Summary
Overview
Work History
Education
Skills
Accomplishments
Timeline
Generic

Jilian Flippo

Winter Haven,FL

Summary

Motivated Senior Claims Adjuster committed to diligently investigating, evaluating and negotiating Bodily Injury claims for policyholders. Adept at training and supporting new adjusters. Trained and knowledgeable in all state, federal and local laws. Skilled in recognizing potential fraudulent claims.

Organized and detail-oriented Investigator dedicated to improving efficiency, productivity and profitability through continuous process improvement. Analytical thinker skilled at developing innovative solutions to complex problems.

Results-oriented Claims Adjuster bringing hands-on law enforcement experience and exceptional leadership and communication skills. Background includes criminal investigation, insurance fraud and surveillance.

Overview

15
15
years of professional experience

Work History

Commercial Senior Claims Adjuster

Progressive
06.2023 - Current
  • Interviewed claimants and witnesses to gather factual information.
  • Examined photographs and statements.
  • Consulted police and hospital records when needed.
  • Examined claims forms and other records to determine insurance coverage.
  • Negotiated with policyholders and claimants to reach mutually satisfactory resolutions.
  • Followed up on potentially fraudulent claims initiated by claims representatives.
  • Directed claims negotiations within allowable limit within authority and supported successful litigations for advanced issues.
  • Identified insurance coverage limitations with thorough examinations of claims documentation and related records.

Senior Claims Adjuster

GEICO
03.2010 - 06.2023
  • Interviewed claimants and witnesses to gather factual information.
  • Investigated and processed Bodily Injury and litigation insurance claims for policyholders.
  • Consulted police and hospital records when needed.
  • Examined photographs and statements.
  • Examined claims forms and other records to determine insurance coverage.
  • Verified insurance claims and determined fair amount for settlement.
  • Evaluated insurance policies and analyzed damages to determine coverage.
  • Answered customer questions regarding deductibles.
  • Reviewed police reports, medical treatment records and physical property damage to determine extent of liability.
  • Documented all investigation activity and presented reports to management.
  • Answered questions posed by insured and attorneys.
  • Negotiated Bodily Injury and litigation settlement agreements to resolve disputes.
  • Investigated and assessed damage to property and reviewed property damage estimates.
  • Evaluated evidence with ultimate goal of creating positive outcomes for client's claims.
  • Conducted comprehensive interviews of witnesses and claimants to gather facts and information.
  • Substantiated legitimate claims and denied unjustified claims.
  • Reviewed new files to determine current status of injury claim and to develop plan of action.
  • Reviewed and analyzed suspicious and potentially fraudulent insurance claims.
  • Investigated claims involving potential and suspected fraudulent activities.
  • Maintained contact with claimants and attorneys to determine treatment status.
  • Trained other claims staff members on proper handling and evaluation of injury claims.
  • Analyzed information gathered by investigations to report findings and recommendations.
  • Partnered with legal counsel on litigation cases.
  • Interviewed agents and claimants to correct errors or omissions and investigate questionable claims.
  • Collaborated with claims department and industry anti-fraud organizations to resolve claims.
  • Followed up with insured individuals regarding premium and deductibles payments.
  • Followed up on potentially fraudulent claims initiated by claims representatives.
  • Trained new staff members in detection of external and internal fraud.
  • Compared data from surveillance footage to data on medical reports.
  • Established productive working relationships with public officials and law enforcement officers.
  • Investigated legal issues pertaining to Bodily Injury claims.

Education

Associate Of Business Administration - Buddhist Studies

Polk State College Collegiate High School
Lakeland, FL

Skills

  • Medical Terminology
  • Microsoft Word
  • Database Management
  • Data Analysis
  • Report Writing
  • Claims File Management Processes
  • Claims File Documentation
  • Excellent Writing Skills
  • Insurance Policy Coverage Knowledge
  • Case Management
  • File Auditing
  • Injury Evaluation
  • Damage Mitigation
  • Advanced Oral and Written Communication Skills
  • Strong Communication and Interpersonal Skills
  • Preparing Claims
  • Legal Processes
  • Liability Determinations
  • Thoughtful Writer
  • Investigation Documentation
  • Litigation Resolution
  • Professional Development
  • Policy Investigations
  • Claims Procedures
  • Evidence Review
  • Interviewing Techniques
  • Accident Scene Investigations
  • Records Preparation
  • Settlement Determinations
  • Claims Pro
  • Advanced Computer Skills
  • Claims Evaluations
  • Courtroom Procedures
  • Field Inspection
  • Complex Cases
  • Customer Satisfaction
  • Analyzing Claims
  • Informational Interviews
  • Repair Negotiations
  • Verbal and Written Communication
  • Legal Proceedings Knowledge
  • Customer Support
  • Insurance Fraud Expertise
  • Determine Coverage
  • Authorize Payments
  • Reserves Adjustment
  • Interview Claimants
  • Customer Experience
  • Reserve Management
  • Claims files management processes

Accomplishments

  • Maintained a superior quality rating of 98% in file handling from 2010 to present, exceeding the 90% department goal.
  • Served as Lead Adjuster for 165 complex claims.

Timeline

Commercial Senior Claims Adjuster

Progressive
06.2023 - Current

Senior Claims Adjuster

GEICO
03.2010 - 06.2023

Associate Of Business Administration - Buddhist Studies

Polk State College Collegiate High School
Jilian Flippo