- 2319 Sandburg St.Ÿ Xxxxxx, XXXXXX xxxxxx ( (xxx-xxx-xxxx * abc@xyz.com

Attorney General Liability Claims Adjuster

Qualifications Profile

    Self-assured, dynamic, and results-driven lawyer and insurance professional with more than 16 years providing high-performance customer services, conflict resolution, multilateral negotiations, project management, and operations support in the claims management aspect of the property insurance service industries.

-    Strong passion for delivering win-win solutions in negotiated claims settlements.

-    Effective people management and interpersonal communication skills that facilitate diplomatic options and adjudication in resolving claims and disputes.

    Highly detailed, analytical and methodical with critical thinking to resolve work issues even under stress.

    Well-organized and resourceful with multitasking skills that optimize limited resources to achieve outstanding results.

Key Expertise

    Insurance Claims Management

    Commercial Property and Automotive Policy Administration

    Worker s Compensation Claims Management

    Customer Service Management

    Investigative Research & Analysis

    Financial Fraud Management

    Relationship Management (Clients, Stakeholders, Attorneys, Medical Practitioners, & the Public)

    Inter-Office / Agency Coordination

    Negotiations & Diplomacy

    Policies & Regulatory Compliance

    Risk Management

    Process/Workflow Improvement

    Staff Supervision, Motixxxxxxtion & Training

    Records & Document Management

Professional Experience

Travelers Insurance Ÿ Chantilly, XXXXXX

    Managed and processed commercial and residential property insurance claims, interacting with clients to address questions on policy coverage, using simple and clear terms in explaining lease provisions and condominium by-laws provisions to resolve claim coverage issues.

    Maintained professional composure in the face of personal insults that may arise in addressing issues and negotiating with clients and contractors while aiming to resolve conflicts and disputes in processing claims on a regular basis.

    Investigated potential fraud, claim coverage, and explored appropriate repair methods for the damages in any claim.

    Inspected damages, provided comprehensive repair estimates on covered damages, and communicated proposed settlement of claim to the client for negotiations.

    Drafted and finalized denial of coverage letters, reserxxxxxxtion of rights letters, and other written communications to customers and 3^rd parties.

    Reviewed and interpreted xxxxxxrious policies on commercial leases and condominium by-laws. 

    Provided HR support in training new adjusters, serving as mentor to 3 new hires.

American Claims Management Ÿ San Diego, CA

    Ensured win-win solutions in claims settlement, negotiating with concerned parties, and conducting investigations that involved documented interviews with employers, injured employee/claimant, and medical personnel to arrive at the proper and just settlement.

    Coordinated all claims settlement processes, from medical visits of injured employees under return-to-work programs of employers to resolve the claims as quickly and efficiently as possible.

    Reviewed medical reports to ensure best care plans for the injured worker in restoring health and determine a plan of action when such plans fail.

    Investigated potential fraud and oversaw surveillance of injured workers when called for to conform a genuine claim.

    Managed insurance claims on auto property damage, bodily injury, and auto theft claims.

    Interacted with clients by phone, conducting documented interviews with concerned parties in investigations to assess possible fraud, or identify responsible parties behind the damages for proper settlement adjudication.

    Reviewed auto damage estimates, police reports, and medical records/reports to assess the xxxxxxlue of the claim prior to any negotiated settlement directly with the customer or with representative attorney.

- 2319 Sandburg St.Ÿ Xxxxxx, XXXXXX xxxxxx ( (xxx-xxx-xxxx * abc@xyz.com

Education & Credentials

    CONCORD LAW SCHOOL KAPLAN UNIVERSITY Ÿ Los Angeles, CA (2016)

Juris Doctor, Online Learning Program, with honors, final GPA: 3.09

-    Currently awaiting results from the CA Bar Exam taken July 2016.

-    Passed the CA First Year Law Students Exam on 1st attempt (about 25% pass this exam on 1st attempt).

-    Earned Distinguished Scholar honors (GPA of 3.3) for the 1st year of law school.

-    Earned Dean s List honors (GPA of 3.0) for the 2nd year of law school.

    TEXAS A&M UNIVERSITY Ÿ College Station, TX (2000)

Bachelor of Business Administration in Accounting

Professional Training & Certifications

    Westlaw Next certified

    Texas All-Lines Adjuster License

Affiliations

    Home Educators Association of Xxxxxx

    Home School Legal Defense Association