
Insurance Claims Leader with proven success managing high-severity auto and total loss claims and leading adjuster teams in fast-paced environments. Expertise in complex claims evaluation, large-loss settlements, regulatory compliance, and escalation management. Demonstrated ability to improve operational efficiency, mitigate financial risk, and deliver fair, timely claim resolutions. Strong background in multi-state claims handling, valuation strategy, and team development.
• Lead a team of 6–8 adjusters handling high-volume, high-severity total loss claims
• Oversee end-to-end claim decisions, including valuation, liability considerations, and settlement approvals
• Serve as primary escalation point for complex claims, regulatory complaints (TDI), and attorney-involved cases
• Approve high-dollar settlement payments, ensuring accuracy and financial risk control
• Direct salvage strategy, including bid approvals and disposal decisions to maximize recovery value
• Review and resolve title defects and ownership issues impacting claim settlements
• Analyze claim trends and generate reports to improve cycle time, accuracy, and customer outcomes
• Coach and develop adjusters on negotiation strategy, coverage interpretation, and compliance standards
• Managed moderate to high-complexity auto claims across 13 states
• Determined coverage, liability, and total loss thresholds in compliance with state regulations
• Conducted detailed market valuations and ACV analysis for total loss settlements
• Negotiated settlements with insureds, claimants, attorneys, lienholders, and repair facilities
• Handled disputed claims, appraisal demands, and value challenges
• Identified and pursued subrogation opportunities to reduce claim costs
• Controlled expenses by negotiating storage, rental, and settlement costs
• Issued payments and ensured proper documentation for GAP claims and lienholder processing
• Analyzed medical documentation and billing records supporting insurance claims and litigation
• Ensured accuracy and completeness of files used in claim evaluation and legal review
• Maintained strict compliance with HIPAA and data privacy regulations
• Provided coaching and oversight to improve accuracy and compliance metrics
• Acted as escalation point for time-sensitive and high-risk files
• Managed pipeline of up to 200+ high-value transactions simultaneously
• Conducted risk analysis, compliance validation, and financial review
• Led training initiatives and improved team performance through coaching
• Collaborated with internal/external stakeholders to resolve complex issues
Microsoft Office Suite (Advanced)
Data Analysis & Reporting
Auto Estimating Tools
Multi-State Regulatory Knowledge