Detail-oriented Senior Complex Claims Specialist with strong investigation, negotiation, and documentation skills. Proven ability to evaluate complex claims and collaborate effectively with stakeholders to achieve fair resolutions.
Overview
5
5
years of professional experience
4
4
Certifications
Work History
Senior Complex Claims Specialist
State Farm
Winter Haven, Florida
03.2023 - Current
Investigated, analyzed and evaluated complex insurance claims to determine coverage and liability.
Negotiated settlements with attorneys representing claimants in order to reach a fair resolution of the claim.
Maintained detailed documentation of all activities related to assigned cases including correspondence, research notes, investigative reports and settlement agreements.
Utilized various computer software applications in a face-paced environment to assist with research and document management tasks.
Managed commercial claims processing for various insurance policies.
Independent Adjuster
Pilot Catastrophe Services
Winter Haven, FL
07.2022 - 03.2023
Evaluated property damage claims for residential and commercial properties, ensuring accurate assessments to facilitate timely resolutions.
Collaborated with clients to gather necessary documentation and evidence.
Maintained accurate records of adjuster activities, supporting thorough reviews by supervisors and auditors.
Calculated estimates of repair costs based on inspections and photographs, providing clients with reliable financial assessments.
Determined the value of personal property such as vehicles or jewelry that has been destroyed or stolen.
Manager
Pizza Hut
Winter Haven, FL
12.2020 - 07.2022
Managed daily operations to ensure efficient restaurant functionality.
Trained and supervised team members to uphold customer service standards.
Implemented inventory control measures to reduce waste and costs.
Oversaw food safety compliance and maintained health regulations.
Resolved customer complaints promptly to maintain high satisfaction levels.
Education
Bachelor of Science - Business Management
Grand Canyon University
Phoenix, AZ
08-2026
Skills
Claims analysis
Document management
Negotiation skills
Problem solving
Attention to detail
Customer service
Certification
Florida All Lines Adjuster License (Home State), also licensed in GA,TX,LA,MI,NC,KY, and others.
Interplan Complex Claims Specialist at Blue Cross Blue Shield of MassachusettsInterplan Complex Claims Specialist at Blue Cross Blue Shield of Massachusetts