Ariel Crum
Tampa
Summary
Organized and detail-oriented Investigator dedicated to improving efficiency, productivity and profitability through continuous process improvement. Analytical thinker skilled at developing innovative solutions to complex problems. Service-oriented Claims Adjuster skilled at applying creative approaches to solving complex problems. Detailed Adjuster with 6+ years of experience in corporate insurance claims. Strong command of claimant information intake processes, records documentation and fraudulent investigation protocols. Impactful skills preparing operational reports, Results-oriented Claims Adjuster bringing hands-on law enforcement experience and exceptional leadership and communication skills. Background includes criminal investigation, insurance fraud and surveillance. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
15
15
years of professional experience
1
1
Certification
Work History
Independent Adjuster Contractor
Allstate Corp
Allen, TX
01.2021 - 01.2024
- Provided exceptional customer service amid high-stress circumstances like natural disasters or widespread property damages events.
- Expedited claim resolution times with prompt onsite inspections after receiving new assignments from supervisors or dispatch centers.
- Ensured regulatory compliance in handling claims by adhering to state laws, insurance policies, and company guidelines.
- Conducted effective interviews with policyholders, witnesses, contractors to gather comprehensive information related to a claim''s investigation process.
- Organized, planned and documented materials for claims.
- Delivered exceptional customer service to policyholders by communicating important information and patiently listening to issues.
- Verified accuracy of records to maintain accuracy of records database.
- Investigated and assessed damage to property and reviewed property damage estimates.
- Collected information from customers to complete claims and legal files.
Total Loss Adjuster
State Farm
Tampa, FL
08.2020 - 01.2021
- Improved overall efficiency within the department by contributing ideas for procedural improvements during team meetings.
- Investigated and analyzed extent of company liability concerning insurance loss or damages.
- Negotiated claim settlements when needed.
- Documented all findings in concise reports.
- Investigated potential fraud cases, protecting company assets from false or exaggerated claims.
- Examined photographs and surveillance and any other documents relating to claims.
- Reduced processing time for total loss claims by implementing more efficient documentation practices.
- Consistently met or exceeded performance metrics related to claim cycle times and customer satisfaction ratings.
- Managed a high volume of claims, ensuring timely resolution and adherence to company guidelines.
- Reviewed police reports, photographs and other documentation to gain complete understanding of accident.
- Approved payment of claims within certain monetary limit.
- Performed managerial duties taking escalated calls and complex claims.
- Collaborated with other adjusters to review complex cases and develop fair settlement offers.
- Enhanced customer satisfaction by delivering honest advice to policyholders in regards to repair work and body shop processes.
- promoted to Lead Trainer
Complex Claims Adjuster
State Farm
Tampa
07.2017 - 01.2021
- Determined liability outlined in coverage and assessed documentation such from police and healthcare providers to understand damages incurred.
- Reviewed questionable claims by conducting agent and claimant interviews to correct omissions and errors.
- Maintained contact with claimants and attorneys to determine treatment status.
- Streamlined internal processes by implementing new claims management software, increasing overall productivity.
- Achieved cost savings through successful subrogation efforts, recovering funds from responsible parties in various claims scenarios.
- Conducted thorough investigations of complex insurance claims, gathering evidence and analyzing relevant documentation.
- Examined claims forms and other records to determine insurance coverage.
- Assisted in updating training materials for new hires based on evolving industry standards and best practices.
- Negotiated favorable settlements with claimants, attorneys, and other insurance carriers to minimize financial risk for the company.
- Provided exceptional customer service during emotionally difficult situations for policyholders following accidents or natural disasters.
- Managed catastrophic loss events effectively by coordinating rapid response efforts and providing support to impacted policyholders.
- Conducted day-to-day administrative tasks to maintain information files and process paperwork.
- Documented all investigation activity and presented reports to management.
- Trained other claims staff members on proper handling and evaluation of injury claims.
- Followed up on potentially fraudulent claims initiated by claims representatives.
- Verified insurance claims and determined fair amount for settlement.
- Reviewed police reports, medical treatment records, and physical property damage to determine extent of liability.
Claims Benefit Specialist
Aetna, A CVS Health
Tampa, FL
02.2014 - 06.2017
- Negotiated settlements on disputed claims, resulting in equitable resolutions for all parties involved.
- Reviewed policy coverage details thoroughly before making determinations on benefits eligibility for each unique claim scenario presented.
- Collected premiums and issued accurate receipts.
- Processed and recorded new policies and claims.
- Handled sensitive claimants'' personal information with discretion, maintaining confidentiality at all times during the claims process.
- Notified insurance agents and accounting departments of policy cancellations and changes.
- Conducted full claim investigations and reported updates and legal actions.
- Modified, updated and processed existing policies.
- Reviewed insurance and claims documents to verify required information and secure any missing data for settlements.
- Calculated adjustments, premiums and refunds.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Decreased turnaround time for claim approvals with thorough investigation and efficient documentation.
- Generated, posted and attached information to claim files.
- Verified client information by analyzing existing evidence on file.
- Maintained a high level of accuracy when inputting data into internal databases, ensuring all information was readily available for review by other team members as needed.
- Posted payments to accounts and maintained records.
- Supported management in identifying areas of potential cost savings through the evaluation and implementation of alternative claim resolution strategies.
Mortgage Loan Officer Assistant
Chase
Tampa, FL
01.2010 - 01.2014
- Assisted in resolving customer complaints, following procedures to find mutually beneficial solutions.
- Maintained compliance with federal regulations by staying up-to-date with industry changes and guidelines.
- Calculated, reviewed and corrected errors on interest, principal and closing costs.
- Maintained referral pipeline by reaching out regularly to real estate agents, referral partners, and past clients.
- Provided ongoing support to new hires as a subject matter expert on company policies, systems, and product offerings.
- Supported loan processing by compiling applicant documentation such as credit reports, employment verifications, and financial history paperwork.
- Assisted in preparing detailed reports for senior management highlighting key performance metrics related to loans processed.
- Collaborated with sales teams to develop marketing strategies that attracted new clients and increased business opportunities.
- Set up, stored and updated customer files, department records and regulatory paperwork.
- Improved borrower experience through prompt follow-ups on inquiries and concerns during the application process.
- Set up files using loan officer checklist and submitted on-time for processing.
- Assembled important paperwork and disclosures for borrower.
- Analyzed credit reports to assess risk and determine applicants' ability to repay loans.
- Liaised with clients to guide through loan closing process and skillfully handle any concerns.
- Provided professional advice on loan applications by interviewing applicants, reviewing applications and verifying information gathered.
- Continuously expanded knowledge of various mortgage products and lending guidelines to provide clients with the best possible solutions for their needs.
- Prepared professional business correspondence on behalf of loan officer to obtain information and facilitate processing steps.
- Reviewed and validated details of loan applications and closing documentation.
Customer Service Representative
AAA Auto Club Group
01.2009 - 01.2010
- Collaborated with team members to develop best practices for consistent customer service delivery.
- Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.
- Developed strong product knowledge to provide informed recommendations based on individual customer needs.
- Sought ways to improve processes and services provided.
- Collaborated with sales team members to stay current on inventory levels, complete accurate orders, and resolve item issues.
- Answered constant flow of customer calls with minimal wait times.
- Delivered prompt service to prioritize customer needs.
- Trained new personnel regarding company operations, policies and services.
- Investigated and resolved accounting, service and delivery concerns.
- Responded proactively and positively to rapid change.
- Answered customer telephone calls promptly to avoid on-hold wait times.
- Promoted superior experience by addressing customer concerns, demonstrating empathy, and resolving problems swiftly.
- Investigated and resolved customer inquiries and complaints quickly.
- Enhanced productivity levels by anticipating needs and delivering outstanding support.
- Tracked customer service cases and updated service software with customer information.
- Followed up with customers about resolved issues to maintain high standards of customer service.
- Resolved associate, tool and service delivery issues revealed by statistical reports.
- Cross-trained and backed up other customer service managers.
- Fostered a customer-centric culture within the team by consistently reinforcing the importance of empathy, understanding, and patience in all interactions with clients.
- Utilized data analytics tools to monitor performance trends regularly, identifying areas for improvement and implementing necessary changes.
- Actively listened to customers, handled concerns quickly and escalated major issues to supervisor.
- Delivered exceptional customer service to every customer by leveraging extensive knowledge of products and services and creating welcoming, positive experiences.
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
- Exceeded performance metrics consistently, earning recognition as a top performer within the team.
- Bolstered customer retention by creating and offering unique discount options and inspiring interest in new product lines.
- Exhibited high energy and professionalism when dealing with clients and staff.
Education
High School Diploma -
Alonso High School
Tampa, FLSkills
- Records Review
- Team Training
- Property valuation
- Innovation and Creativity
- Active Listening
- Damage itemization
- Coverage Assessment
- Valuation knowledge
- Benefits review
- Advanced computer skills
- Human relations
- Coaching and Mentoring
- Litigation Support
- Claims Investigation
- Property Damage Assessment
- Policy analysis
- Claim Form Analysis
- Payment Processing
- Medical Coding
- Denied claims identification
- Microsoft Publisher
- Healthcare Common Procedures Coding System (HCPCS)
- Settlement Negotiations
- Accident scene investigations
- Complex Mathematics
- Liability Analysis
- Coverage Determination
- Record preparation
- Casualty and property loss
- Certified Claims Professional (CCP)
- Customer service and support
- Certified Claims Professional
- Emergency Response
- Risk Management
- Risk Assessment
- Fraudulent Claims Investigation
- Decision-Making
- Highly motivated
- Critical Thinking
- Team Leadership
- Microsoft Office Suite
- Team Collaboration
- Insurance policy coverage knowledge
- Automobile claims specialist
- Claims adjustment
Certification
MEDICAL CODING AND BILLING
PATIENT CARE TECH LICENCE
USAA IA CLAIM CERTIFICATION
Timeline
Independent Adjuster Contractor
Allstate Corp
01.2021 - 01.2024
Total Loss Adjuster
State Farm
08.2020 - 01.2021
Complex Claims Adjuster
State Farm
07.2017 - 01.2021
Claims Benefit Specialist
Aetna, A CVS Health
02.2014 - 06.2017
Mortgage Loan Officer Assistant
Chase
01.2010 - 01.2014
Customer Service Representative
AAA Auto Club Group
01.2009 - 01.2010
High School Diploma -
Alonso High School