Chelsea James
Kopperl,USA
Summary
I am proud of my accomplishments over my 15 plus years of insurance experience and take personal accountability in my individual and team performance. I am actively engaged with staff and other departments to optimize the best results and service for customers, employees, and the organization. Leading by example, availability, positive attitude, and very strong work ethic have allowed me to excel as a top employee, leader, and manager during my career. I believe in diversity, continuous improvement, ongoing development, building relationships, utilization of technology, and ongoing ways to tailor your work product and results to evolve with the industry and ongoing service standards to drive retention, results, and profitability.
Overview
17
17
years of professional experience
Work History
File Reviewer/QA Claims Examiner
Ryze Claims Solutions
- Investigate homeowner claims and negotiate settlements
- Review pictures of the damages and pay per policy terms and conditions
Subrogation Analyst
National Subrogation Services
06.2024 - 03.2025
- Setup, investigate, and analyze facts of the perusing liability and property defects, water losses, work to conclusion with 75-85% conclusions interfacing with adjuster and insureds to satisfy of the client and insured
- Full Time
Claims Adjuster/Account Manager
Veterans Catastrophe Services
03.2022 - 11.2023
- Supervise 45 + field adjusters for catastrophe and daily claims for multiple clients to provide exceptional customer service
- Provide feedback and resolve inquiries and complaints fairly and effectively
- File review for Frontline Insurance claims
- Working from home while being very agile and available as needed
- Able to work with others and ability to solve “inter office” conflicts
- Trainable and take directions well
- Full Time
Claims Adjuster/Account Manager
Prime Consulting Group
08.2021 - 01.2022
- Supervise 25 desk adjusters for catastrophe and daily claims for State Farm Insurance to provide exceptional customer service
- Provide feedback and resolve inquires and complaints fairly and effectively
- Working from home and in office being very agile and available as needed
- Able to work with others and ability to solve inter office conflicts
- Trainable and take directions well
- Full Time
Claims Adjuster/Account Manager
One Call Claims, LLC
09.2020 - 04.2021
- Supervise 37 + field adjusters for catastrophe and daily claims for multiple clients to provide exceptional customer service
- Provide feedback and resolve inquiries and complaints fairly and effectively
- File review for Farm Bureau and Lloyds of London claims
- Working from home and in office being very agile and available as needed
- Able to work with others and ability to solve inter office conflicts
- Trainable and take directions well
- Full Time
Subrogation Analyst
National Subrogation Services
03.2020 - 09.2020
- Setup, investigate, and analyze facts of the perusing liability and property defects, water losses, work to conclusion with 75-85% conclusions interfacing with adjuster and insureds to satisfy of the client and insured
- Full Time
Customer Service Representative
Insight Global-Molina Healthcare
11.2019 - 03.2020
- Respond to incoming calls from members and providers for billing inquiries, service requests, suggestions, and complaints
- Resolve member and provider inquires and complaints fairly and effectively
- Provide product and service information to members and providers
- Full Time
Velocity Insurance Claims Examiner
Choice TPA
06.2019 - 08.2019
- Investigate homeowner claims and negotiate settlements
- Review pictures of the damages and pay per policy terms and conditions
- Full Time
American Integrity Insurance Claims Examiner-Hurricane Michael
Ryze Claims Solutions TPA
10.2018 - 03.2019
- Investigate homeowner claims and negotiate settlements
- Review pictures of the damages and pay per policy terms and conditions
- Full Time
SafePoint Insurance Claims Examiner-Hurricane Irma
Choice TPA
03.2018 - 08.2018
- Investigate homeowner claims and negotiate settlements
- Review pictures of the damages and pay per policy terms and conditions
- Full Time
TWIA Claims Examiner-Hurricane Harvey
U.S. Adjusting Services
09.2017 - 11.2017
- Investigate homeowner claims and negotiate settlements
- Review pictures of the damages and pay per policy terms and conditions
- Full Time
National Homeowners Senior Claims Counselor
Horace Mann Insurance
02.2015 - 09.2017
- Investigate homeowner claims and negotiate settlements
- Review pictures of the damages and pay per policy terms and conditions
- Full Time
Auto Property Damage Adjuster
Direct General Insurance
07.2013 - 02.2015
- Review Auto policies to verify and determine coverage
- Investigate claims for liability, negotiate settlements with the insured and claimants and issue payments
- Review pictures of the damages, interview witnesses, and all parties involved to determine accurate liability
- Full Time
National Homeowners Senior Claims Counselor
Horace Mann Insurance
03.2013 - 07.2013
- Investigate homeowner claims and negotiate settlements
- Review pictures of the damages and pay per policy terms and conditions
- Full Time
MedPay/PIP Claims Counselor
Horace Mann Insurance
02.2012 - 03.2013
- Oversee the medical claims for 1st party auto and homeowners liability
- Review pictures of the damages, interview witnesses, and all parties involved to evaluate the medical claim
- Review all medical records and bills for accuracy and relevance
- Process payments
- Full Time
Auto Property Damage Claims Counselor
Horace Mann Insurance
09.2009 - 02.2012
- Investigate claims for liability, negotiate settlements with the insured and claimants and issue payments
- Review pictures of the damages, interview witnesses, and all parties involved to determine accurate liability
- Full Time
Lead Loss Prevention Investigator
Neiman Marcus Loss Prevention
10.2007 - 09.2009
- Assisted loss prevention manager in supervising staff of three investigators with emphasis on training, professionalism, and creating a team environment
- Worked with senior management to resolve deficiencies identified through CAAPS, LP audits, and nightly closing checklist
- Managed second annual POP (Protect our Profits) Week campaign.
- Conducted week long all store meetings to promote awareness
- Conducted training of new hire associates to communicate loss prevention awareness programs
- Worked closely with operations manager to ensure yearly OSHA training and monthly safety program compliance
- Conduct shoplift surveillance and employee investigations
- Perform profit protection and shortage protection audits
- Enforce merchandise protection standards and awareness training
- Full Time
Education
Bachelor's - Arts and Sciences
University of North Texas
Denton, TX08.2007
Skills
- Leadership
- Teamwork
- Building Positive & Successful Cultures
- Project Management
- Training & Education
- Customer Service
- Positive Attitude
- Work Ethic
- Diversity
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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LICENSING STATES
Adjuster Licensure held in the following states: AL, FL, GA LA, SC, NC, TX, and MN.
Work Preference
Work Type
Full TimeLocation Preference
RemoteImportant To Me
Work-life balanceWork from home optionCareer advancementCompany CultureTimeline
Subrogation Analyst
National Subrogation Services
06.2024 - 03.2025
Claims Adjuster/Account Manager
Veterans Catastrophe Services
03.2022 - 11.2023
Claims Adjuster/Account Manager
Prime Consulting Group
08.2021 - 01.2022
Claims Adjuster/Account Manager
One Call Claims, LLC
09.2020 - 04.2021
Subrogation Analyst
National Subrogation Services
03.2020 - 09.2020
Customer Service Representative
Insight Global-Molina Healthcare
11.2019 - 03.2020
Velocity Insurance Claims Examiner
Choice TPA
06.2019 - 08.2019
American Integrity Insurance Claims Examiner-Hurricane Michael
Ryze Claims Solutions TPA
10.2018 - 03.2019
SafePoint Insurance Claims Examiner-Hurricane Irma
Choice TPA
03.2018 - 08.2018
TWIA Claims Examiner-Hurricane Harvey
U.S. Adjusting Services
09.2017 - 11.2017
National Homeowners Senior Claims Counselor
Horace Mann Insurance
02.2015 - 09.2017
Auto Property Damage Adjuster
Direct General Insurance
07.2013 - 02.2015
National Homeowners Senior Claims Counselor
Horace Mann Insurance
03.2013 - 07.2013
MedPay/PIP Claims Counselor
Horace Mann Insurance
02.2012 - 03.2013
Auto Property Damage Claims Counselor
Horace Mann Insurance
09.2009 - 02.2012
Lead Loss Prevention Investigator
Neiman Marcus Loss Prevention
10.2007 - 09.2009
File Reviewer/QA Claims Examiner
Ryze Claims Solutions
Bachelor's - Arts and Sciences
University of North Texas
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