Justin Pyles
Imperial,MO
Summary
Professional with 17+ years of experience in both claims and project management. Known for delivering best in class results for high visibility programs. Seeking to transfer this experience to the Program Manager position at Harley Davidson.
Overview
19
19
years of professional experience
1
1
Certification
Work History
Program/Vendor Manager
AFICS (American Family Insurance Claims Services)
10.2020 - Current
- The Program Manager creates and manages strategies for vendor accountabilities and agency operations
- Drives operational execution and influences department strategy based on external industry and economic trends, and internal capabilities and business performance
- Recommends and leads innovative solutions to improve claim handling efficiency to improve LAE
- Partners with Vendor Procurement on RFP, RFI, SOW and MSA execution
- Partners with Claims Strategy, Financial Planning and Results, to identify opportunities and develop short- and long-term initiatives to improve operational performance
- Research industry leading products and practices enabled by new products, services, and technology that can be built into the line of business model
- Oversees straight through processing and digitally enabled outcomes to ensure alignment and support business goals
- Participates in testing the value stream of new strategies, products, or services and in the decision to pursue opportunities
- Partners with exclusive agency council and sales leadership to identify opportunities and recommends process and system enhancements to support agency needs
- Partners with exclusive, independent, and partner distribution strategies to ensure claim strategies align with distribution strategies
- Manage Vendor relationships including performance as well as other service level agreements
- Lead strategy and performance of the Enterprise Roadside and Towing operation achieving best in class results
- Lead strategy and performance of the Enterprise Rental management program achieving best in class performance in length of rental as well as near best in class in automation.
Policies and Procedures Administrator
American Family Insurance
04.2017 - 10.2020
- The Policies and Procedures Administrator provides technical and expert guidance to the Company’s operational divisions
- Initiates strategic development and testing of tools, techniques and processes to improve quality and productivity
- Manages departmental and enterprise projects and delivers training to enhance proficiency and facilitate a Lean working environment
- Reviews continuous improvement initiatives and aid in their implementation
- Create and maintain Standard Work, Best Practices, Job Aids and other process documents to aid in operational accuracy and efficiency
- Conduct audits to determine the effectiveness of programs and strategies
- Monitor compliance with all applicable laws, statutes and regulations
- Conduct estimatic audits to ensure compliance to our internal guidelines
- Developed and delivered training on processes and estimatic platforms
- Develop strategy, implement new technology and manage vendor performance for our roadside assistance program
- Developed policy training specific to cycles, camper and recreational vehicles.
Auto Physical Damage Adjuster
American Family Insurance
12.2008 - 04.2017
- Handle first and third party repairable and total loss vehicles that require on-site inspection and face-to-face interactions with customers and repair facilities
- Appraise damage, estimate repairs, negotiate settlements, and issue payments
- Work with a diverse customer base and effectively explain settlements
- Follow all corporate guidelines, policy provisions, insurance laws and regulations to ensure prompt and fair claim handling
- Partner with agents and underwriting to resolve coverage issues
- Research and handle complex issues with minimal to no manager assistance
- Train and mentor other adjusters on all aspects of file handling including policy interpretation
- Serve as Subject Matter Expert (SME).
Casualty Claims Adjuster
American Family Insurance
03.2006 - 12.2008
- Investigated auto claims involving coverage issues, liability, comparative negligence, and injuries
- Take recorded statements from insureds, claimants, and witnesses
- Assess negligence and liability
- Negotiate settlements
- Evaluate complex injury claims
- Understand and interpret policy as well as laws and regulations.
Child Abuse Investigator
State of Missouri Children’s Division
04.2005 - 03.2006
- Investigated allegations of child abuse and neglect and linked families with various community services
- Maintain detailed records of all investigations
- Prepare affidavits and testified in court hearings
- Lead meetings with families and members of other agencies to determine proper placement of children in need.
Education
Master of Arts - Criminology/Program Implementation
University of Missouri - St Louis
St Louis, MOBachelor of Arts - Psychology/Sociology
Maryville University of Saint Louis
St Louis, MOSkills
- Project Management
- Vendor Management
- Change Management
- Continuous Improvement
- Training
- Process Improvement
- Data Analytics
- Digital Solutions
- Contract Creation/Negotiation
- Customer Service
- Auto/Property/Casualty Insurance Products
Leadership Experience
- Program Strategy Lead at AFICS for:
- Emergency Roadside/ Towing
- Digital Solutions
- Agency Engagement
- Licensing
- Rental
- Estimatics
- Insurance Product Training
- Measurement and Inspection Services
Certification
Associate in Claims
Timeline
Program/Vendor Manager
AFICS (American Family Insurance Claims Services)
10.2020 - Current
Policies and Procedures Administrator
American Family Insurance
04.2017 - 10.2020
Auto Physical Damage Adjuster
American Family Insurance
12.2008 - 04.2017
Casualty Claims Adjuster
American Family Insurance
03.2006 - 12.2008
Child Abuse Investigator
State of Missouri Children’s Division
04.2005 - 03.2006
Master of Arts - Criminology/Program Implementation
University of Missouri - St Louis
Bachelor of Arts - Psychology/Sociology
Maryville University of Saint Louis
Associate in Claims
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