Experienced, reliable, and innovative individual contributor with a strong focus on providing excellent customer service and problem-solving skills. Diligent in receiving and disbursing cash, maintaining workplace tidiness and safety, and effectively managing time in a retail or specialty store environment. Possessing over 7 years of experience in All Lines Adjusting, 2+ years in AML Investigation & Compliance, Fraud, and SIU (Special Investigation Unit) Insurance Adjuster roles, with comprehensive knowledge of AML, BSA, KYC. Consistently adhering to policies and procedures while ensuring compliance with state regulatory requirements that impact the company and its operations. Successfully performing AML investigations and QC reviews for all transaction monitoring operations. Excellent writing and oral communication skills complemented by proficiency in utilizing various software such as MS Office, Excel, Actimize, Lumen, DMV, Guidewire, AS400, ECS, Simbility, Xactimate, and Lexis Nexis.
Assignments: Property/Commercial
•Investigate claims to determine liability, including reconstruction of complex events, obtaining evidence and statements of claimants and witnesses, obtaining photos, and gathering evidence.
•Develop and implement claim management response to significant or complex claim events including strategies to mitigate loss, identify and implement necessary interventions, litigation management and negotiation of settlements, as applicable. •Develop and maintain loss control programs and advise operating units on implementation.
•Coordinate and implement services of health professionals, insurance adjusters and other external resources that pertain to a loss to a third party.
•Evaluate the contributing causes of claimed losses, pursuit of subrogation opportunities and determination of appropriate claim payment.
•Respond to inquiries and requests regarding interpretation and explanation of general policies and procedures. •Determine causal relationships of multiple parties or events and determine the compensability or degree of liability for bodily injury, property damage and/or employee injuries. Coordinate investigation with outside parties including departments, legal counsel and external agencies. •Identify subrogation opportunities and pursue recovery of losses.
•Establish and manage adequate case reserves. Settle liability, property damage and workers compensation claims against the University within established guidelines and authority levels; assist in the negotiation of settlements for claims beyond such guidelines and authority levels.
•Produce reports analysing claim information, litigation review, and others as needed, Produce status reports and detailed reports/ correspondence with departments reflecting claim management and/or loss control strategies and recommended actions.
Detail-oriented and have strong customer service skills
Proficient in the use of the Internet and Microsoft Office and capable of learning industry specific software
Demonstrated strong written and oral communications skills
Demonstrated strong interpersonal, analytical, investigative, and negotiation skills Problem Solving
Enhanced organizational skills with the ability to work on multiple tasks simultaneously Enhanced ability to work with confidential data and maintain privacy
Enhanced ability to evaluate and interpret policies and procedures
Ability to work in a fast-paced, collaborative team environment