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Click here or scroll down to respond to this candidateCandidate's Name
Conyers, Ga Street Address H: PHONE NUMBER AVAILABLE EMAIL AVAILABLEExperienced customer service professional with strong successful leadership and relationship-building skills. Excellent in juggling multiple tasks and working under pressure. Broad call center industry experience which includes Claims, Management, Research, Billing/Payments, Scheduling, Investigating, and Potential Fraud background. Proficient in Microsoft office, Win.10, Word, Excel, Avaya, & Chat. Team leadership and liaisonExtremely organizedClient assessment and analysisStrong verbal communicationPowerful negotiatorCritical and creative thinkingClaims Adjuster Examiner, 05/2010 to 11/2014Ameri-Claims Outsource TPA Panama City, FLSupervisory responsibilities of escalated fraudulent activity for detailed interviewing, investigations, negotiations and researching all policies & procedures guidelines to expedite the settlement of the claims. Over-viewed the process of the claims which resulted in marked evaluation performance improvements for accuracy. Researched and updated all required recorded materials for escalated issues. Analyzed departmental documents needed for approval and verification to the claims. Provided end reports for all investigations, clearances, and approvals for adjusters to close out the claims. Business Sole Proprietor: Business Management c/o 2010 Ga P&C Adjuster & Agent: RS Thomas c/o 7/2019 Certificate of Completion *Non Licensed* Florida Business Licensed (Cosis) Sole Proprietor 2010 PROFESSIONAL SUMMARYSKILLSWORK HISTORYEDUCATIONClaims Adjuster Associate, 02/2015 to PresentPilot Catastrophe Management Solutions *Contract Positions* Sedgwick Dunwoody, GA Assisted with different accounts for setting up file reports for Property & Casualty, General Liability for Personal/ Commercial, Injuries, Slip & Fall, and other Third Part claims. Tier 3 higher investigation claims were passed to a senior adjuster (Claims Examiner III). Obtained official records from police, fire reports, and hospitals to rule out any fraud or investigation requirements. Reviewed and analyzed suspicious and potential fraudulent insurance claims for the Fraud Department. Finalized all decisions on general liability processed claims. Answered all concerns about claim status, deductibles, and injury policy limits pertaining to the claim. Claims Specialist, 01/2019 to 08/2019State Farm Insurance Company Dunwoody, GAWorked all levels of claims to finalized completion. Task varied per claim. Evaluated the claims for payments or reserves. Examined claims that were investigated by the field adjuster or appraisers. Analyzed all documents pertaining to the claim, and made a sound determination if the claim needed to go for litigation or subrogation. Examined claims for concise consistency and accurate details to close the claim with or without payment for no errors reports status. Handled all medical, towing, rentals and other legal transactions regarding repair shops or impounds. Sent out all payments and reimbursements. Determined the at fault factors and accepted liability. Processed letters and all payments to manage a timely completion of the claims. |
