Elexus Rose-Chong

• Results-driven versatile Independent Insurance Adjuster with 9 years of experience managing high-volume claims across property and casualty lines. As an independent adjuster I was employed through a claims firm to help assist a carrier with a high claim volume. I adjusted first and third party commercial and personal auto claims.
• Conduct thorough investigations to determine fault. This includes reviewing police reports, interviewing drivers and witnesses, and analyzing scene photos.
• Interpret complex commercial policies to verify coverage for specific vehicle Symbols, Hired and Non-Owned Auto, and Drive Other Car endorsements.
• Coordinate with specialized appraisers to evaluate damages for heavy equipment, trailers, and cargo. For smaller losses, you may audit estimates from repair facilities to ensure cost accuracy.
• Establish and maintain accurate indemnity and expense reserves to forecast the ultimate cost of the claim, ensuring the carrier has sufficient funds set aside.
• Ensure all claim handling follows Department of Transportation and Federal Motor Carrier Safety Administration regulations, particularly for interstate trucking.
• Evaluate and negotiate Downtime or Loss of Use claims for businesses that lose revenue while a specialized commercial vehicle is out of service.

I independently managed a pending of 98+ high-complexity BI files involving fatalities, permanent disability, and catastrophic injuries. Effectively negotiated settlements with 89% of claims resolved prior to litigation, saving the carrier an estimated $31,000.00 in legal fees annually.

• Managed bodily injury claims from initial investigation through settlement negotiations.
• Analyzed medical records and accident reports to evaluate claim validity and damages.
• Collaborated with legal teams and external vendors to facilitate efficient claim resolution.
• Reviewed and approved settlements, ensuring consistency with company guidelines.
• Minimized litigation costs through effective case management and proactive settlement negotiations.
• Identified fraudulent claims swiftly through meticulous review processes that safeguarded company resources from unnecessary expenses.
• Developed comprehensive knowledge of relevant laws and regulations pertaining to bodily injury insurance claims handling.

• Conducted comprehensive coverage investigations to determine the cause of loss, extent of damage, and policy coverage for commercial and personal auto, residential and commercial properties.
• Utilized Mitchell to create accurate, line-itemrepair estimates, ensuring compliance with carrier-specific guidelines.
• Consistently met or exceeded "Time to Inspect" and "Time to Close" KPIs while managing a rotating roster of 55+ active claims.
• Deployed as desk adjuster to evaluate hurricanes and hail to provide rapid-response adjustments and emergency professional services.

• Delivered exceptional customer service by resolving inquiries and concerns efficiently.
• Utilized CRM systems to track customer interactions and improve response times.
• Enhanced customer satisfaction by promptly addressing concerns and providing accurate information.
• Developed rapport with customers through active listening skills, leading to higher retention rates and positive feedback from clients.
• Maintained detailed records of customer interactions, ensuring proper follow-up and resolution of issues.
• Analyzed customer service metrics to identify trends and develop strategies for improvement.
• Responded to customer requests, offering excellent support and tailored recommendations to address needs.

• Streamlined claim review processes to enhance efficiency and reduce processing times.
• Enhanced efficiency by staying up-to-date on industry trends, regulations, and best practices in bodily injury claims management.
• Negotiated settlements with claimants and attorneys ensuring fair compensation aligned with policy guidelines.
• Evaluated bodily injury claims to ensure compliance with legal regulations and company policies.
• Reviewed bodily injury demands and responded to demand before or on due date.
• Collaborated with cross-functional teams to resolve complex claims issues efficiently.
• Managed a high volume of claims effectively by prioritizing tasks and maintaining excellent organizational skills.
• Analyzed liability claims to determine coverage and settlement options.

• As a Preferred Customer Service Representative, I assist agents in processing new business applications, complete endorsements, process cancellations, and reinstatements.
• Policy Explanation: Simplified complex terms and conditions for customers, ensuring they fully understood their rights and obligations this mirrors explaining policy language to an insured.
• Documentation Excellence: Documented every interaction with a high level of detail to ensure a seamless "hand-off" between departments this mirrors claim file documentation.
• Billing: Accepting payment for premium payments, renewals, cancellations, and collections.
• Efficiency & KPIs: Consistently met or exceeded performance metrics, including Average Handle Time AHT and Customer Satisfaction Scores CSAT.

• Under general supervision, I reviewed and analyzed claim files to determine potential exposures. I identified cases that should be recommended for settlement and maintained production and inventory levels.
• Complex Coverage Investigation: Conducted in-depth coverage reviews for "high-risk" policies, identifying potential issues such as unlisted drivers, misrepresentation on applications, and material lapses in coverage.
• Recorded Statements: Secured detailed, sworn recorded statements from insureds, claimants, and witnesses to verify the facts of loss and identify inconsistencies early in the claim cycle.
• High-Volume Inventory Management: Successfully managed a high-frequency pending of 100+ claims, maintaining strict adherence to state-mandated "First Contact" and "Status Letter" timelines.
• Fraud Identification & SIU Referral: Actively identified "Red Flags" associated with non-standard risks, including staged accidents, "jump-ins" unreported passengers, and prior damage claims, referring suspicious files to the Special Investigations Unit SIU.
• Comparative Negligence Application: Applied state-specific negligence laws to resolve liability disputes, often negotiating with other non-standard carriers to reach favorable settlement outcomes.
• Total Loss & Salvage: Managed the end-to-end process for total loss vehicles, including valuation through CCC One or Audatex, title procurement, and salvage disposal.

• As a DMV title clerk, I was responsible for the daily processing of vehicle titles. Through a thorough understanding of corresponding state and local title processing regulations and Copart policies. In addition, I also maintain file documentation, update customers on file status, and maintain accurate records of vehicle titling within company guidelines.
• Title & Registration Submission: Accurately prepared and submitted legal transfer documents (titles, registrations, and license plate applications) to state DMV offices within strict regulatory deadlines.
• VIN & Odometer Verification: Verified Vehicle Identification Numbers (VIN) and odometer readings against physical records and state databases to prevent fraud and ensure data integrity.
• Out-of-State Transactions: Managed complex "cross-border" titling for out-of-state buyers, researching specific state requirements to ensure tax and registration reciprocity.
• Customer Service: Resolved customer inquiries regarding missing titles or delayed license plates, providing clear timelines and de-escalating frustrations.

• As a Senior Claims Resolution Specialist, This role consisted of high-exposure, complex, and often litigated files. Reviewed medical records, pain and suffering, and long-term prognosis.
• Liability Investigation: Conduct thorough investigations to determine fault. This includes reviewing police reports, interviewing drivers and witnesses, and analyzing scene photos.
• High-Exposure Oversight: Managed a caseload of high-complexity claims with individual exposures exceeding $250,000+, involving catastrophic injuries, complex liability, and multi-party disputes.
• Strategic Resolution Plans: Developed and executed comprehensive resolution strategies for long-tail claims, balancing aggressive negotiation with the financial risks of protracted litigation.
• Coverage Analysis: Performed expert-level interpretations of manuscript policies, excess/umbrella layers, and complex "Additional Insured" or indemnity agreements.
• Reserve Integrity: Evaluated and set high-level indemnity and expense reserves, presenting detailed "Reserve Justification" reports to executive leadership for high-profile losses.

• This role combines sales, consultative advising, and regulatory compliance.
• Client Consultation & Needs Analysis: Conducted comprehensive interviews to assess clients' financial situations and healthcare needs, recommending suitable medical, dental, vision, and disability plans.
• Policy Education & Comparison: Simplified complex insurance terms (deductibles, out-of-pocket maximums, HMO vs. PPO) to help clients make informed decisions during Open Enrollment and Special Enrollment Periods.
• Enrollment Management: Guided clients through the application process for Individual ACA/Marketplace and Group health plans, ensuring 100% accuracy in document submission and subsidy eligibility.
• Medicare & CMS Compliance: If applicable Performed detailed needs analysis for seniors, identifying matching Medicare Advantage, Supplement Medigap, or Part D plans while strictly adhering to Medicare Marketing Guidelines.
• Lead Generation & Prospecting: Developed a robust pipeline of potential clients through cold calling, networking, community outreach, and digital marketing strategies.
• Customer Retention & Servicing: Provided ongoing support by resolving billing discrepancies, assisting with claim submissions, and conducting annual policy reviews to ensure continued coverage fit.

• Worked effectively in fast-paced environments.
• Supervised deck operations, ensuring safety and compliance with maritime regulations.
• Led training programs for junior crew members, enhancing skills and operational efficiency.
• Excellent communication skills, both verbal and written.
• Coordinated schedules and appointments for management and staff effectively.
• Implemented process improvements that reduced administrative errors significantly.
• Led initiatives to digitize records, enhancing data accessibility across the organization.
• Handled incoming phone calls and answered questions from callers.
• Reduced errors in data entry tasks through diligent attention to detail and thorough verification procedures.