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Click here or scroll down to respond to this candidateCandidate's Name
Durham, NC Street Address PHONE NUMBER AVAILABLE EMAIL AVAILABLESUMMARYDedicated and seasoned bilingual Claims Adjuster with a proven track record of delivering exceptional customer service and ensuring fair and timely resolution of insurance claims. Skilled in assessing damages, negotiating settlements, and adhering to industry standards and guidelines. Strong analytical abilities combined with effective communication and negotiation skills, resulting in efficient claim handling and client satisfaction.SKILLSProperty claimsClaims ProcessingClaims reviewClaims InvestigationPolicy InterpretationCoverage assessmentsRisk ManagementDamage AssessmentLitigation resolutionAllocating claimsRisk AssessmentProperty adjustingSettlement NegotiationPolicy understandingCoverage DeterminationTeamwork and CollaborationNew Policies ProcessingPolicy KnowledgeInformation SecurityCritical ThinkingDe-Escalation TechniquesCustomer ServiceMulti-Task ManagementMicrosoft Office SuiteTechnical ProficiencyActive ListeningPrioritizationCoordinationEXPERIENCE05/2023 to Current Staff Property AdjusterAssurantManaged claims from start to finish, ensuring comprehensive handling and resolution.Maintained 24-hour availability for contact calls, providing prompt assistance to customers.Gathered detailed loss description information to accurately assess and process claims.Settled claims efficiently and fairly, adhering to policy guidelines and customer needs.Provided exceptional customer service throughout the claims process, addressing inquiries and concerns with professionalism and empathy. Collaborated with stakeholders such as adjusters, agents, and customers to facilitate smooth claim resolution.Ensured compliance with regulatory requirements and company policies in claims handling and customer interactions. 10/2022 to 12/2022 Property AdjusterBurton Claims Insurance IA DeploymentSupported insurance claims activity, assisting in the resolution of various types of claims.Estimated and determined coverage based on policy and carrier guidelines, ensuring accuracy and compliance.Managed efficient cycle times and maintained high-quality standards in claims handling processes.Mobilized additional resources as needed for thorough claim investigation and resolution.Coordinated loss investigations on all assigned claims, ensuring comprehensive assessment and fair settlements.Participated in escalation teams, overseeing claim progression and handling communications with insureds, contractors, and Public Adjusters (PA's).Supported the resolution of all types of claim-related complaints and inquiries, contributing to positive customer experiences. 05/2022 to 09/2022 Property Desk AdjusterAuto-Owners Insurance IA DeploymentHandled claims from beginning to closure using the Guidewire System, ensuring thorough and efficient processing.Specialized in wind and hail claims for residential and commercial properties, as well as farms and mobile homes.Managed supplements and additional claim requirements to ensure accurate and complete settlements.Represented carriers in settlements of claims with Public Adjusters and legal representatives, ensuring fair and equitable resolutions. Interacted and interfaced with agents daily, facilitating smooth communication and collaboration in the claims process. Maintained a high level of accuracy and attention to detail in all claim- related activities within the Guidewire System.Contributed to the effective management and resolution of claims, supporting positive outcomes for both carriers and policyholders. 09/2021 to 12/2021 Virtual Flood AdjusterAssurant Insurance IA Firm DeploymentHandled flood claims from the first notice of loss to closure, ensuring fair and prompt processing.Successfully reduced loss ratios by maintaining a focus on quality and attention to detail throughout the claims process. Reviewed data, including prior claims, ISO information, and other sources, to verify the validity of claims.Completed Quality First Call assessments, ensuring accuracy and completeness in claim documentation.Interviewed claimants and interfaced with related parties such as field adjusters, public adjusters, and legal representatives. Identified and collected evidence necessary to make coverage decisions, ensuring thorough assessment of claims. Issued non-coverage and denial letters, negotiated settlements, and processed payments in accordance with policy guidelines. 06/2021 to 09/2021 Auto Complex Claims AdjusterState Farm Insurance IA DeploymentHandled incoming calls from insureds, claimants, and representatives regarding claim status, providing timely and accurate information. Reviewed current claim status and worked on claims to the furthest possible point, ensuring progress and resolution.Communicated with involved parties and negotiated appropriate settlements within approved payment and policy guidelines. Reviewed supplement claims for additional or missed property damages, ensuring comprehensive assessment and resolution. Recorded statements and completed determinations on liability and percentages, contributing to fair and accurate claim assessments. Utilized State Farm proprietary software and Claims Experience Collaboration for receiving photos of damages and adjusting auto claims onsite or virtually.Processed claim payments, summary of loss documents, payment letters, requests for information, and closed or updated claims accordingly, meeting daily processing quotas and maintaining efficient claim handling operations.03/2021 to 06/2021 CAT/Daily Independent Auto Adjuster AllState Insurance (Daily & Catastrophe) IAProvided excellent customer service by phone, text, chat, and email, ensuring effective communication and resolution of inquiries. Managed claims from beginning to end, including First Notice of Loss, preparing estimates, handling total losses, and collaborating through audio and video channels with adjusters or teams.Conducted fast, thorough, and accurate investigations, obtaining necessary documents, photos of damages, and conducting assessments up to total loss scenarios.Obtained forms from insured individuals to successfully process daily and CAT auto claims, including collision losses, supplements, personal property, rental car/towing expenses, and more.Managed a high daily claim volume of 40 to 45 successful contacts, demonstrating efficiency and productivity in handling customer inquiries and claims processing.Partnered effectively with assigned adjusters or teams, fostering collaboration and streamlined claim resolution.Demonstrated strong organizational and multitasking skills, ensuring timely processing and resolution of claims while maintaining a high level of customer satisfaction.01/2021 to 03/2021 CAT/Daily Independent Property Adjuster AllState Insurance (Catastrophe) IA Firm Deploymen Provided excellent customer service in the specialty areas of condo, limited mobile home, and warehouse structures, ensuring prompt and effective support.Rapidly determined coverage and payment of Additional Living Expenses (ALE), adhering to guidelines and policies. Made advanced payments per guidelines based on covered damages, facilitating timely financial assistance to policyholders. Responsible for handling contents claims, partnering with insured individuals in inventorying and valuating damaged personal effects, concluding with fair and accurate payment.Managed all supplements submitted, updating estimates per guidelines as needed to reflect additional damages or expenses. Completed the settlement process efficiently, ensuring all necessary paperwork and documentation were accurate and in compliance with policies.Handled escalated calls, overseeing claim progression, and ensuring completion of pending work, maintaining a high level of customer satisfaction and resolution.02/2020 to 12/2020 CAT/Daily File ReviewerUS CAT AdjustersReviewed adjuster estimates to ensure technical accuracy and compliance with industry guidelines and standards for repair. Verified inclusion of appropriate file documentation for completion of the review process, maintaining thorough records.Verified the correct use of estimating software and pricing databases, ensuring accuracy in cost assessments.Ensured proposed repairs were accurate based on knowledge of construction standards, practices, and client requirements. Compiled specific estimate revision requests and communicated with adjusters and team managers for necessary corrections. Reviewed supplemental repair estimates and completed secondary reviews for technical accuracy and adherence to standards. Documented all review and assignment activities in XactAnalysis and internal systems, ensuring proper tracking and documentation compliance.Quality Control Inspector03/2019 to 02/2020 PerezProvided excellent customer service by partnering with homeowners, insurance adjusters, and building inspectors via phone or written correspondence.Ensured claim handling consistently met industry guidelines and standards, facilitating smooth processes.Updated system file notes daily with claim status, maintaining accurate and up-to-date records.Submitted and coordinated supplements with property desk adjusters, enhancing claim efficiency.Adhered to all governmental guidelines in projects, ensuring regulatory compliance.Exceeded homeowner expectations by delivering exceptional service and support throughout the claim process.Collaborated effectively with stakeholders to achieve successful outcomes and customer satisfaction.11/2007 to 02/2019 Insurance AgentGEICOProvided excellent customer sales and service by phone or written correspondence, ensuring client satisfaction.Specialized in property and casualty insurance, offering tailored solutions to meet client needs.Prepared personalized rate quotes for individuals and homeowners, optimizing coverage and affordability.Excelled in guiding clients on selecting appropriate insurance coverage, enhancing their understanding and decision-making. Consistently led the local office in sales, achieving top 10% ranking among agents in Florida.Participated in training and readiness of new agents, sharing expertise and promoting team success.Emphasized expertise in auto and homeowner policies, offering comprehensive insurance solutions.EDUCATION AND TRAINING01/2002 Bachelor of Science: Medical Assistant / Nursing Program Valencia College Orlando, FloridaHigh School DiplomaRoosevelt H.S. Bronx, New YorkCERTIFICATIONSCalifornia Earthquake CEAXactimate 28 & X1CCC OneAudatexECSGuidewireFile TracNexGenNavigatorFIAC State Farm Catastrophe CertificationAIAC State Farm Catastrophe CertificationTower Hill Catastrophe CertificationFlorida, P065431, Independent Adjuster - All Lines Adjuster Alabama, Independent AdjusterArkansas, Independent AdjusterFlorida, Independent AdjusterGeorgia, Independent AdjusterIndiana, Independent AdjusterKentucky, Independent AdjusterLouisiana, Independent AdjusterMichigan, Independent AdjusterMississippi, Independent AdjusterNorth Carolina, Independent AdjusterOklahoma, Independent AdjusterSouth Carolina, Independent AdjusterTexas, Independent AdjusterWest Virginia, Independent Adjuster |
