Summary
Overview
Work History
Education
Skills
Timeline
Generic

Duane Simien

Dallas,TX

Summary

Claims professional who values precision and efficiency in claims evaluation and resolution. Proven track record of managing high caseloads and settling claims accurately in compliance with company standards. Known for strong collaboration with team members and adaptability to changing needs, ensuring reliable performance and positive results.

Overview

13
13
years of professional experience

Work History

Sr. Commercial trucking Claims Adjuster (Auto Liability/PD)

Edge Claims
01.2019 - Current
  • Investigates the claim or coverage by making timely and appropriate contact with involved or interested parties including but not limited to the insured or employer representatives, claimant, witnesses, and producers.
  • Verifies coverage and policy conditions. Reviewed coverage issues as needed with supervisor. Typically utilized standardized language to draft positions if needed.
  • Establishes reserves based on estimating outcome of a claim based on the facts for the case and company standards. Adjust reserves based on fact, company standard and experience.
  • Manages time and diary entries effectively and efficiently, prioritizing work in a fast-paced environment.
  • Collaborated with clients and stakeholders to gather necessary documentation for claims processing.

Claims Adjuster (AUTO, HOME / PROPERTY)

Pilot Catastrophe
01.2015 - 11.2019
  • Evaluated and processed complex insurance claims to ensure compliance with company policies and regulations.
  • Analyzed claim data to identify trends, leading to improved risk assessment strategies and enhanced decision-making processes.
  • Mentored junior adjusters on best practices for claims handling, fostering a culture of continuous improvement within the team.
  • Conducted thorough investigations into disputed claims, gathering evidence and documentation to support resolution efforts.
  • Examined claims forms and other records to determine insurance coverage.

Claims Adjuster (AUTO)

State Farm
02.2013 - 12.2015
  • Evaluated claims to determine validity and compliance with policy guidelines.
  • Followed up on potentially fraudulent claims initiated by claims representatives.
  • Identified suspicious losses and contacted manager for investigative assistance.
  • Investigated and assessed damage to property and reviewed property damage estimates.
  • Researched claims and incident information to deliver solutions and resolve problems.

Education

Bachelor of Medical Biology - Biology

University of North Texas
Denton, TX
01.2010

High School Diploma -

West Mesquite High
Mesquite, TX
01.2008

Skills

  • Critical thinking
  • Claims investigation
  • Active listening
  • Highly motivated

Timeline

Sr. Commercial trucking Claims Adjuster (Auto Liability/PD)

Edge Claims
01.2019 - Current

Claims Adjuster (AUTO, HOME / PROPERTY)

Pilot Catastrophe
01.2015 - 11.2019

Claims Adjuster (AUTO)

State Farm
02.2013 - 12.2015

Bachelor of Medical Biology - Biology

University of North Texas

High School Diploma -

West Mesquite High
Duane Simien