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Yyyyyy x. yyyyyy

2645 Austin Dr. | Mesquite, TX 7518xxx-xxx-xxxx | abc@xyz.com

 

Claims Specialist

 

Knowledgeable and focused professional with 15 years of valuable experience in handling commercial claims. Skilled in implementing continuous improvements to bolster company levels of productivity and profit. Developer of innovative solutions using analytical acumen. Adept at rendering comprehensive, intentional decision. Personable with a customer-focused demeanor. Driven to excel independently and in teams. Seeking an Independent Insurance Adjuster role with opportunities for further career growth and opportunities for professional development.

 

Areas of Expertise

 

Claims Processes | Customer Issue Resolution | Policy Interpretation | Problem Solving | Risk Assessment & Mitigation

Problem Solving | Interpersonal Communication | Leadership | Organization | Time Management | Multitasking

Attention to Detail | Records Management | Arbitration Contentions | CPT Codes | Arms | CCC Pathways

Microsoft Office, Outlook | Lotus Notes | Claims Connect

 

Professional Synopsis

 

Wardlaw Claims Services/CNC Catastrophe & National Claims (State Farm)

Independent Claims Adjuster (2017)

         Worked with clients intensively to determine the type of auto coverage to best suit their respective needs

         Investigated claims by interviewing claimants and witness to reach a settlement; included resolution of total loss settlements

         Determined insurance carrier liability clients instructions and authority levels required 

         Provided salvage processing instructions in the case of total losses; answered related questions with care and timeliness

 

Zurich Insurance

Liability Claims Specialist (2001-2015)

         Fielded liability claims, e.g. commercial general, premises and auto

         Also worked to resolve auto property damage, total loss, trucking and bodily injury claims of moderate exposure and complexity claims, all per best practices within authority limits

         Often worked to resolve multi-party claims in a multi- state jurisdiction; served as a dedicated claim handler for these specific accounts

         Documented claims by accurately capturing and updating data for filing and recordkeeping purposes

         Gathered and assessed relevant facts utilizing applicable laws; followed up using sound judgment to determine liability

         Worked diligently to establish the basic principles of negligence

         Exercised judgment to determine policy verification and coverage determination; swiftly and accurately resolved claims by devising effective case strategies and evaluations

         Established timely reserves and engaged in continual review processes during the claims cycle, all within authority limits

         Leveraged optimal strategies in skillfully negotiating claims settlements

         Proactively communicated with clients at all phases of the claim review process; resolved to deliver the utmost in quality customer care at all times

         Handled litigation processes, always ensuring legal compliance and adherence to internal control requirements during negotiation processes

         Identified and responded in full to potential instances of subrogation and fraud

         Achieved profit growth through the delivery of risk and trends insight to business units and customers; worked jointly with colleagues to surpass set goals and complete special projects as assigned

 

Education & Credentials

 

Certification, State Farm Auto Certified

Credentialed, SCLA Designation

Licensure, States of TX, Al, AK , CT, FL, IN, KY, LA, MI, MN, MS, NV, NH, NC, OK, OR, SC, WV, WY and AZ

Associate of Science, Nursing, Eastfield College

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