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special investigator resume example with 5+ years of experience

Jessica Claire
Montgomery Street, San Francisco, CA 94105 609 Johnson Ave., 49204, Tulsa, OK
Home: (555) 432-1000 - Cell: - resumesample@example.com - - -
Summary
An attention to detail Fraud Investigator, successful at reducing company costs by employing results- focused problem solving techniques. Offers superior oral and written communication skills while being a resourceful professional, proficient at working with individuals from diverse cultural backgrounds.
Highlights
XACTvalue and XACTimate Property Estimating, ISO, Accurint, LPR, CARCO, OASIS, Insight, Adobe Photoshop, InDesign and Illustrator, Macromedia Flash, Dreamweaver, Microsoft FrontPage, Word, PowerPoint, Access, Excel, HTML Language
Experience
10/2012 to 01/2016
Special Investigator State Of Iowa , ,
  • Complete investigations on both personal and commercial auto files in a timely manner.
  • Analyze first notice of loss reports and all file material to determine if a claim is suspect.
  • Evaluate validity of property damage claims against the reported facts of loss.
  • Conduct surveillance on clinics and parties to claim.
  • Review medical bills, charts, and imaging diagnostics for accuracy and medical necessity.
  • Navigate social media for details and connections between claim parties ruling out staged losses.
  • Successfully settle Uninsured Motorist, PIP, and Bodily Injury claims.
  • Search database sites for current and accurate residency info on parties not able to be located through phone or other means of communication.
  • Maintain membership with local anti-fraud committees: NICB & DIF.
  • Collaborate with law enforcement and state prosecutors on fraudulent/criminal cases.
  • Train other investigators on interview techniques, insurance contract language, and how to identify potentially fraudulent claims / red flags.
  • Meticulously interview insured's, claimants, employers, doctors, and attorneys while gathering intelligence for claim file through examination under oaths.
  • Esurance; Property and Casualty Adjuster, February 2012 ­ October 2012 Properly set adequate reserves for the potential outcome of claim.
  • Record detailed facts of loss statements for all involved parties.
  • Examine appraisals and photos to determine accurate parts usage and mitigate over expenditures.
  • Maintain communication with Direct Repair Facilities while monitoring all supplement requests.
  • Use Property and Casualty expertise and industry knowledge to think outside the box.
  • Negotiate disposition of claims with insured's, claimants, and their legal representatives.
  • Mentor less experienced adjusters to improve team moral and strength.
  • Ensure compliance with Insurance rules, regulations and Unfair Claim Practice Acts.
  • Investigate each file thoroughly ruling out any fraudulent activity.
  • Issue and accept all subrogation demands.
  • Analyze comparative negligence percentages to assess proper liability.
03/2011 to 02/2012
Geico; Insurance Development Agent , ,
  • Provide outstanding level of customer service.
  • Up sell policyholders with additional services and coverage's.
  • Handle 75-100 calls per day with a handling time of under 4 minutes per call.
  • Pre-underwrite and screen individuals for high level of risk, business use, and fraudulent claims history.
  • Exhibit 100% accuracy when explaining billing, refunds, transfers, exchanges and account information.
  • Multi-task with several insurance based and risk analysis software programs.
  • Collaborate closely with management and senior underwriting officials to determine insurability.
  • Process high level of call volume dealing with strong language barriers, upset policy holders, and individuals with little knowledge of insurance, regulations, claims, and underwriting procedures.
12/2009 to 12/2010
Insurance & Investment Agent Western & Southern Life , ,
  • Responsible for collaborating with clients to design policies to suit their needs; preparing retirement, estate, and business planning services.
  • Manage a book of 9,000 property and casualty, life, and investment clients.
  • Deliver quality customer service, office management, and technical support.
  • Utilize extensive property and casualty experience.
  • Train new employees on home, auto, life, annuity products.
  • Cross sell new and existing clients a full range of financial planning products.
  • Responsible for conducting in-person quarterly, semi-annual, and annual portfolio reviews.
  • Performs verbal cold calls and walk-ins to local businesses to solicit new business.
04/2009 to 11/2009
Financial Representative Prudential Financial / Liberty Mutual , ,
  • Educate, advise, and implement strategies through one-on-one counseling with clients.
  • Manage relationships with fifty clients simultaneously and assist them with financial decisions through utilizing pro/con assessments.
  • Help clients assess their financial net worth, develop their short and long term financial plans, and attainment of financial goals.
  • Ensure complete accuracy on all accounts, policies, and portfolios.
  • Schedule telephone surveys and in-person medical exams with clients.
  • Collaborate with senior advisors on complex individual cases and businesses with a net worth of over 2 million dollars.
Education
Expected in December 2006 to to
Bachelor of Arts:
Florida Southern College - Lakeland, FL
GPA:
The American Institutes Chartered Property and Casualty Underwriter Designation, CPCU In progress
Expected in to to
Computer Information Systems Certification - 600 hours of training in Data Processing, Web Design, Intranet/Internet Services:
Indian River Community College - Stuart, FL
GPA:
Additional Information
  • ACCREDITATIONS: All Lines Property and Casualty Adjuster License # P191984 Life, Health, and Variable Annuity License # P191984 Personal Lines Property and Casualty License # P191984 NASD Series Six Investment and Variable Contract License # 5688910
Skills
Dreamweaver, Adobe Photoshop, billing, book, business planning, charts, counseling, clients, customer service, Data Processing, database, Estimating, financial, financial planning, Macromedia Flash, Microsoft FrontPage, HTML, Illustrator, imaging, InDesign, Information Systems, Insurance, Internet Services, ISO, law enforcement, legal, Mentor, Access, Excel, PowerPoint, Word, office management, policies, progress, quality, risk analysis, surveys, technical support, telephone, phone, Underwriter, underwriting, Web Design

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Resume Overview

School Attended

  • Florida Southern College
  • Indian River Community College

Job Titles Held:

  • Special Investigator
  • Geico; Insurance Development Agent
  • Insurance & Investment Agent
  • Financial Representative

Degrees

  • Bachelor of Arts
  • Computer Information Systems Certification - 600 hours of training in Data Processing, Web Design, Intranet/Internet Services

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