Senior Claims Specialist Resume Example
Love this resume?Build Your Own Now
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
|
|
Work History
10/2013 to Current
Senior Claims SpecialistChubb – Wilmington , DE
- 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 SpecialistMidfirst Bank – San Fernando Valley , CA
- 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 SpecialistMidfirst Bank – Shawnee , OK
- 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 AdjusterW.R. Berkley Corporation – Alpharetta , GA
- 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 AdjusterW.R. Berkley Corporation – Charlotte , NC
- 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 AdjusterEmployers Holdings, Inc. – Maitland , FL
- 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 AdjusterEmployers Holdings, Inc. – NC, State
- 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 managerWerner Enterprises Inc – Breinigsville , PA
- 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 - City, State
Administration of Criminal Justice
NORTHEASTERN STATE UNIVERSITY - City, State
Administration of Criminal Justice
Skills
accounting, arbitration, attorney, Customer service, insurance, litigation, loss prevention, Market, mediation, Negotiating, negotiations, Reporting, settlements, transportation, type, video
DISCLAIMER
Resumes, and other information uploaded or provided by the user, are considered User Content governed by our Terms & Conditions. As such, it is not owned by us, and it is the user who retains ownership over such content.
How this resume score could be improved?
Many factors go into creating a strong resume. Here are a few tweaks that could improve the score of this resume:
Resume Strength
- Completeness
- Word choice
- Measurable results
- Clear contact info
- Typos
Resume Overview
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
Similar Resumes
