An experienced representative with over 19 years within the financial services and industrial arena. Has held roles as a Relationship Manager, Executive Case Manager as well as a Claims Specialist. He has also functioned as a Consumer Associate, Commercial Associate, Private Client/Wealth Management Associate, and Internal Wholesaler. Looking to secure a position as a Customer Service Specialist. Strong skillset and experience in settlement, negotiating, pricing, project management, relationship building, documentation, effective and clear communications, organization, research, follow-up, and closing.
Management in gathering requirements, analyzing structure, and processing procedures. Dedicated to promoting a diverse and inclusive environment that fosters the inherent ability to learn within. Abilities in setting and implementing goals, public relations management, and developing and facilitating team-building activities. Proven ability to influence and negotiate.
Overview
25
25
years of professional experience
Work History
COMPLEX CLAIMS ADJUSTER
AMERICAN FAMILY INSURANCE
10.2022 - 08.2023
Answered customer questions regarding deductibles, policies, endorsements, and coverage, and communicated plan of action on each claim
Prepared summaries of damage, payments, and policy coverage
Examined claims forms and other records to determine insurance coverage
Verified insurance claims and determined a fair amount for settlement
Evaluated insurance policies and analyzed damages to determine coverage
Conducted comprehensive interviews of named insured and occasionally claimants to gather facts and information pertaining to said loss/claim
Negotiated Complex Claims and partnered with Large Loss representatives in settlement agreements to resolve disputes as a desk representative
Investigated and assessed damage estimates
Reported to management on customer problems, field conditions, safety issues, and policy problems
Maintained claims data in Guidewire/As400 and XactAnalysis systems
Analyzed information gathered by investigations to report findings and recommendations
Drafted investigative reports covering phases of investigation in each claim
Assisted with re-inspections of disputed claims, inspecting high-value losses, drafting large loss reports, drafting, estimates, and securing information/documents
Handled carrier high-value large loss claims, total losses, and complex fire losses
Worked with vendors, experts, contractors, and attorneys during all phases of a claim
Drafted coverage letters, response letters, and various letters in terms of communication
Handled daily complex to include hurricane, tornado, fire, and wind/hail losses
Worked closely with members of management on sensitive claims, and large losses, and assisted with creating plans of action
Occasionally handled mediations during overflow/peek seasons
Worked closely with vendors/preferred contractors/experts on high-end losses for large fire claims, water, and water losses, creating plans of action to best move claims to resolution.
PROPERTY FIELD ADJUSTER
CRAWFORD & CO
03.2019 - 09.2022
Perform Residential and Commercial field inspections and examinations of insurance claims from losses of $5K up to $100K, which resulted in fires, wind, hail, theft, vandalism, water, and catastrophes while simultaneously achieving monthly and yearly performance goals
Perform file constructing, including notes, photos, videos, and various provided insured documents of loss site information
Set up all appointments to inspect and examine loss damages which concludes with creating settlement estimates utilizing various systems which mainly includes the use of Xactimate
Communicate with the provider, insurer, and contractor to produce concise estimates and reports
Evaluate facts, provide solutions to complex problems, take in and understand data, and negotiate materials and expenses related to loss damages
Utilize the following systems: CMS2, CMS3, Xactanalysis, PLRB, Xactimate, Hover, and Contractor Connections.
SENIOR CLAIMS ADJUSTER
METLIFE
08.2019 - 02.2021
Settle, negotiate, and evaluate small to complex claims with a cap of $90k with loss from wind, hail, theft, vandalism, fire, and water which affected main residential dwellings, other properties, personal properties, and additional living expenses
Negotiated with large to small general contractors which included all represented trades
Daily managed at least 13 and more newly assigned claims along with daily loop times, and buddy services which involved managing claims for fellow adjusters, taking first notice of lost calls, managed daily set diaries, and multiple conferences and Zoom meetings
Receive many customer service comments at least several monthly
Carry a knowledgeable basis of xactanalysis, Xactimate, guidewire, outlook, PLRB, claims experience, settle assist, itel, and outlook
Maintained working relationships with various vendors daily, including Serv Pro, Service Master, Paul Davis, Enservio, CRDN, Contractor Connections, ALE Solutions, Strikecheck, HVACI, EFI Global, American Leak Detection, and many others
Able to work remotely and independently.
PROPERTY CLAIMS ADJUSTER
KEMPER INSURANCE
12.2016 - 06.2019
Evaluate, negotiate, organize, investigate, measure, and resolve daily property insurance claims resulting in fires, wind, hail, theft, vandalism, water, and catastrophes while achieving monthly and yearly performance goals
Accurately interpreted homeowner policies to claimants and make coverage decisions based on policy provisions
Performed initial subrogation investigations by gathering the necessary information
Performed SIU referrals to qualified claims and partnered with SIU agents during all qualified claims to provide investigative results
Provided underwriting referrals on all qualified claims
Wrote settlement estimates utilizing xactimate and xactanalysis software and programs
Provided investigative information for all qualified liability claims involving third-party claimants
Assisted with training new hires
Attended continuing education training and additional job skills training classes
On a daily bases negotiated with contractors ranging from roofers to painters
On a daily bases partnered with various contracted vendors through the Contractor Connections program
On a daily basis partnered with various Additional Living Vendors which included ALE Solutions CRS Temporary Housing and many other temporary housing vendors.
INSURANCE CLAIMS ADJUSTER
ALLSTATE INSURANCE
08.2013 - 10.2016
Daily investigation, evaluation, and negotiation of all property claims reaching fair, timely, and equitable settlements
Achieve daily, and monthly target performance goals, manage cost, and support industry-leading operational standards
Daily assimilation of data, evaluating facts, and solving solutions to very complex problems
Exposed daily to specialized industries including but not limited to medical, legal, and construction along with advanced computer and IT systems such as Xactimate, Xactanalysis, Next Gen, and various other industry systems.
CLAIMS SPECIALIST/COORDINATOR - EXECUTIVE CASE MANAGER
LOWES
07.2010 - 06.2013
Conducted audit and processed dispatch and non-dispatch claims
Review and process OPE (Outdoor Power Equipment - John Deer) claims within a 24-hour period
Successfully and carefully processed and completed daily Altaquip OFR (Out For Repair) Preauthorization; with a daily range of 300 daily preauthorization
Conduct minor audits on specific John Deer claims and Altaquip Preauthorization
Created spreadsheets that identify various products, service providers, and comments on product diagnosis
Update processes and procedures on how to effectively audit and process dispatch and non-dispatch claims
Provided valuable services in relation to escalated executive customer cases regarding repair services; which involved Better Business Bureau, Attorney General customer complaints and issues
Initialize service calls for timely and sensitive product repairs
Managed and monitored the relationship between customer and service provider; store and customer; and service provider and store
Initiated, managed, and monitored product pricing negotiations between customers, stores, and manufacturers
Monitored and managed executive-made decisions involving Regional Vice Presidents, Store Managers, District Managers, and manufacturer representatives.
BUS DRIVER
CHARLOTTE MECK SCHOOLS
08.2008 - 05.2013
Transporting and managing students in a Bus environment safely to and from Elementary, Middle, and High School
Arranged organized seating assignments which assisted in safely transporting the students to assigned schools
Arranged a naming system to familiarize student’s names which added to the success of transporting students
Made daily progress and attendance reports to all the schools assigned administrators for the accounting of each and every student
Created a lost and found section on the bus for any materials and/or apparel the students left behind to identify upon boarding the bus
Performed daily bus inspections prior to bus routes and post bus routes and reported any operating failures that the bus may have
Performed daily interior cleaning duties of the bus to managerial standards providing a clean and safe riding environment for the students
Provided monthly progress, attendance, and action reports to the transportation manager.
Assumed the position of Vendor Relationship Manager
Managed and supported vendor relationships by way of monitoring monthly, quarterly, and annual service level reports and key performance indicators related to all vendor and bank system applications, and external and internal customer surveys
Manage vendor products and programs utilized by the bank
Create and implement bank/vendor processes for streamlining and improvement purposes
Manage and facilitate ordering system applications, and projects including but not limited to VRU(voice response unit), WBO(Wachovia bank online application), Super-link, and Pegasis(Wachovia/vendor ordering base Applications)
Managed and facilitated companywide product awareness programs which included buy-ins and participation from senior-level management, training/demonstration calls, and point-of-sale mailings
Tour Vendor production facilities and call centers for quality control and review of Vendor operations along with productivity measures
Provided multi-level Business partner support as it relates to resolving daily bank/vendor related Issues for products, programs and systems.
Education
Skills
Insurance policy coverage knowledge
Claims Investigation
Highly motivated
Advanced oral and written communication skills
Caseload Management
Policy Interpretation
Computer Skills
Negotiation and mediation
Claims adjustment
Team Leadership
Settlement Negotiation
Claims Evaluation
Relationship Building
Certifications And License
Property and Casualty Insurance License
Effective Consumer Communication
Diversity Training
Microsoft Office
Service bench
Officiating Experience
6 Years Womens Div II (SAC)
7 Years Womens Div III/Juco (MidSouth USA)
2 Years NCAA Mens Div II(SIAC)
2007-2008 NCAA Womens DIII Tournament
2 Years Premier Basketball League(Minor Professional)
12 years of NCHSAA(High School) Charlotte, NC
Piedmont Association, 2007-2008
Sectional/Regionals & State Championships(2007-2008, 2010 – 2011 & 2012-2013)
9 years of NWBA officiating(officiated DII & DIII Regionals and Nationals, Carolina Conference Tourny 2008-2009 National Championships
4 years of officiating Charlotte Pro Am Summer League
6 years of Officiating ABA Free Agent Camps and scrimmages.
10 years of AAU (USSSA, USBA, YBOA, NIT, HYSA, Hoopstars Invitational and UCBA) as well as Various Adult Men Leagues, Recreational Church Leagues.
Major Accomplishments
Through successful relationships, transitioned banks’ marketing and business promotional plans for the Western part of North Carolina through various communication and programs.
While maintaining the position of Relationship Manager I, served as the liaison between vendors and business partners within Wachovia while leading and facilitating numerous weekly meetings.
Developed and implemented a system for processing dispatch and non-dispatch claims for Lowe’s Corporation.
Masterfully managed multi-level business partners in resolving daily bank and vendor-related issues for products, programs, and systems.
Licensed in Property and Casualty Insurance
Worked daily on the following operating systems: Guide Wire-Claim Center, XactAnalysis, XactImate, Claims Experience, ISO system, and PBLR.
Timeline
COMPLEX CLAIMS ADJUSTER
AMERICAN FAMILY INSURANCE
10.2022 - 08.2023
SENIOR CLAIMS ADJUSTER
METLIFE
08.2019 - 02.2021
PROPERTY FIELD ADJUSTER
CRAWFORD & CO
03.2019 - 09.2022
PROPERTY CLAIMS ADJUSTER
KEMPER INSURANCE
12.2016 - 06.2019
INSURANCE CLAIMS ADJUSTER
ALLSTATE INSURANCE
08.2013 - 10.2016
CLAIMS SPECIALIST/COORDINATOR - EXECUTIVE CASE MANAGER