Edward Brown
Anniston,AL
Summary
Insurance Adjuster skilled in investigating and analyzing liability concerning personal, casualty or property loss. Proven history of leveraging excellent negotiation skills to facilitate settlements. Excellent communication skills demonstrated through 4 years of experience interviewing specialists, witnesses and claimants to compile information.
Overview
11
11
years of professional experience
1
1
Certification
Work History
MEDICAL/PIP/MEDPAY CLAIMS ADJUSTER
KEMPER INSURANCE
08.2023 - Current
- Identify and analyze medical and expense claims for coverage eligibility
- Establish accurate loss and reserve for damages
- Research injury-related statutory provisions and case law
- Obtain necessary documentation and conduct detailed research for claims
- Utilize IME and Peer Review processes when appropriate
- Reduce company costs by identifying fraud and misrepresentation attempts from attorneys and medical providers
- Thoroughly document injury-related treatment and expense history, detail insite into billing and procedure breakdowns
- Managed a caseload of 80+ claims per month, improving claim resolution times
- Negotiated favorable settlements to minimize financial risk for the company
- Conducted thorough investigations of complex insurance claims
- Collaborated with SIU and legal teams to defend against fraudulent claims, saving company resources
- Maintained compliance with state regulatory requirements through meticulous documentation
COMMERCIAL CLAIMS ADJUSTER
KEMPER INSURANCE
08.2020 - 08.2023
- Maximized profitability by developing standards for determining complex coverage situations and liabilities in commercial auto claims
- Saved company resources by processing attorney demands in a timely manner, reviewing authority reports, and managing all relevant documents
- Conducted negotiations with various parties including attorneys, subrogation adjusters, and early BI settlements
- Handled claims, investigations, policy reviews, valuation, and managed exposures, large pending volumes, and property damage
- Exceeded goals with a 10-day closing cycle based on claim volume (100+ monthly) and percentages
- Coordinated efforts between all parties involved in claims processing
- Contributed to the integrity of the business by following state and federal guidelines for claim processing
- Handled multi-jurisdictional claims and conducted objective reviews of claims, policies, and contract assessments
FIELD SERVICE MANAGER
Dish Network/MCK
02.2016 - 03.2020
- Minimized liability cost by investigating damage claims onsite by documenting that the install is up to code, taking pictures of alleged damage, taking witness statements, and sending findings into headquarters with a denial/acceptance decision
- Created strong company reputation with excellent customer service and interactions with customer at their residence and over the phone
- Expanded the company's qualified work staff by supervising 12-20 technicians, developing, hiring, and training, set up expectations, accountability standards, onsite inspections of work, sales, and safety
- Review balance sheets and income statements
- Administrate using company software.
SATELLITE TECHNICIAN
Dish Network/MCK
05.2013 - 02.2016
- Installed Dish Network television systems into customer’s residence, provided exemplary customer service, upselling of products.
Education
Associate in Art and Science Business and Accounting -
PIERCE COMMUNITY COLLEGE
Fort Steilacoom, WA12.2002
Skills
- Critical Analysis
- Data Analysis
- Caseload Management
- Interpersonal Skills
- Claims Investigation
- Problem Solving
- Legal Compliance
- Insurance Regulations
- Medical Terminology
- High level claims processing
- Insurance Policy Coverage Knowledge
- Casualty and Property Loss
- Legal Proceedings Knowledge
- Claims Processing
- Familiar With Fraud Statutes
- Policy Investigations
- CCC Reports
- Best Practices Implementation
- Regulatory Compliance
- Coverage Assessments
- Quality Control
- Medical Coding
- Advanced Computer Skills
- Advanced Oral and Written Communication Skills
Certification
- Adjuster License for the following states CT, LA, DE, KY, NM, OK, RI, SC, NC, TX, VT, WY
- FL Home state All Lines License
Timeline
MEDICAL/PIP/MEDPAY CLAIMS ADJUSTER
KEMPER INSURANCE
08.2023 - Current
COMMERCIAL CLAIMS ADJUSTER
KEMPER INSURANCE
08.2020 - 08.2023
FIELD SERVICE MANAGER
Dish Network/MCK
02.2016 - 03.2020
SATELLITE TECHNICIAN
Dish Network/MCK
05.2013 - 02.2016
Associate in Art and Science Business and Accounting -
PIERCE COMMUNITY COLLEGE
Similar Profiles
Bryan BurnsideBryan Burnside
Insurance Agent at Kemper InsuranceInsurance Agent at Kemper Insurance
Shanice SinghShanice Singh
Manager, Finance Strategy Project Management at KEMPER INSURANCEManager, Finance Strategy Project Management at KEMPER INSURANCE
Heidy LuqueHeidy Luque
Customer Service Representative at Kemper InsuranceCustomer Service Representative at Kemper Insurance
Joseph CorbettJoseph Corbett
Commercial Lines Claims Auto Liability Adjuster at Kemper InsuranceCommercial Lines Claims Auto Liability Adjuster at Kemper Insurance
April MApril M
Material Handler at CVGMaterial Handler at CVG