sr workers compensation claims adjuster resume example with 20+ years of experience
JessicaClaire
, , 100 Montgomery St. 10th Floor(555) 432-1000, resumesample@example.com
Summary
Experienced Senior Claims Adjuster professionally handles minor to complex worker's compensation claims for customers. Adept at working directly with customers and providing guidance throughout the claims process. Committed to successfully managing a complex and diverse caseload and ensuring each party is satisfied with the outcome. Reliable Senior Claims Adjuster with excellent written and oral communication talents thoroughly investigate assigned claims. Experience supervising ew junior claims adjusters and providing the motivation and training needed to succeed. Outstanding negotiation and organizational skills. Driven Senior Claims Adjuster with over 31 years of experience handling worker's compensation claims. Dynamic and understanding to remain professional in stressful situations. Skilled in claims files management processes.
Skills
Understanding of Worker's Compensation laws and guidelines in GA, AL, TN, NC and SC
Excellent writing skills
Workers' compensation claims
Litigation resolution
Claims file management processes
Strong interpersonal and communication skills
Staff development of new hires
Licensed in Property & Casualty
Experience
02/2005 to CurrentSr. Worker's Compensation Claims Adjuster Copperpoint | Irvine, CA,
Obtained necessary information to complete proper evaluation of worker's compensation claims for the state of Georgia and Alabama.
Conducted interviews, gathered detailed information and completed investigations.
Reviewed data to verify validity of claims and determine case management actions.
Drafted statement of loss to summarize payments and case strategies for file handling.
Completed required investigations on referred files within established timeframes.
Identified and collected evidence and determined value to specific claims.
Complied with company and insurance client's guidelines in claims processes, estimate writing and closing of claims, resulting in good outcomes.
Analyzed first reports of loss and underlying file material to determine compensability.
Investigated potentially fraudulent claims with focus on thoroughness, quality and cost control.
Interviewed claimants, medical specialists and employers to determine pertinent claim information.
Mentored new members of claims staff in proper procedures.
Managed caseload of 160 clients each quarter.
Reduced loss ratios through fair and prompt processing of claims.
11/2003 to 02/2005Sr. Claims Adjuster Copperpoint | Las Vegas, NV,
Interviewed claimants, medical specialists and employers to determine pertinent claim information.
Reduced loss ratios through fair and prompt processing of claims.
Investigated claims, determined losses and reported findings.
Mentored new members of claims staff in proper procedures.
Obtained relevant evidence and information regarding suspicious claims.
Managed caseload of 160 clients each quarter.
Contacted injured parties and legal representatives to negotiate final settlements for claims.
Analyzed first reports of loss and underlying file material to determine compensability
Completed required investigations on referred files within established timeframes.
Reviewed data to verify validity of claims and determine case management actions.
Obtained necessary information to complete proper evaluation of injury claims.
03/2003 to 11/2003Sr. Claims AdjusterCompManagement | City, STATE,
Conducted interviews, gathered detailed information and completed investigations.
Obtained necessary information to complete proper evaluation of injury claims.
Reviewed data to verify validity of claims and determine case management actions.
Completed required investigations on referred files within established timeframes.
Analyzed first reports of loss and underlying file material to determine to determine compensability.
Contacted injured parties and legal representatives to negotiate final settlements for claims.
Investigated potentially fraudulent claims with focus on thoroughness, quality and cost control.
Reduced loss ratios through fair and prompt processing of claims.
Interviewed claimants, medical specialists and employers to determine pertinent claim information.
Mentored new members of claims staff in proper procedures.
Managed caseload of 175 clients each quarter.
Recommended settlement offers and negotiated payment arrangements.
12/96 to 03/03Sr. Worker's Compensation Claims ManagerManagedComp | City, STATE,
Spoke to witnesses and claimants and interviewed for pertinent information.
Conducted interviews, gathered detailed information and completed telephonic investigations.
Obtained necessary information to complete proper evaluation of injury claims.
Reviewed data to verify validity of claims and determine case management actions.
Drafted statement of loss to summarize case strategies
Completed required investigations on referred files within established timeframes.
Analyzed first reports of loss and underlying file material to determine compensability
Participate in quarterly claim reviews
Reduced loss ratios through fair and prompt processing of claims.
Interviewed claimants, medical specialists and employers to determine pertinent claim information.
Managed caseload of 150 clients each quarter.
Education and Training
Expected in 09/2010 to to Senior Claims Law Associate | InsuranceAmerican Insurance Institute, Basking Ridge, NJ, GPA:
Expected in to to Bachelor of Science | Criminal JusticeUniversity of Louisiana At Lafayette, Lafayette, LAGPA:
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