Donald James
Saraland,Alabama
Summary
- 5 1/2 years of claims handling experience.
- Proven ability to work independently & multi-task effectively.
- Strong history in handling flood, Property, Auto claims & Bodily injury/ General liability, Commercial & Business Interruption.
- History of settling claims in timely fashion.
- Adept at working under pressure & time restraints.
- Maintained spreadsheets to ensure claim compliance deadlines met.
- Negotiation to resolve claim amicably, agreed settlement with executed released.
- Proficient in Xact Analysis, NextGen, FCS, Flood Connect, Guidewire & Claims Center.
- Outstanding training, leadership, and communication skill.
- QA/QC claim handling & claim review.
- Motivated Claims Adjuster specializing in personal, property, and casualty loss and damages.
- Negotiates peaceful resolutions of all claims with emphasis on fairness and thoroughness.
- Organized, trustworthy, and dependable.
Overview
4
4
years of professional experience
Work History
Claims Adjuster
Pilot Catastrophe Services
03.2022 - 02.2023
- Accurately and efficiently reviewed field adjuster work product submissions and provide appropriate feedback and revision direction as necessary.
- Identify and track issues and trends in all facets of field investigation, damage identification, estimation, and reporting quality to drive training and other performance enhancement initiatives.
- Communicate directly with the policyholder and their agent as needed.
- The ability to explain flood coverages and flood policy.
- Responsible to prioritize work appropriately and meet our client's claim handling timelines.
- Review field adjuster work product submission for quality and adherence to the NFIP Standard Flood Insurance Policies, Fema Claims Manual, client-specific guidelines, best practices, and estimating standards.
- Determine the appropriateness and accuracy of recommended repairs based on photographs, diagrams, narrative reports, documentation submitted by policyholder and drone footage.
- Provide constructive feedback and revision requests to field adjusters by telephone and in writing.
- Effectively manage a claims case load.
- Establish and maintain strong working relationships with policyholders, agents, and other claim participants.
- Objectively evaluate adjuster performance and document systems.
QA/QC/Desk Examiner-Restore Louisiana Project 2020
IEM
10.2020 - 03.2021
- Reviewed files and endorsements to confirm coverage and eligibility met to approved payment.
- Electronically entered payments on submitted documents and photos to be reviewed for claim settlement review.
- Provided courteous customer care.
- Entered information on submitted claims to ensure the timely progression of claim, determination and eligibility.
- Ensure compliance standards were met for all claims.
- Submitted file for payment after all documentation submitted and attached to file.
Auto Bodily Injury/General Liability
The Jacobson Group
02.2019 - 09.2020
- Utilizes automated estimating systems to prepare repair estimates.
- Review supplement requests and make subsequent adjustments to estimates.
- Provides technical support to claim handlers on vehicle repair issues.
- Uses estimating vendor tools and the NextGen System.
- Applies knowledge of market value and other factors affecting reparability issues.
- Refers information on possible vehicle total loss claims to the appropriate contact.
- Evaluates bid content and photo documentation, vehicle damage, causation issues, and potential
- Completed necessary claim file documentation in NextGen in support of subsequent claim handling.
- Applies thorough understanding of Standard Claim Process and Auto Service Damage Program (ASDP).
- Continuously develops professional / technical expertise regarding vehicle repair trends, automated estimating systems, repair techniques, tools, and other industry-related topics.
Education
Bachelor of Science - Computer And Information Systems
University of South Alabama
Mobile, AL09.2001
Skills
- Home State License Alabama
- Certifications - State Farm Auto and Property
- Mobile Devices
- Microsoft Word
- Microsoft Excel
- Project Management Abilities
Timeline
Claims Adjuster
Pilot Catastrophe Services
03.2022 - 02.2023
QA/QC/Desk Examiner-Restore Louisiana Project 2020
IEM
10.2020 - 03.2021
Auto Bodily Injury/General Liability
The Jacobson Group
02.2019 - 09.2020
Bachelor of Science - Computer And Information Systems
University of South Alabama
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