Summary
Overview
Work History
Education
Skills
Timeline
Generic

Jahzier Jay Arias

Pembroke Pines,FL

Summary

Proven leader in claims management with extensive experience in Daily/CAT claims handling and fostering strong team dynamics. Excelled in accurate estimating and alternative dispute resolution using streamlined communication, achieving cost-effective settlements and enhancing carrier/client satisfaction. Profound understanding of policy and claims process, demonstrating sensible adaptability and accountability in high-volume environments.

Overview

16
16
years of professional experience

Work History

Complex Claims Manager & Appraiser

Synergy Insurance Adjusting Services — TelaClaims
2015.10 - Current


As owner of Synergy Ins. Adj. Services, I'm responsible for procuring, administering, and fulfilling income producing contracts. Satisfying obligations pertaining to SLAs with TPAs, carrier partners, and independently contracted general adjusting assignments; working as a Claims Manager, Appraiser, Special Projects Coordinator, and Mediation. Performing the following duties:


  • Conducting on-site inspections of damaged properties, assessing repair costs and evaluating coverage eligibility for each claim.


  • Negotiating favorable settlement terms with policyholders and attorneys to achieve cost-effective outcomes in disputed cases. Leveraging consideration in exchange for full claim releases.


  • Exemplified strong decision-making skills, balancing the interests of policyholders and insurance carriers while adhering to ethical guidelines.


  • Direct TPA/Carrier assistance in a first response adjuster role or indirect management role, not limited to a back-end ADR role. I handle catastrophe losses promptly, providing assistance to affected communities during times of crisis or natural disasters.


  • Managed claims adjusting teams in daily and CAT scenarios, providing training, guidance, and leadership. Successfully executing TPA contract rescue efforts in-house, remote, and abroad.


Managed Repair Program Adjuster

Florida Peninsula Claims Services - V. Scheuring
2015.01 - 2016.01


Responsibilities and achievements performed:


  • Managed the entire claims process within a managed repair network, ensuring adherence to program guidelines, quality standards, and policy specific timelines.


  • Developed and maintained strong relationships with our insured party and repair contractors, ensuring timely repairs and positive customer experiences to achieve claim resolution.


  • Proficiently used Xactimate to accurately assess property damage and create detailed repair estimates.


  • Negotiated with repair contractors and customers to secure fair pricing and achieve standard business costs objectives.


  • Successfully demonstrated expertise in identifying UW alerts and addressing subrogation opportunities to recoup our insured's deductible and carrier claim costs. Detection of loss amounts above limits of liability absorbed into applicable deductible as unrealized financial loss.


Managed Claim Model Adjuster

BSA Claims Service — Team One Claims
2008.11 - 2015.01

Performing my role as an 'MCM Adjuster' for Citizens Property Insurance Corp. (CPIC), I was held accountable and relied upon to own the following responsibilities:


  • Policy Analysis & Coverage Reserves: Interpreting insurance policies and their coverage provisions, while assessing applicable points of coverage in contrast with prior losses. Directly working with the subject policy to confirm risk location , carriers liability limits, and special limits of liability to determine exposure and necessary reserves. Early as possible, managing our insured's expectations pursuant to policy coverage.


  • Damage Assessment & Evaluation: I performed timely first contact, scheduling, inspection, expert assignments, setting reserves, estimating, and settlement of commercial and residential first-party claims (i.e., vandalism, malicious mischief, fire, water, wind, and hail). My inspection included all rooms, affected, and unaffected by the reported claim/loss. Conducting a recorded interview, procuring substantive documentation, composing a complete sketch of the risk, and obtaining photos of the loss and overall risk. Graphically estimating/documenting the confirmed financial loss using Xactimate, in compliance with CPIC's estimating guidelines and service level agreements. Documenting and communicating my findings with our insured party. Referring UW alerts, potential subrogation opportunities, and necessary SIU involvement.


  • Coverage Decision & Settlement: Based on my total findings, expert reports, in relation to policy coverage, I'd tender a coverage decision. When necessary, my coverage decision would cite partial denial and applicable policy language. The same was discussed and corresponded to our insured party to maintain transparent communication during the settlement process. I'd also complete any initial, interim, and closing letters to insured party along with loss adjusting expense submittals to CPIC.


  • Litigation: Initial preparation of defense counsel and presented for duces tecum as corporate representative on behalf of CPIC.


  • Desk Manager/Examiner: Responsible for a team of 8-20 remote field adjusters individually tasked to separate claims assigned to my desk for coverage decision approval.


Education

Accredited Claims Adjuster - All-Lines Insurance Adjusting

Miami Dade College
Miami, FL

School of Environmental Sciences - Fire Prevention & Firefighting Certification I/II

Miami Dade College
Miami, FL

First Responder Certification - Emergency Medical Services

Miami Dade College — Medical Campus
Miami, FL

High School Diploma -

Miami Springs Sr. High & Lindsey Hopkins College
Miami Springs, FL

Skills

    √ Accurate Estimating and Review Using Xactimate (Previous Beta-Testing Experience with Xactware Solutions)

    √ Adept Communication and Tracking Using XactAnalysis, MS Teams, Zoom, and Slack

    √ Wind vs. Water Damage and Proximate Causal Expertise

    √ Florida Building Code & Ordinance Law Knowledge & Construction Management Experience

    √ Agile CAT Claims Handling & High-Volume Caseload Management

    √ Proven Productive Adaptability and Accountability Managing Multiple Teams in a CAT Setting

    √ In-depth Understanding of ADRs and Claim Settlement Techniques

    √ Experience Identifying Special Investigations, Prior Loss Analysis, Subrogation, and Excess Policy Coverage

    √ Ability to Perform Complex File Review and Determine the Critical Path of a Claim

Timeline

Complex Claims Manager & Appraiser

Synergy Insurance Adjusting Services — TelaClaims
2015.10 - Current

Managed Repair Program Adjuster

Florida Peninsula Claims Services - V. Scheuring
2015.01 - 2016.01

Managed Claim Model Adjuster

BSA Claims Service — Team One Claims
2008.11 - 2015.01

Accredited Claims Adjuster - All-Lines Insurance Adjusting

Miami Dade College

School of Environmental Sciences - Fire Prevention & Firefighting Certification I/II

Miami Dade College

First Responder Certification - Emergency Medical Services

Miami Dade College — Medical Campus

High School Diploma -

Miami Springs Sr. High & Lindsey Hopkins College
Jahzier Jay Arias