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workers compensation claims adjuster resume example with 2+ years of experience

JC
Jessica Claire
Montgomery Street, San Francisco, CA 94105 (555) 432-1000, resumesample@example.com
Professional Summary

Results-oriented Claims Adjuster bringing hands-on service experience and exceptional leadership and communication skills. Background includes claims/compliance investigation, insurance fraud and quality-focused processes. My Objective is to leverage my education and work experience while continuously being challenged. Personally, I have the determination to create win-win solutions for everyone and I know how to get the best from people by applying myself and having a can do attitude.

Skills
  • Team-player, multi-tasking aficionado
  • Data entry and processing
  • Impeccable people skills
  • Project Management
  • Microsoft Office Suite
  • Risk management
  • Proficient typer (65+ wpm)
  • Office automation
  • Customer Satisfaction
  • Fast learner
  • Data Analysis
Work History
12/2019 to 05/2020 Workers Compensation Claims Adjuster Risk Strategies Company | Orlando, FL,
  • Demonstrated Ethics & Integrity by conducting business and claims adjusting in a legal, ethical, fair and responsible manner.
  • Prepared Monthly Status Reports documents for managers and shareholders detailing claim status, exposure risks, and plan of action.
  • Negotiated settlement agreements to resolve disputes.
  • Maintained contact with claimants and attorneys to determine treatment status.
  • Handled incoming and outgoing calls from customers and other stakeholders about Workers Compensation processes.
  • Reviewed and analyzed suspicious and potentially fraudulent insurance claims.
  • Reviewed new files to determine current status of injury claim and to develop plan of action.
  • Maintained claims data in Origami Risk systems.
  • Internally processed claims to ensure claimant's work injuries were addressed in a timely and cost-effective manner.
  • Consistently maintained a 99% closure rate for claims.
  • Monitored 106 clients caseload for each quarter.
04/2018 to 07/2018 Workers Compensation Compliance Examiner Michigan Millers | Madison, WI,
  • Actively monitored businesses to ensure compliance in accordance with the state's workers' compensation law.
  • This includes informing corporation members of the parameters of the law as it pertains to their specific industry and business.
  • Duties also included filing litigation on companies that refuse to adhere to guidelines and setting personal time line for case work to fit requirements set by counsel.
  • Responsible for 13 counties in Northeast Alabama
  • •Fulfilled duties through written correspondence, personal visits, and verbal conversations with members.
  • Increased case closure rate on a mothly basis.
  • Delivered targeted advise on issues such as applicable employment regulations, compensation strategies and internal systems to help companies update antiquated or ineffective approaches.
11/2015 to 05/2017 Liability Claims Adjuster GEICO | City, STATE,
  • Conducted liability and coverage investigations for a Fortune 500 company through analysis of factual information provided and adherence insurance regulations.
  • Prioritizing claims based upon customer needs and company procedures •Highest ranked employee with section based upon core metrics (July) •40 hrs/week.
  • Reviewed and analyzed suspicious and potentially fraudulent insurance claims.
  • Established productive working relationships with public officials and law enforcement officers.
  • Directed and coordinated various investigations conducted by field investigation team.
  • Reviewed new files to determine current status of injury claim and to develop plan of action.
  • Provided above excellent customer service as evidenced by Customer Satisfaction Surveys.
  • Evaluated all evidence with ultimate goal of creating positive outcomes for client's claims.
  • Executed job requirements based upon company operation guidelines and review standards, while maintaining a self-set work plan and addressing shareholder concerns/complaints.
03/2015 to 11/2015 Business Development Center Specialist Lowe Toyota | City, STATE,
  • Planned marketing initiatives and leveraged referral network to promote business development.
  • Expanded customer base by identifying needs, developing solutions and delivering client-centered products
  • Provided research and development on Toyota products to showcase benefits and retain customers.
  • Solely responsible for at least fifty-five additional sales from hire date.
  • Responsible for successful follow-up and appointment booking of unsold patrons.
  • Additional duties included: •Carrying out successful response and referral capture of all internet and phone prospects in a timely matter.
  • Serving as first point-of-contact for potential clients and relaying all information necessary to gain their business..
Education
Expected in 12/2014 MBA | Business Administration University of Phoenix, Tempe, AZ GPA:

GPA: 3.42

Expected in 04/2013 Bachelor of Science | Exercise Science and Wellness Jacksonville State University, Jacksonville, AL GPA:
  • Graduated cum laude
  • Graduated with3.52 GPA
  • Dean's List
  • Minored in Psychology
  • Received Gamecock Scholarship

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Resume Overview

School Attended

  • University of Phoenix
  • Jacksonville State University

Job Titles Held:

  • Workers Compensation Claims Adjuster
  • Workers Compensation Compliance Examiner
  • Liability Claims Adjuster
  • Business Development Center Specialist

Degrees

  • MBA
  • Bachelor of Science

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