the investigation in each case.
Compared data from surveillance footage to data on medical reports.

09/2002 to 03/2005

Senior Claims AdjusterGEICO INSURANCE – Dallas, TX

Communicating with customers, as well as attorneys and medical providers to reach a timely and accurate resolution to resolve claims timely.
Reporting potential fraud claims.
Investigate loss details, policy coverage, liability, property damages, bodily injury and settlement opportunities.
Preparing files for arbitration, mediation and litigation.
Reviewing time demands and handling appropriately.

10/2001 to 09/2002

Claims AdjusterClaims AdjusterPETER CORRICK & ASSOCIATES – San Luis Obispo, CA

Investigate and determine liability.
Handle bodily injury and negotiate settlement.
Monthly status reports for primary insurance carrier with evaluations of claims process.
Reviewed and analyzed suspicious and potentially fraudulent insurance claims.
Compared data from surveillance footage to data on medical reports.
Directed and coordinated various investigations conducted by field investigation team.

09/2000 to 09/2001

Claims AdjusterSHELTER INSURANCE – Tulsa, OK

Investigate, negotiate and settle bodily injury claims for both first and third party.
Preparing files for arbitration, mediation and litigation.
Reviewing time demands for settlement.
Med pay, underinsured and uninsured claims for first party losses.
Answered questions posed by insured and attorneys.
Maintained contact with claimants and attorneys to determine treatment status.
Documented all investigation activity and presented reports to management.
Substantiated legitimate claims and denied unjustified claims.

01/1999 to 09/2000

Account managerJB HUNT CORPORATE – Lowell, AR

Contractor on the Sears account for international, over the road and intermodal transportation.
Soliciting for freight and monitoring loads nationally.
Customer service with appointment setting along with accounting and spot quotes.
Supervised material flow, storage and global order fulfillment.
Redirected shipments en route in response to customer requests.
Established long-term customer relationships through prompt and courteous service.
Communicated all emergencies, delays due to weather and carrier schedule changes to customers and supervisors.

Education

1994

Bachelor of Science: Administration of Criminal Justice
NORTHEASTERN STATE UNIVERSITY - Tahlequah, Oklahoma
Administration of Criminal Justice

Skills

accounting, arbitration, attorney, Customer service, insurance, litigation, loss prevention, Market, mediation, Negotiating, negotiations, Reporting, settlements, transportation, type, video

Resume Overview

Companies Worked For:

MetLife Auto and Casualty
CSAA
FARMERS INSURANCE
CLAIMS MANAGEMENT INC
GEICO INSURANCE
Claims AdjusterPETER CORRICK & ASSOCIATES
SHELTER INSURANCE
JB HUNT CORPORATE

School Attended

NORTHEASTERN STATE UNIVERSITY

Job Titles Held:

Senior Claims Specialist
Senior Litigation Specialist
Senior Claims Adjuster
Claims Adjuster
Account manager

Degrees

Bachelor of Science : Administration of Criminal Justice

Senior Claims Specialist Resume Example

Resume Score: 90%

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