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Click here or scroll down to respond to this candidateCandidate's Name
Street Address - Cell: PHONE NUMBER AVAILABLEEMAIL AVAILABLEObjection:Looking to obtain a position within a well-established organization where skills and experience can be used for mutual success. History of providing residents and insured with assistance in activities of daily living.Experience:Pilot Catastrophe 4/2023 2/2024Inside Property Claim Adjuster Cat Claims, Daily claims, CVE claims, supplement, claim processor, Contents claims, Coordinated Claims. Building trust with insured and managing their claim with confidence of knowing the coverages provided within their policy. Coordinated resources, scheduled, and prioritized work assignment. Reviewed photographs and other claim documents. NEXT-GEN Conducted a detailed investigation of claims. Inspected property damage, conducted an analysis of the claimants policy limits, assessed the cost or value of an insured item. Reviewed photographs that insured, and contractor sent in on other claims document. Negotiated with other professionals, such as contractors, on behalf of the policyholder, to come to an agreement to restore the policyholder to pre-loss condition. Negotiated with the claimant to settle the claim, calculated benefit payments and approved payment of claims within a certain monetary limit, made payments to the insured. Ensured accurate and timely benefit payment and services, proactively managed claim costs and expenses. Continuously analyzed case facts and monitored activities to identify fraud or abuse, and/or third -party liability throughout the course of the claim. Coordinated resources, scheduled, and prioritized work assignments. Crawford and Company 06/2022-03/2023State Farm HCCS Stewardship Investigated, evaluated, and settled insurance claims. o Determined whether the insureds policy covers the claimed loss. o Decided an appropriate amount the company should pay out. o Ensured that claims were not fraudulent.o Contacted claimants employers or doctors for additional information if the claim was questionable.o Conferred with legal counsel when needed.o Negotiated settlements and authorized payments. Used communication skills to gather needed information from individuals, including medical experts, claimants, and witnesses. Paid attention to detail to carefully review damaged property and documents. Used interpersonal skills to meet with claimants and other relevant individuals who may be upset by a situation, by being understanding, yet firm with the companys policies. Reconciled submitted estimates with replacement cost benefits payments. Assisted policyholder phone scopes/secures inventory of damage to personal property and enter into contents estimating platform and issues claim settlement payment. Documented the claim file according to the documentation workflow and standard claim processes. Determined whether the insureds policy covers the claimed water loss. Determined if water damage was sudden and accidental. Decided the settlement on the total-loss of water damage to the home. Handled claims of sewer drains back up into homes, which resulted in significant water loss.Handled claims with frozen pipe during the winter months. Strong investigative skills are needed to make a coverage determination and subsequent damage evaluation once coverage is accepted. Investigates insurance claims to decide the settlement amount for an insured. Manage any kind of claim from property damages after storm to personal injury claims after a car accident.Pilot Catastrophe Auto 5/2021 -1/2022Inside Property Claim Adjuster All state program CCC Process auto claims under first damage, supplement, and total loss. Examine damaged vehicles to decide extent of structural, body, mechanical, electrical, or interior damage. Estimate parts and labor to repair damage, using standard automotive labor and parts cost manuals and knowledge of automotive repair. Review repair cost estimates with automobile repair shop to secure agreement on cost of repairs. Decide salvage value on total-loss vehicle. Interview or correspond with claimants, witnesses, police, physicians, or other relevant parties to determine claim settlement, denial, or review. Review police reports, medical treatment records, medical bills, or physical property damage to determine the extent of liability. Negotiate claim settlements and recommend litigation when settlement claim cannot be negotiated.Mid-America 10/2020 - 5/2021Remote Property Claim Adjuster Built trust with insured and handled their claim with confidence of knowing the coverages provided within their policy. Handled claims from start to finish which entailed dealing with vendor, agency, contractor, etc. Obtained and negotiated repairs and pricing on both initial and supplements claims with insured to obtained efficient claim handling policyholders and claimants. Reviewed and negotiated settlement of Subro requests from third party carriers. Calculated benefits payment, approved payment of claims, and issued settlements, to close claims within a timely matter. Settled and issued payments, compiled estimates, created loss, settled, and handled all claims process from the quality first contacts until final closure. Documented all conversations with insured, contractor, agents, etc. and maintained quality document of the claim. Reviewed photographs through Image Right for Mid-America that insured, and contractor send in on other claims document. Scoped and photographed property for defects and damages. Pilot Catastrophe 2017 - 2019Inside Property Claim Adjuster Cat Claims, Daily claims, CVE claims, supplement, claim processor, Contents claims, Coordinated Claims. Building trust with insured and managing their claim with confidence of knowing the coverages provided within their policy. Coordinated resources, scheduled, and prioritized work assignment. Reviewed photographs and other claim documents. NEXT-GEN Conducted a detailed investigation of claims. Inspected property damage, conducted an analysis of the claimants policy limits, assessed the cost or value of an insured item. Reviewed photographs that insured, and contractor sent in on other claims document. Negotiated with other professionals, such as contractors, on behalf of the policyholder, to come to an agreement to restore the policyholder to pre-loss condition. Negotiated with the claimant to settle the claim, calculated benefit payments and approved payment of claims within a certain monetary limit, made payments to the insured. Ensured accurate and timely benefit payment and services, proactively managed claim costs and expenses. Continuously analyzed case facts and monitored activities to identify fraud or abuse, and/or third -party liability throughout the course of the claim. Coordinated resources, scheduled, and prioritized work assignments. Mobile Chevrolet 6/2019 - 3/2020Car Sales Representative Closed sales by overcoming objection; asking for sales; negotiating price; completing sales or purchase contracts. Explained provisions and offered warranties, services, and financing. Matt Bowers Nissan 8/2018-7/2019Car Sales Representative Closed sales by overcoming objections; asking for sales; negotiating price; completing sales or purchase contracts. Explained provisions and offered warranties, services, and financing. End of the Road Chevron 1/2012-6/2017Deli Manager Responsible for Inventory and Purchasing Managed payroll and scheduling for all employees. Successfully suggested sales campaigns for better market exposure. Responsible for training and staffing and provided customer service daily. Made deposits. Accounts Payable and computed Profit/Loss statements. Skills:Xactimate, Guidewire, Next Gen, CCC One Technicaland Analytical Claim Handling Skills, Certified in Xactimate.Certified in Scoping damage Properties.Certified in Estimating Properties CorrectlyCertified in Sketching Rooms and Sub-RoomsSUMMARY OF QUALIFICATIONSExperience Managing over 10+ years.Ability to work in a fast-paced environment.Basic Computer Skills EnvironmentAdministrative ExperienceProductive interpersonal and time organized and meticulous management skills.Ability to work independently.Cash handling experience more than three yearsCustomer service-oriented collections experience EDUCATIONTheodore High School Theodore, AL 1985DiplomaReference Available Upon Request |
