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Click here or scroll down to respond to this candidateLexington, SC 29072 PHONE NUMBER AVAILABLE EMAIL AVAILABLECandidate's Name
Insurance Adjuster skilled in investigating and analyzing liability concerning personal, casualty or property loss. Proven history of leveraging excellent negotiation skills to facilitate settlements. Excellent communication skills demonstrated through over 30 years of experience interviewing specialists, witnesses and claimants to compile information. Multi-State Licensed, Multi-Line Experience, CAT, Casualty, Property, Bodily Injury, Mediation, Arbitration and Alternative Dispute Resolution, Litigation Specialist who is Authorized to work in the US for any employer.PROFESSIONALSUMMARYSKILLS Claims Evaluations Accident InvestigationsSettlementDeterminations Liability DeterminationsClaims ProcessExplanationNatural DisasterExperience Damage Mitigation Litigation ResolutionPersonal, Casualty andProperty Loss Insurance Claims NegotiationNegotiation and MediationSkills Subrogation Expertise Professional DevelopmentLITIGATION SPECIALIST 04/2022 to 01/2023Pacesetter Claims Service, Jacksonville, FLCAT DESK ADJUSTER 09/2021 to 12/2021CAT, Olympia Claim Service, RemoteWORK HISTORY Full review of claim file and report completed post Triage. Documents approved for electronic court filings at state level along with discovery, evidence, exhibits, motions and subpoenas.Successfully maintained database and document organization for in all assigned cases in Claim and Legal Systems. Completed Pre-Deposition Conferences and Depositions for matters in suit. Prepared and presented matters for various Company standard Conferences. Full investigation, evaluated insurance policies and analyzed damages to determine coverage. Received and reviewed property damage estimate. Organized, planned and documented materials for payment of CAT claims. Contacted insured and explained payment and/or denial. Successfully maintained 50 to 70 pending CAT claims. Self-motivated, with strong sense of personal responsibility. QUALITY ASSURANCE VISUAL INSPECTOR 04/2019 to 09/2021 Nephron Pharmaceuticals, West Columbia, SCSENIOR CLAIMS SPECIALIST 06/2018 to 10/2018S & S, Texas Hail and Windstorm, Training in Austin, TX, Then Remote SENIOR CLAIMS EXAMINER 08/2017 to 10/2017Olympia Claim Service, Paola, KSCLAIMS EXAMINER 07/2015 to 06/2017Seibels Claims Solutions, Columbia, SCCUSTOMER SERVICE REPRESENTATIVE 09/2014 to 07/2015 Seibels Bruce Company, Columbia, SCQuality Assurance Visual Inspection of medicinal syringes, IV bags, bottles and vials per FDA requirements for labeling, packaging and shipping to customers. GMP Certified, GDP Certified, EBR and BBR Certified, trainer of new employees. Collaborated with team members to achieve target results. Learned new skills and applied to daily tasks to improve efficiency and productivity. Inspected 1000's of syringes and IV bags each day as instructed by FDA Guidelines. Cultivated interpersonal skills by building positive relationships with others. Completed in depth file review of Property claims as result of Hurricane Harvey for settlement with insured and/or public adjuster/attorney for settlement prior to filing of Appraisal or Litigation. Researched claims and incident information to deliver solutions and resolve problems. Prepared summaries of damage, payments and policy coverage.. Analyzed information gathered by investigation and submitted report findings and recommendations to Manager for payment. Contact made with insured and/or attorney and/or PA regarding outcome of decision. Successfully maintained pending of 50 to 60 files for review. Receipt of claim, contact with insured, assignment made to field. Evaluated insurance policies and analyzed damages to determine coverage. Maintained claims data in Claims Cube systems. Received and reviewed property damage estimate. Prepared Loss Reports to Management requesting authority to settle. Successfully maintained pending of 50-70 claims. Receipt of new claim and contact with insured to verify loss and details of damage. Assigned to field for inspection. Established productive working relationships with independent adjusters and vendors. Reviewed field inspections and photographs and coordinated settlement and conclusion of claims. Reviewed insurance policy to determine if coverage. Interviewed insured to gather to information factual suspicious and potentially fraudulent insurance claims Prepared summaries of damage, payments and policy coverage. Delivered exceptional customer service to policyholders by communicating important information, and advising outcome of their claim as indicated by investigation and coverage. Maintained pending or 50-70 claims. Effectively managed high-volume of inbound and outbound customer calls. CLAIMS ADJUSTER 07/2014 to 08/2014Insurance Staffing, Chicago, ILSENIOR CLAIMS AND SUBROGATION ADJUSTER/ARBITRATOR 04/1994 to 12/2010 SC Farm Bureau Insurance Company, West Columbia, SC CLAIMS CLERICAL SUPPORT STAFF MANAGER 06/1992 to 04/1994 American Centennial Insurance Company, Columbia, SC Accurately documented, researched and resolved customer service issues. Recorded actions taken, issues resolved and made changes to information to effectively manage customer accounts.Promoted superior experience by addressing customer concerns, demonstrating empathy and resolving problems swiftly. Successfully answered between 75 and 100 calls per day. Actively listened to customers, handled concerns quickly and escalated major issues to supervisor. Evaluated all evidence with ultimate goal of creating positive outcomes for client's claims. Examined claims forms and other records to determine insurance coverage. Investigated and assessed damage to property and reviewed property damage estimated Verified insurance claims and determined fair amount for settlement. Contact with insured regard coverage and/or payment of denial and explained same. Managed pending of 100 Claims during short assignment. Multi-Lined Claim Specialist, Subrogation, Inter-Company Arbitrator, Mediation and Litigation claims. Completed investigation of claim from reporting, investigation and to its conclusion. Coordinated outside referrals for property damage estimating for Automobile and Property Damage claims and accident scene. Submitted reports regarding investigation when needed for payment and reserve approval, Documented all investigation activity and presented reports as needed. Completed investigation, moved forward with payment and/or denial, contacted insured and explained outcome of company regarding coverage decision..Successfully maintained pending of 800 to 1000 collection matters with individuals and other carriers. Trained other claims staff members on proper handling and evaluation of injury claims. Developed and maintained courteous and effective working relationships with peers, vendors and defense counsel.Managed team of employees, overseeing hiring, training and professional growth of employees Staff directly handled Claims Call Center and claim assignment. Intake, handling and processing of salvage vehicles. Worked directly with all Department Managers. Resolved problems, improved operations and provided exceptional service by Clerical Staff. Actively listened to customers, handled concerns quickly and escalated major issues to supervisor. Performed annual employee reviews.EDUCATIONPelion High School, Pelion, SCHigh School Diploma, 06/1984 Member of National Honor Society Awarded Valedictorian President of Beta Club Editor of School Newspaper Student Council ReporterAssociate in ClaimsAssociate in Insurance ServicesLicensed Adjuster in the following States:AlabamaConnecticutDelawareFloridaGeorgiaLouisianaMississippiSouth CarolinaTexasProficient In following Computer Systems:Guidewire/Claim CenterClaim CubeAcuityAS400CERTIFICATIONS |
