Dominique N. Edwards
Forney,United States
Summary
Experienced Claims Adjuster at managing high caseloads in fast-paced environments. Organized, driven and adaptable with excellent planning and problem-solving abilities. Offering 9 years of experience and willingness to take on any challenge. Experienced with handling litigation claims and under state laws and regulations. Negotiating, setting litigation strategy according to Litigation Guidelines.
Overview
11
11
years of professional experience
1
1
Certification
Work History
Office Manager
Ernie Williams Insurance
01.2023 - Current
- Handled sensitive information with discretion, maintaining confidentiality of company documents and personnel records.
- Provided exceptional customer service when addressing client inquiries or concerns via phone calls or email correspondence.
- Assisted in recruitment process, conducting interviews and onboarding new employees to promote seamless integration into team dynamic.
- Successfully managed budgets and allocated resources to maximize productivity and profitability.
SIU Claim Specialist
State Farm
08.2018 - 01.2023
- Recognizes NICB Indicators of Fraud, focuses on suspicious loss indicator resolution and follow up on inconsistencies discovered during investigation of claim
- Investigates claims to resolve indicators of fraud and initiate payment or, if investigation determines claim is without merit, resist payment of claims
- Collaborated with legal teams and law enforcement to gather information, resolve disputes, and facilitate legal actions related to fraudulent claims
- Reviewed and maintained accurate claim files, ensuring all necessary documentation was in place for future reference.
- Maintained compliance with industry regulations by staying up-to-date on changes in policies and procedures, ensuring proper handling of sensitive information.
SR. Claims Resolution Representative
Liberty Mutual Insurance
10.2015 - 11.2017
- Provide positive customer experience while appropriately handling routine auto claims by obtaining information and maintaining accurate records
- Arrange and reschedule appraisals, review appraisal reports and communicate with customers and repair shops
- Determine and negotiate settlement amount for damages
- Thoroughly investigate claims using internal and external resources
- Review claims handled for fraud and subrogation potential
Member Service Specialist II
AAA Of Texas
07.2013 - 10.2015
- Perform sales processing functions, mediating member service requests and inquiries via telephone or internet demonstrating proficiency in one or more line of business
- Act as liaison between customers and company by assisting with complaints, orders, errors, account questions, billing, cancellations, and other queries
- Coordinate work activities with other department, offices, or external sources as required, answer member telephone requests, and providing quality customer service as needed
- Conducted thorough research to provide accurate information and recommendations, enabling informed decision-making by members.
- Established strong relationships with members to foster loyalty and trust, contributing to a high retention rate.
Education
Bachelor of Science - Criminal Justice, Minor Sociology
Univeristy of North Texas
Denton, TX12.2014
Skills
- Policy interpretation
- Legal compliance
- Financial acumen
- Claims investigation
- Settlement Determinations
- Fraud Detection
- Special Projects
- Settlement Documents
- Claims Understanding
- Strategic Initiatives
- Complex Problem-Solving
- Policy and Procedure Explanations
Certification
Licensed Adjuster, 9
Timeline
Office Manager
Ernie Williams Insurance
01.2023 - Current
SIU Claim Specialist
State Farm
08.2018 - 01.2023
SR. Claims Resolution Representative
Liberty Mutual Insurance
10.2015 - 11.2017
Member Service Specialist II
AAA Of Texas
07.2013 - 10.2015
Bachelor of Science - Criminal Justice, Minor Sociology
Univeristy of North Texas
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