James Baxter
Kissimmee
Summary
Seasoned claims professional with a proven track record in successful claims management, risk mitigation, and client advocacy initiatives. Expertise includes Workers’ Compensation, General Liability, Auto claims, and OCIP/CCIP programs, with a strong focus on client service leadership. Recognized for enhancing claims processes and optimizing operational efficiencies while fostering robust partnerships with clients, carriers, and third-party administrators. Known for meticulous attention to detail and consistently achieving high client satisfaction rates, along with the ability to adapt to dynamic environments through strong analytical and communication skills.
Overview
39
39
years of professional experience
1
1
Certification
Work History
Claims Quality Analyst
Dane Street
Palm Beach Gardens, FL
08.2025 - Current
- Perform detailed evaluations of Independent Medical Exams related to New York State Workers' Compensation to ensure compliance and accuracy for insurance carriers and third-party administrators.
- Manage the preparation and submission of reports to maintain compliance with statutory deadlines.
- Act as a liaison to ensure seamless interaction between clients and panel physicians, focusing on issue resolution.
Claims Advocate, Risk Services
Insurance Office of America
Longwood, FL
04.2019 - 12.2024
- Oversaw resolution of claims issues for designated accounts, guaranteeing swift and accurate responses to client needs.
- Worked closely with internal producers and account teams to provide superior service, focusing on improving client satisfaction.
- Directed communication efforts among clients, carriers, and third-party administrators to facilitate appropriate claims management and timely issue resolution.
- Facilitated file reviews and audits, contributing to improved workflow and compliance, focusing on reserves and settlements.
Claims Advocate Lead
Alliant Insurance Services
New York, NY
12.2015 - 12.2018
- Acted as client advocate for major construction risk accounts, including OCIP and CCIP wrap-up programs.
- Facilitated decision-making processes for claims adjusters regarding acceptance, denial, and recovery planning to ensure effective settlements.
- Provided expert escalation support for key accounts, notably Skanska, to streamline and resolve intricate claims effectively.
- Cultivated vendor relationships and ensured alignment with client expectations for defense investigation and medical services.
Claims Manager
Construction Risk Partners
New York, NY
07.2014 - 12.2015
- Guided clients through daily claims processes, streamlining their experience with complex requirements.
- Analyzed and verified initial reports alongside insureds, ensuring efficient submission to carriers.
- Performed monthly billing audits and loss run analyses to enhance claims performance evaluation.
- Facilitated renewal preparation through comprehensive analysis of claims history.
Senior Technical Manager
AIG Claims Services
New York, NY
07.2009 - 04.2014
- Analyzed claims data and showcased findings through presentations to enhance understanding during team reviews with customers and brokers.
- Oversaw comprehensive wrap-up program caseload, emphasizing financial exposure evaluation and resolution strategies.
- Designated to negotiate liens and recoveries for the office.
Claims Manager
AIG Claims Services
New York, NY
01.1997 - 01.2009
- Oversaw operations of a 15-member workforce team in a stand-alone satellite office.
- Facilitated customer review sessions and fostered cross-departmental collaborations.
- Participated in many prospective client and kick-off meetings.
- Facilitated staff performance evaluations and managed HR-related issues.
Senior Claims Representative
AIG Claims Services
New York, NY
01.1996 - 01.1997
Claims Representative II
AIG Claims Services
New York, NY
01.1993 - 01.1996
Claims Examiner
Greater New York Mutual Claims
New York, NY
01.1987 - 01.1993
Education
Bachelor of Science - Management & Marketing
Manhattan University
Bronx, NYSkills
- Claims analysis
- Verbal communication
- Insurance claims review
- Time management
- Customer focus
- Claims auditing
Certification
- New York State Insurance Adjuster License
- Florida Insurance Adjuster License
Timeline
Claims Quality Analyst
Dane Street
08.2025 - Current
Claims Advocate, Risk Services
Insurance Office of America
04.2019 - 12.2024
Claims Advocate Lead
Alliant Insurance Services
12.2015 - 12.2018
Claims Manager
Construction Risk Partners
07.2014 - 12.2015
Senior Technical Manager
AIG Claims Services
07.2009 - 04.2014
Claims Manager
AIG Claims Services
01.1997 - 01.2009
Senior Claims Representative
AIG Claims Services
01.1996 - 01.1997
Claims Representative II
AIG Claims Services
01.1993 - 01.1996
Claims Examiner
Greater New York Mutual Claims
01.1987 - 01.1993
Bachelor of Science - Management & Marketing
Manhattan University