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Yyyyyy x. yyyyyy

Xxxxxx, XXXXXX xxxxxx (xxx-xxx-xxxx abc@xyz.com

 

 

Claims Adjusting Processes Investigations / Evaluations / Settlements

Client Relationship Management Litigation Management Multi-Claims Negotiations

Fraud Investigations Exposure Analysis Data / Records Management Regulatory Compliance

 

Dynamic Claims Adjuster who makes sound decisions to rexxxxxxect positively on efficient third-party claims management processes from initial policyholder contact through to final reporting. Ambitious Self-Starter who rises above claims challenges to achieve winning outcomes, including quickly adapting to evolving scenarios. Top Performer who offers solutions-centric critical thinking for insightful, change-oriented results. Excellent Communicator who develops synergistic relationships with cross-geographical decision-makers, key vendors, legal / healthcare teams, and clients, and who leads peers by example and with ethics and integrity.

 

Career Highlights Include:

  Successfully settling up to five claims per week.

  Reducing exposure to prolonged disability payments.

  Achieving high client satisfaction and maximum retention rates.

  Expertly operating software related to finances and tracking key orders.

  Exhibiting recognition as a quick study who rapidly picks up new concepts.

  Offering skill with Level 3 Workers Compensation claims and Catastrophic claims.

  Handling claims throughout the states of XXXXXX, AL, GA, KY, LA, MS, NC, SC, TN, and VA.

  Providing hands-on support always willing to go the extra mile to surpass the status quo.

 

Professional Synopsis

 

  • Capitalize on the opportunity to lead forward-thinking claims conclusions to policyholders / clients by providing comprehensive coverage investigation, determination, and evaluation while determining initial reserve following detailed reviews to cover claim exposure and reviewing files for potential settlements.
  • Exhibit solid communication and interpersonal relations talents toward interviewing and taking recorded statements of involved parties, including investigating possible fraud and assigning FCM and surveillance.
  • Proactively participate in mediations, hearings, and / or depositions, and managed detailed documentation.
  • Optimize administrative efficiency by submitting payments to injured workers to avoid late fees / penalties.
  • Expertly review diaries on a monthly basis, meet with employers for claims status, and follow up with claimants every two weeks, along with reviewing files and providing proper documentation of file notes.
  • Play a vital role in completing special projects, including reviewing takeover claims for exposure and proper reserves, as well as requesting payments and placing files in diaries to meet or exceed objectives.
  • Collaborate among employers, injured workers, vendors, excess carriers, attorneys, healthcare providers, judges, and mediators during claims adjustment processes, as well as with employees, managers, and IT staff.

 

Professional Experience

 

Claims Adjuster III Catastrophic Claims AmTrust Financial Services, Inc. 2016 2017

Claims Adjuster Sedgwick Claims Management Services 2014 2016

Claims Adjuster York Risk Services Group 2013 2014

Claims Adjuster Ace Metal Building 2011 2013

Claims Adjuster Workers Compensation USIS 1994 2011

 

Education, Professional Development & Technical Summary

 

Undergraduate Studies Valencia Community College Clayton State College

 

State of Xxxxxx 5-20 All Lines Licenses

Xxxxxx Department of Financial Services (Since 2011)

 

Workers Compensation Adjuster License

Alabama Georgia South Carolina North Carolina Mississippi

 

AS400 Corus QuickLink JURIS / SIR ClaimConnect Microsoft Word Microsoft Outlook ANA ImageRight

 

Yyyyyy x. yyyyyy

Xxxxxx, XXXXXX xxxxxx (xxx-xxx-xxxx abc@xyz.com

 

 

Date

 

Hiring Agent Name

Company Name

Address

City/State/Zip Code

 

Dear__________________:

 

I am exploring a new career opportunity within a challenging [ Insert Job Title ] role, and I believe that I can make a positive contribution to your team.

 

To acquaint you with my background, I offer proven talents in Claims Adjusting Processes, including expertise in Investigations, Evaluations, Settlements, Negotiations, Potential Fraud Analysis, and Exposure Analysis. I am also well-versed in Client Relationship Management, Litigation Management, Data / Records Management, and Regulatory Compliance, and consistently achieve success due to my superior skills in critical thinking, conxxxxxxict resolution, work prioritization, time management, and attention-to-detail.

 

Throughout my career, I have excelled in Workers Compensation and Catastrophic Claims Adjuster roles for high-profile employers such as AmTrust Financial Services, Sedgwick Claims Management Services, and York Risk Services Group, among others, where I demonstrated my myriad of professional talents toward driving efficient claims conclusions to policyholders / clients by providing comprehensive coverage investigation, determination, and evaluation. Within these positions, I actively participated in mediations, hearings, and / or depositions and managed detailed documentation. I also met with employers for claims status, and followed up with claimants every two weeks. Furthermore, I continually collaborated with employers, injured workers, vendors, excess carriers, attorneys, healthcare providers, judges, and mediators during claims adjustment process, as well as with employees, managers, and IT staff.

 

A sample of my achievements included:

 

  Successfully settling up to five claims per week.

  Reducing exposure to prolonged disability payments.

  Achieving high client satisfaction and maximum retention rates.

  Expertly operating software related to finances and tracking key orders.

  Handling claims throughout the states of XXXXXX, AL, GA, KY, LA, MS, NC, SC, TN, and VA.

 

To complement this experience, please note that I hold a State of Xxxxxx 5-20 All Lines License, as well as a Workers Compensation Adjuster License for the states of Alabama, Georgia, South Carolina, North Carolina, and Mississippi.

 

As this is just an example of my abilities, please refer to my enclosed resume for additional experience.

 

I am eager to discuss how my qualifications uniquely match your current and future needs, and look forward to interviewing with you soon.

 

Sincerely,

 

 

 

Yyyyyy x. yyyyyy

 

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