JOSEPH PAIGE
Framers Branch,TX
Summary
Detail oriented with strong organizational, verbal, and written communication skills. Excels in a fast paced, high volume work environment. Exceeds expectations at complying with guidelines, policies, and procedures. Skilled in LexisNexis, Actimize, and all Microsoft Office applications. Experience in BSA, AML, Patriot Act, OFAC, FinCEN, SARS filing, EDD and KYC. A dedicated risk and compliance professional with several years’ experience in Fraud investigating, banking compliance, transaction monitoring and risk assessment. Also have achieved high levels of experience in all lines insurance adjusting and customer account management.
Overview
10
10
years of professional experience
Work History
Senior Claims Specialist
Kemper Insurance
01.2019 - Current
- Responsible for creating manual subrogation demands through data analysis and KYC procedures
- Managed daily communications with all lines of management within company alignment and oversaw customer relationships through common business to business(B2B) practices
- Met all associated service level agreements for each workflow alerted as well as work closely with the risk monitoring team, internal partners (compliance, legal, and internal audit) as well all external partners (bank, law enforcement, etc.)
- Exceeded company goal by processing more than 60 calls on any given day
- Mediated and Negotiated with B2B agreed upon dollar amounts for damages, cause, and terms for auto collision
- Rental, storage, commercial, and property total losses adjusters for settlements
- Responsible for issuing deductible checks to insureds
- Conducted a prompt, thorough and fair investigation by obtaining relevant data to determine coverage, origin, and extent of property losses
- Affirms or denies coverage of the claim based on the facts and the policy terms and conditions
- Run PricePoint to obtain the Actual Cash Value(ACV) to aggregate settlement offers
- Keeps the electronic claim file properly documented with accurate, clear and timely information and reports that reflect the adjustment activities and substantiate any payments made
- Assisted in the peer development on all new software’ and applicable process flows
- Met and exceeded company and team goals for processing 50 claims or more daily.
- Communicated with other departments to establish action plans and manage open claims to closure.
Team Lead Collection Specialist
Regus
Addison, TX
04.2018 - 10.2019
- Manage and oversaw the onboarding & trsining, daily performance reviews, and KPI development of a 8-10 person team
- Responsible for communicating team objectives through compiling team data reports daily, weekly, and monthly to both higher management and individual team members
- Negotiate escalated and complex settlement balances
- Manage corporate accounts
- Process all credit card payments
- Handled and researched all escalated calls and account deficiencies
- Investigate, locate, and allocate payments
- Assisted clients on navigating through online portals and best practices
- Created Excel spreadsheets and reporting for each team member to communicate individual account closure completion ratios on a monthly basis
- Reviewed QA/QC results for individual team members to determine if results were valid or if able to present credible rebuttal to reverse decision
- Assisted with monthly/daily duties as needed
- Organized and led team update meetings weekly
- Participated in department development meetings and all company departmental development meetings witnessed and participated in any and all team disciplinary action reviews and meeting
- Processed payments over phone and set up recurring drafts.
- Met demands of busy collections group by performing high volume of daily calls.
- Completed month-end and year-end closings, kept records audit-ready and monitored timely recording of accounting transactions.
Claims Adjuster
Accelerated Service Insurance
Richardson, TX
11.2016 - 03.2018
- Verified MSRP auto parts through PartsAuthority and compared to OEM parts for more desirable company price point
- Researched and reviewed damage evidence including photographic LexisNexus data entry, Identifix auto details, and through collaboration with third-party onsite damage adjusters
- Made appropriate recommendations to management based on audit findings
- Identify fraud schemes or patterns through proactive file reviews, auto fraud referrals, and data analysis
- Maintain effective and timely communication with interested parties on pending investigations
- Prepare investigative reports to present to senior management
- Developed initiatives of mitigation for the correspondent alerts and articulate recommendations based on risk analysis preliminary research, investigation, and decisions to formulate a conclusion.
- Identified and obtained evidence to ascertain claim value.
- Explained premiums owed to policyholders, agents and underwriters.
Subrogation Claims Specialist
Allstate
Irving, TX
04.2015 - 11.2016
- Draft and file SARs with the fraud department as necessary and assist the Enterprise Fraud examination, in relation to account takeover with investigating, developing and implementing new Fraud authentication policies and procedures to insure lines of business operations
- Monitors a portfolio of complex institutions and holding companies and provides ongoing summary reports on the organization’s current condition and any emerging BSA/AML risks
- Reported any factual or partial findings to management in a precise, timely manner
- Delivered expertise in recommended action for each client based on the bank’s risk tolerance, regulatory guidelines, and the customer’s activity
- Review Fraud cases processed by other teams as well as review and approve Suspicious Activity Reports (SARs) prepared by company team members for accuracy and quality.
AML/KYC Investigator
Bank of America
Dallas, TX
02.2013 - 03.2015
- Handled large volume of cases
- Assisted with new hires
- Loan modifications, review loan documents
- Receive and respond to calls and emails
- Conduct reviews
- Compile and submit reports
- Audits
- Compliance with rules and regulation
- Review legal documents
- SAR reporting, high risk account
- BSA Secrecy Act, EDD
- Analyzed results of complex investigations and delivered concise written conclusions to management.
- Investigated fraud referrals and researched to minimize risk and resolve inquiries.
- Prepared reports, metrics and research to support fraud initiatives and projects.
- Reviewed compliance publications and websites and participated in conferences and other training events to stay apprised of regulatory matters and developments.
- Provided regulatory compliance training to employees.
Education
American Adjuster Academy
01.2023
Associate Degree -
Cedar Valley College
01.2010
Skills
- LEXIS
- MSP
- Nexus
- Actimize
- EMP
- PIE
- Parson Tool
- Excel
- Word
- AS400
- SHAREPOINT
- EXCEL
- MICROSOFT OFFICE
- ADDITIONAL INFORMATION
- Licenses: All Lines Adjuster
- Documentation Review
- Accident Investigations
- Team Collaboration
- Critical Thinking
- Claim Form Analysis
- Claims Processing
Timeline
Senior Claims Specialist
Kemper Insurance
01.2019 - Current
Team Lead Collection Specialist
Regus
04.2018 - 10.2019
Claims Adjuster
Accelerated Service Insurance
11.2016 - 03.2018
Subrogation Claims Specialist
Allstate
04.2015 - 11.2016
AML/KYC Investigator
Bank of America
02.2013 - 03.2015
American Adjuster Academy
Associate Degree -
Cedar Valley College
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