Experienced with managing claims processes and leading teams to achieve high performance. Utilizes strategic thinking to streamline workflows and enhance team efficiency. Track record of fostering collaborative environments and resolving complex claims effectively.
Overview
13
13
years of professional experience
1
1
Certification
Work History
Claims Team Manager
LIBERTY MUTUAL INSURANCE COMPANY
Plano, TX
01.2015 - 11.2025
Led claims resolution processes, ensuring compliance with regulatory standards and company policies.
Implemented process improvements resulting in reduced claim cycle times and increased customer satisfaction.
Mentored junior staff, promoting best practices in claims management and fostering professional development.
Developed training programs to enhance team performance and improve claims handling efficiency.
Analyzed complex claims data to identify trends, informing strategic decision-making for operational enhancements.
Coordinated cross-functional teams to streamline claims workflows, enhancing collaboration and communication effectiveness.
Conducted regular audits of claims processes, ensuring accuracy and adherence to quality standards.
Streamlined claims processing procedures, resulting in increased productivity and reduced errors.
Facilitated regular team meetings to review progress, address concerns, and share best practices for improved results.
Reduced claim processing time by implementing efficient workflow management strategies.
Enhanced team performance by providing consistent coaching and feedback to team members.
Contributed substantially toward cost savings initiatives through effective negotiation skills during settlement discussions.
Ensured compliance with federal regulations by staying current on industry guidelines, sharing updates with staff regularly.
Led a highly effective claims team, consistently achieving or exceeding company benchmarks for accuracy and efficiency.
Collaborated with other managers to develop standard operating procedures that streamlined claim adjudication processes across teams.
Assisted in the hiring process by conducting interviews and selecting top candidates who contributed positively to the overall success of the Claims Team Manager role.
Demonstrated exceptional leadership qualities throughout tenure as Claims Team Manager, resulting in high employee satisfaction and retention rates.
Established performance goals for employees and provided feedback on methods for reaching those milestones.
Defined clear targets and objectives and communicated to other team members.
Established team priorities, maintained schedules and monitored performance.
Recognized as a subject matter expert within the organization because of comprehensive knowledge about various aspects of insurance claims processing.
Property - Catastrophe Claims Specialist I
Safeco Insurance Company
Richardson, TX
10.2012 - 01.2015
Responsible for informing customers regarding various programs offered by the company, assisting with payment transactions, and helping maintain customer service by handling customer disputes. This position reports to Customer Service Manager and is responsible for quarterly promotions.
Key Contributions:
Investigates claim damages and situation using internal and external resources.
Investigation steps include speaking with the insured or other involved parties such as contractors, requesting and receiving a field investigation report, research on past claim activity, research on external websites for Catastrophe event confirmation, and engaging vendors for services, material supply and/or pricing
Determines policy coverage through analyzing investigation data and policy terms, including whether claim will be approved or denied. Notifies insured of coverage or any issues
Makes coverage and reserve decisions, and reviews work for accuracy
Maintains accurate and current claim file communication and documentation throughout the life cycle of claim cases
Determines and negotiates settlement amounts for damages claimed
Alerts underwriting, marketing and/or risk management regarding questionable risks encountered to ensure potential hazards are clearly documented
Participates in conducting suit committees, roundtables, arbitrations and mediations
Updates and maintains various systems with claims data
Reviews recommendations for causation, approval / denial to determine whether to approve / deny the claim
Performs quickly and effectively in a fast paced / high volume environment
Creates spreadsheets for breakdown of claims estimate details
Hires outside sources such as engineers to determine cause of damages
At times, works with public adjusters and attorneys to resolve claim dispute resolution
Analyzed complex claims to determine validity and appropriate resolution strategies.
Evaluated and processed high-volume insurance claims, ensuring compliance with company policies.
Led training sessions for new staff on claims handling processes and systems usage.
Implemented process improvements that increased efficiency in claims review procedures.
Mentored junior team members, enhancing their skills in claim assessment and customer service.
Resolved escalated customer inquiries, fostering positive relationships through effective communication.
Managed a high volume of claims effectively by prioritizing tasks and maintaining excellent organizational skills.
Enhanced customer satisfaction with timely communication, empathy, and clear explanations of claim outcomes.
Settled complex claims fairly by applying critical thinking, negotiation skills, and detailed knowledge of insurance policies.
Collaborated with cross-functional teams to optimize claims handling procedures, resulting in improved productivity.
Achieved performance targets consistently through attention to detail, effective time management, and strong decision-making abilities.
Reviewed insurance and claims documents to verify required information and secure any missing data for settlements.
Maintained accurate records by diligently updating claim files and ensuring all required documentation was submitted in a timely manner.
Coordinated with legal teams on complex claims, ensuring all regulatory requirements were met and protecting company interests.
Negotiated settlements with claimants and attorneys, achieving favorable outcomes for all parties involved.
Independent Insurance Adjuster
Pilot Catastrophe Services
Grand Prairie, TX
10.2012 - 01.2015
Responsible for informing customers regarding various programs offered by the company, assisting with payment transactions, and helping maintain customer service by handling customer disputes. This position reports to Customer Service Manager and is responsible for quarterly promotions.
Key Contributions:
Investigates claim damages and situation using internal and external resources.
Investigation steps include speaking with the insured or other involved parties such as contractors, requesting and receiving a field investigation report, research on past claim activity, research on external websites for Catastrophe event confirmation, and engaging vendors for services, material supply and/or pricing
Determines policy coverage through analyzing investigation data and policy terms, including whether claim will be approved or denied. Notifies insured of coverage or any issues
Establishes reserve levels at the beginning of handling a claim and adjusts as appropriate based on investigation findings
Maintains accurate and current claim communication and file documentation throughout the life cycle of claim cases
Determines and negotiates settlement amounts for damages claimed
Performs quickly and effectively in a fast paced / high volume environment
Education
High School Diploma -
Forney High School
Forney, TX
05-2011
Skills
Claims investigation
Training and mentoring
Claims management
Positive attitude
Time management
Attention to detail
Multitasking
Excellent communication
Organizational skills
Effective communication
Adaptability and flexibility
Decision-making
Certification
Licensed [Job Title] - [Timeframe]
Additional Information
SKILLS AND LICENSES
Property Licenses - 12 States (available upon request)
Highly organized, diligent, and detail oriented
Ability to establish credibility with customers; demonstrate confidence in dealing with his/her peers
Strong analytical and problem solving skills. Ability to derive innovative solutions
Focused and goal-oriented team player who strives for perfection
Attested ability to work in a busy environment productively
Proficient with all Microsoft applications (Word, Outlook, Excel etc.)
Efficient use in 10-key by touch; excellent typing skills