Julie Lawson
Orange Park,United States
Summary
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.
Overview
16
16
years of professional experience
Work History
Claims Adjuster
Sedgwick
09.2023 - Current
- Improved claim resolution times by efficiently managing a caseload of 50+ claims per month.
- Achieved high customer satisfaction ratings by providing clear and timely communication throughout the claims process.
- Negotiated favorable settlements with claimants, attorneys, and other insurance carriers to minimize financial risk for the company.
- Conducted thorough investigations of complex insurance claims, gathering evidence and analyzing relevant documentation.
- Maintained compliance with state regulatory requirements through meticulous documentation and adherence to company policies.
- Provided exceptional customer service during emotionally difficult situations for policyholders following accidents or natural disasters.
- Evaluated coverage accurately by interpreting complex insurance policies and applying them to specific claim scenarios.
- Facilitated smooth transitions for policyholders during the claim process by liaising between various departments, ensuring all parties were informed and engaged.
- Contributed to a positive work environment through active participation in team meetings and collaborating on cross-functional projects.
- Conducted comprehensive interviews of witnesses and claimants to gather facts and information.
- Verified insurance claims and determined fair amount for settlement.
- Substantiated legitimate claims and denied unjustified claims.
- Delivered exceptional customer service to policyholders by communicating important information and patiently listening to issues.
- Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
- Conducted day-to-day administrative tasks to maintain information files and process paperwork.
- Researched claims and incident information to deliver solutions and resolve problems.
- Investigated and assessed damage to property and reviewed property damage estimates.
- Analyzed information gathered by investigation and reported findings and recommendations.
- Resolved complex, severe exposure claims using high service oriented file handling.
- Managed catastrophic loss events effectively by coordinating rapid response efforts and providing support to impacted policyholders.
Claims Supervisor
Proficient Auto Transport
12.2020 - 09.2023
- Review claims from car manufacturers
- Retrieve repair invoice and pictures from dealership
- Once retrieve repair invoice, determine if the damage to the vehicle was transportation damage, damage from the rail or damage caused at the dealership
- We would also work with outside carriers to retrieve pay back for the claim
- At times would have to contact insurance companies for out side carriers for total losses.
- Resolved complex claims issues with thorough investigation, resulting in fair settlements for all parties involved.
- Achieved high customer satisfaction ratings by maintaining open lines of communication and addressing concerns promptly.
- Increased accuracy in claim evaluations through comprehensive documentation and attention to detail.
- Collaborated with various departments to develop and implement strategies for improving overall claims handling process.
- Optimized case management with establishment of best practices.
- Handled claims consistent with client and corporate policies, procedures, best practices and regulations.
- Reduced claim processing time by implementing efficient workflow improvements and streamlining processes.
Cargo Claims Adjuster
Suntecktts
01.2018 - 09.2020
- Receive new claims paperwork
- Review paperwork to verify if the claim is valid
- Work with the carrier to resolve the claim
- Depending on the severity of the claim, file the claim with the carrier insurance
- Also worked with Suntecktts insurance to get salvage on products and resolve a claim when a carrier would not.
- Once payment is received from the carrier, work with accounting to process payment to out customer.
- On many occasions, there are accidents and would need to work with the police, tow companies and insurance to get the product moved to a safe location for midigation.
- Negotiated favorable settlements with claimants, attorneys, and other insurance carriers to minimize financial risk for the company.
- Conducted thorough investigations of complex insurance claims, gathering evidence and analyzing relevant documentation.
- Managed catastrophic loss events effectively by coordinating rapid response efforts and providing support to impacted policyholders.
- Resolved complex, severe exposure claims using high service oriented file handling.
- Achieved high customer satisfaction ratings by providing clear and timely communication throughout the claims process.
- Improved claim resolution times by efficiently managing a caseload of 50+ claims per month.
Cargo Claims Adjuster
Yusan
08.2017 - 01.2018
- Receive new claims paperwork
- Set up the claim in the company system
- Working with each carrier on every claim to resolve claims
- Achieved high customer satisfaction ratings by providing clear and timely communication throughout the claims process.
- Conducted thorough investigations of complex insurance claims, gathering evidence and analyzing relevant documentation.
Senior Claim Adjuster
Suddath Van Lines
01.2014 - 07.2017
- Train new Adjusters that come into the department.
- Create new department Handbooks.
- Help create a new system for the department.
- Verified validity, analyzed payment and agent liability on claims submitted
- Participated in peer coaching
- Implemented all MAGIC training into phone calls with customers, clients, agents, and interoffice personnel
- Member of a process review initiative that renovated and automated processes in the claims department.
- Liaison between claims and the IT departments to ensure the new processes were implemented accurately
- Conceptualized and developed procedures for a paperless work flow
- Utilized lean thinking to revitalize procedures in the claims department including paperless procedures
- Participated in developmental training to learn about and utilize customer service oriented skills
- Help create a new claims system that allow a smoother work flow and upper management pull more reports.
- Reduced claim processing time by implementing streamlined procedures and efficient documentation practices.
- Enhanced customer satisfaction by promptly addressing and resolving complex claim issues through thorough investigation and analysis.
- Expedited claims settlements with successful negotiation strategies and effective communication skills.
- Improved team productivity, providing comprehensive training to junior adjusters on industry best practices and company guidelines.
- Achieved high accuracy rates in claims evaluation by consistently applying knowledge of policy coverage, liability assessment, and damage valuation.
- Optimized workload management, prioritizing time-sensitive cases to ensure timely resolutions for clients.
- Collaborated with cross-functional teams to expedite claim handling processes, enhancing overall efficiency and client satisfaction scores.
- Developed strong relationships with external partners such as repair shops, medical providers, and legal professionals to facilitate seamless claim resolutions.
- Contributed to the continuous improvement of departmental policies and procedures through the identification of inefficiencies and proactive problem-solving techniques.
- Provided exceptional customer service during stressful situations, demonstrating empathy, patience, and professionalism throughout the entire claims process.
- Implemented cost-saving measures by effectively negotiating settlement amounts within authorized limits while ensuring fair compensation for policyholders'' losses.
- Maintained detailed records of all case-related activities, ensuring accurate documentation for auditing purposes and future reference.
- Participated in ongoing professional development opportunities such as industry conferences, workshops and webinars to stay current with industry trends and advancements.
- Mentored junior adjusters on effective time management and organizational skills, leading to improved work quality and job satisfaction.
- Served as a subject matter expert within the company for complex claims issues, providing guidance and support to colleagues when needed.
- Examined photographs and statements.
- Investigated properties to determine extent of damage and estimate repair costs.
- Documented all investigation activity and presented reports to management.
- Substantiated legitimate claims and denied unjustified claims.
- Delivered exceptional customer service to policyholders by communicating important information and patiently listening to issues.
- Conducted day-to-day administrative tasks to maintain information files and process paperwork.
- Researched claims and incident information to deliver solutions and resolve problems.
- Resolved complex, severe exposure claims using high service oriented file handling.
- Reviewed new files to determine current status of injury claim and to develop plan of action.
- Evaluated original investigation reports and documents to resolve secondary concerns.
- Directed claims negotiations within allowable limit of $10,000 and supported successful litigations for advanced issues.
Claim Adjuster
Suddath Van Lines
01.2011 - 01.2014
- Verified validity, analyzed payment and agent liability on claims submitted
- Participated in peer coaching
- Implemented all MAGIC training into phone calls with customers, clients, agents, and interoffice personnel
- Member of a process review initiative that renovated and automated processes in the claims department.
- Liaison between claims and the IT departments to ensure the new processes were implemented accurately
- Conceptualized and developed procedures for a paperless work flow
- Utilized lean thinking to revitalize procedures in the claims department including paperless procedures
- Participated in developmental training to learn about and utilize customer service oriented skills
- Improved claim resolution times by efficiently managing a caseload of 50+ claims per month.
- Achieved high customer satisfaction ratings by providing clear and timely communication throughout the claims process.
- Streamlined internal processes by implementing new claims management software, increasing overall productivity.
- Developed strong relationships with repair vendors, ensuring quality service and fair pricing for clients in need of repairs after an incident.
- Mentored junior adjusters on best practices and industry regulations, contributing to their professional growth and development.
- Managed catastrophic loss events effectively by coordinating rapid response efforts and providing support to impacted policyholders.
- Achieved cost savings through successful subrogation efforts, recovering funds from responsible parties in various claims scenarios.
- Provided exceptional customer service during emotionally difficult situations for policyholders following accidents or natural disasters.
- Attended industry conferences and workshops to stay current on trends and developments within the field of claims adjusting.
Claims Administrator
Suddath Van Lines
07.2010 - 01.2011
- Received and processed new claims, acknowledging claims with agents and military personnel
- Coordinated inspections on specific claims, filing, and provided customer service
- Processed checks, invoicing and crediting agents, and assisting management
Fraud Specialist II
Citi Bank
08.2007 - 07.2010
- Reviewed client accounts and transactions to locate potential fraud trends
- Answered inbound calls from clients to review potential fraud cases
- Placed outbound calls to verify if card activity was valid or fraudulent
- Closed accounts for fraud victims
- Prepared and sent all relevant paperwork to resolve fraud issues
- Maintained exception customer service
- Provided accurate information to clients regarding the fraud closure process and steps to prevent future cases
- Reduced instances of fraud by implementing comprehensive detection and prevention strategies.
- Collaborated with cross-functional teams to develop and implement effective anti-fraud policies.
- Conducted thorough investigations into suspected fraudulent activities, resulting in timely resolution of cases.
- Improved customer trust by promptly addressing and resolving reported instances of fraud.
- Maintained detailed records of all detected fraud incidents for future reference and analysis.
- Identified trends in fraudulent activities through data analysis, which informed updates to anti-fraud strategies.
Education
High School Diploma -
Nease High School
Ponte Vedra06.1998
Skills
- Magic
- Imaging Systems
- AS400
- Time Management
- Liability
- Work Flow
- Customer Inquiries
- Customer Service
- Outbound Calls
- Filing
- Invoicing
- Closed Accounts
- Excellent Communication Skills
- Self Motivated
- Documentation
- Inspections
- Retail Sales
- Acrobat
- Excel
- Microsoft Office
- Microsoft Powerpoint
- Powerpoint
- Windows XP
- Claims Processing
- Policy Investigations
- Highly Motivated
- Record Preparation
- Advanced Computer Skills
- Advanced Oral and Written Communication Skills
- Analytical Thinking
- Training and Development
- Empathy and Compassion
- Decision Making
- Conflict Resolution
- Caseload Management
- Teamwork Abilities
- Fraud Detection
- Active Listening
- Professionalism
- Claims Investigation
- Claims Evaluation
- Property Damage Assessment
- Relationship Building
- Decision-Making
- Team Collaboration
- Settlement Negotiations
- File and Record Management
- Coaching and Mentoring
- Customer Service and Support
- Coverage Determination
- Damage Assessment
Professional Summary
- Congenial and enthusiastic contributor and supporter of team goals
- Strong attention to detail, great time management skills, works well under pressure
- Excellent communication skills
- Proven ability to prioritize and handle multiple tasks in a challenging environment
- Prioritizes tasks and workload to focus on issues that directly impact quality and service
- Perform other duties as requested or assigned
- Utilize specialized industry and company computer systems and procedures, reference materials documentation and personal industry knowledge to process client shipments
- Further increase customer satisfaction and business share through proactive and regular contact
- Adheres to company standards on customer service quality, accuracy and timeliness
- Answer all customer inquiries in accordance with the Customer Service Policy standards
Work Authorization
United States
Timeline
Claims Adjuster
Sedgwick
09.2023 - Current
Claims Supervisor
Proficient Auto Transport
12.2020 - 09.2023
Cargo Claims Adjuster
Suntecktts
01.2018 - 09.2020
Cargo Claims Adjuster
Yusan
08.2017 - 01.2018
Senior Claim Adjuster
Suddath Van Lines
01.2014 - 07.2017
Claim Adjuster
Suddath Van Lines
01.2011 - 01.2014
Claims Administrator
Suddath Van Lines
07.2010 - 01.2011
Fraud Specialist II
Citi Bank
08.2007 - 07.2010
High School Diploma -
Nease High School