Jessica Claire
Montgomery Street, San Francisco, CA 94105 609 Johnson Ave., 49204, Tulsa, OK
Home: (555) 432-1000 - Cell: - - -

Energetic and enthusiastic insurance professional motivated to succeed in a fast-paced and deadline-driven professional environment. Comprehensive knowledge of claims adjustments with special knowledge in identifying elements of fraud.

  • Claims file management processes
  • Insurance fraud expertise
  • Interviewing techniques
  • Database management
  • Strong interpersonal and communication skills
  • Self-directed
  • Report writing
  • Analytical
  • Team player
  • Critical thinker

Promoted to Claims Special Investigator within 1 month of initial claims handling.

Audit scores consistently exceeded expectations and successfully maintained the highest audit scores within the Special Investigations Unit.

01/2013 to 01/2015
Special Investigative Unit I Guaranteed Returns Portland, OR,
  • My primary mission has been to detect, deter and defeat insurance fraud.
  • Worked closely with management in various departments and assist in making coverage decisions with a focus on thoroughness, quality, cost control and mitigation of future risk.
  • Conducted interviews, gathered detailed information and completed field investigations.
  • Developed connections with local fraud bureaus, district attorneys' offices and professional associations.
  • Worked with house counsel in preparing cases for legal purposes.
  • Train claims adjusters in identifying fraud and working closely with them in addressing coverage issues and red flags.
  • Example of typical investigations: theft, fire, vandalism, personal injury protection (first party medical payments), third party bodily injury, rate evasion, material misrepresentation at application, out of state losses and staged losses.
  • Worked an intense case load in a high pace environment and had to quickly become familiar with policies in the following states: Pennsylvania, New York, Connecticut, Illinois, Texas, South Carolina and Georgia.
  • Share intelligence with other fraud investigators and entities, including regularly attended conferences and seminars addressing current trends and methods for combating potential fraud.
09/2010 to 01/2013
Field Adjuster II/ Claims Special Investigator Merck & Co., Inc. City, STATE,
  • Investigate coverage and liability for personal auto policies. My performance was such that within one month of general claims handling, I was promoted to Claims Special Investigator, given the responsibility of handling the most sensitive files, often of a suspicious nature.
  • Reduced loss ratios through fair and prompt processing of claims.
  • Conducted interviews, gathered detailed information and completed field investigations.
  • Mentored new members of the claim staff.
  • Recommended settlement offers and negotiated payment arrangements.
  • Obtained all necessary information to complete proper evaluation of injury claims.
  • Drafted statement of loss to summarize damages, payments and underlying policy coverage.
  • Individually responsible for a high volume of work in an intense, fast paced environment working directly with management in resolving all issues related to the claim.
  • Manage time and work load between the office and the field.
  • Investigating residency, employment, automobile history, narratives given by interviewees, inspecting vehicle damage Routinely handling theft, fire, vandalism, questionable losses & other complex files.
07/2009 to 2010
Warehouse Manager Executive Apparel City, STATE,
  • Supervised material flow, storage and global order fulfillment.
  • Oversaw special orders and after-hours, urgent shipping jobs.
  • Unloaded, picked, staged and loaded products for shipping.
  • Operated Visual 2000, Fedex Ship Manager and UPS WorldShip shipping systems efficiently and accurately.
  • Oversaw the completion of highly detailed, custom orders up to bulk product shipping.
  • Oversaw warehousing and storage practices and housekeeping.
  • Received incoming shipments and reviewed contents against purchase order for accuracy.
  • Telemarketing, cold calling new clients and following leads -utilized ms Excel, ms Word, and email.
06/2006 to 07/2009
Operations Manager Provence Distinctive Catering City, State,
  • Executive position. Key member of operations staff and event planning.
  • Managed and operated day to day activities of the warehouse and janitorial staff.
  • Instrumental in event planning by providing supply options that solved logistic and aesthetic issues.
  • Evaluated operational records and made scheduling adjustments to maximize efficiency.
  • Created and implemented all of the systems of organization for sending and receiving.
  • Oversaw special orders and after-hours, urgent shipping jobs.
  • Unloaded, picked, staged and loaded products for shipping.
  • Worked independently, had to think quickly on my feet and constantly solve evolving problems.
  • Independently pulled and completed work orders with on the fly adjustments.
  • Routinely planned out my schedule two weeks in advance.
  • Conducted monthly, quarterly and yearly inventories of warehouse stock.
Expected in 2012
Continuing Education:
Kaplan - ,

Continuing education through Infinity Insurance.

Expected in 2005
Bachelor's degree: Fine Arts
Pennsylvania Academy of Fine Arts - Philadelphia, PA

Fine Arts

Expected in 2001
Hussian School of Art - Philadelphia, PA

Four year commercial art school, transferred after two years to PAFA

Expected in 1999
High School Diploma:
Woodstown-Pilesgrove High School - Woodstown, NJ
Additional Achievements

Founder and Owner of Warrior Class LLC

Certified Instructor in Israeli Krav Maga

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School Attended

  • Kaplan
  • Pennsylvania Academy of Fine Arts
  • Hussian School of Art
  • Woodstown-Pilesgrove High School

Job Titles Held:

  • Special Investigative Unit I
  • Field Adjuster II/ Claims Special Investigator
  • Warehouse Manager
  • Operations Manager


  • Continuing Education
  • Bachelor's degree
  • High School Diploma

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