Kimberly Plavchak

• Collaborated with other departments to improve overall organizational effectiveness in addressing client needs.
• Enhanced customer satisfaction with timely and accurate claims resolutions.
• Streamlined communication between adjusters and clients, expediting claim resolution times.
• Implemented quality assurance measures, monitoring staff performance and providing constructive feedback for continuous improvement efforts.
• Managed a team of adjusters (2 Lit Specialists and 4 Senior Adjusters), providing coaching and performance feedback for improved productivity.
• Handled claims consistent with client and corporate policies, procedures, best practices and regulations.
• Documented and communicated timely claims information while supporting accurate outcomes.
• Developed training materials to ensure consistent handling of claims across the department.
• Conducted thorough investigations of pharmacy malpractice complex claims, gathering evidence to support decision-making processes.
• Negotiated settlements with claimants, achieving fair outcomes while controlling costs.

• Attend depositions, mediations, and court

conferences, as required.

• Mentored new hires on company policies/procedures enabling them to quickly become proficient in managing claims.
• Established strong relationships with external partners such as medical providers, legal professionals, and repair services for efficient case management.
• Oversaw regular audits of claim files ensuring accuracy in reserve amounts and adherence to established guidelines.

• Review and investigate general liability and druggist liability lawsuits to minimize the corporations' claim exposures.
• Ensured compliance with court deadlines by maintaining an organized calendar system for all active cases.
• Enhanced client satisfaction by addressing concerns promptly and providing regular updates on case progress.
• Monitored industry trends and changes in legislation pertinent to clients'' interests.
• Developed strong working relationships with opposing counsel for effective communication and negotiation throughout the litigation process.
• Assisted attorneys in trial preparation, drafting pleadings, motions, and discovery documents.
• Negotiated settlements in mediation and arbitration settings, resulting in reduced litigation costs for clients.
• Attend depositions, mediations, and court conferences, as required.
• Achieved favorable outcomes in complex cases through meticulous research and analysis.
• Identified potential risks or weaknesses in cases early on allowing proactive strategizing towards optimal resolution.
• Conducted thorough investigations of general liability and pharmacy malpractice claims, gathering critical evidence to support case resolution.
• Open, close, and adjust reserves in accordance with industry practices to ensure actuarial adequacy.
• Kept up-to-date on case progress by frequently reviewing records and reporting findings.
• Reduced case backlog by efficiently prioritizing and managing high-volume caseloads.
• Collaborated with legal teams to develop winning strategies for clients in various industries.
• • Interact with excess insurance carriers on complex litigation matters.

• Third Party Administrator for Rite Aid Corporation.

• Interviewed claimants and witnesses to gather factual information.
• Review and investigate general liability and druggist liability lawsuits to minimize the corporation claim exposure.
• Examined photographs and statements.
• Reduced claim processing time by implementing streamlined procedures and efficient documentation practices.

• Open, close, and adjust reserves in accordance

with industry practices to ensure actuarial

adequacy.

• Negotiated terms and handled settlements and adjustments with attorneys, claimants and co-defenders.
• Participated in ongoing training programs to stay up-to-date on industry trends, regulatory changes, and best practices for bodily injury claims handling.
• Interviewed relevant parties to determine claim denial or settlement.
• Prepared and presented complex cases to management and client.
• Interviewed policyholders, witnesses and third parties to gather information and details regarding injury event.
• Coordinated independent medical examinations to verify injury severity when required.
• Prevented unnecessary litigation by diplomatically resolving disputes over coverage, liability, and damages through negotiation.
• Determined liability and estimated and approved benefit payments.
• Prepared reports of findings in investigations.
• Consistently met or exceeded performance metrics for claims handling quality, productivity, and customer service.
• Achieved high levels of customer satisfaction through empathetic listening skills, clear communication style, and prompt attention to concerns expressed by claimants or their representatives.
• Enhanced customer satisfaction by providing timely updates on claim status and answering inquiries professionally.
• Reduced claim costs by effectively negotiating settlements with attorneys and claimants.
• Reviewed police reports and medical treatment records to determine extent of liability.

• Reduced claim processing times by implementing efficient workflow procedures.
• Reduced claim processing times by implementing efficient workflow procedures and training team members on best practices.
• Managed a diverse caseload of commercial automobile and casualty claims, prioritizing tasks effectively to meet deadlines and maintain productivity.
• Conducted thorough investigations of complex claims, gathering evidence and interviewing witnesses to determine liability accurately.
• Stayed current on industry trends and state regulations to ensure compliance in all aspects of claim handling.
• Developed strong relationships with insurance agents, brokers, and policyholders by providing exceptional service during the claims process.
• Recognized for maintaining a high level of customer service while managing a large volume of claims simultaneously, exceeding performance expectations.
• Negotiated favorable settlements with claimants, ensuring cost-effective outcomes for the company while demonstrating empathy towards clients.
• Delivered exceptional customer service to clients by communicating important information and patiently listening to issues.
• Read over insurance policies to ascertain levels of coverage and determine whether claims would receive approvals or denials.
• Conducted comprehensive interviews of witnesses and claimants to gather facts and information.
• Reviewed police reports, medical treatment records, and physical property damage to determine extent of liability.
• Identified suspicious losses and contacted manager for investigative assistance.
• Achieved cost savings for the company through effective negotiation strategies with third-party vendors and service providers.

• Acted as a reliable point of contact for customers throughout the claims process, addressing their concerns with empathy and professionalism.
• Demonstrated expert knowledge of auto insurance policies and coverages, allowing for accurate assessment of damages and appropriate claim payouts.
• Documented all findings in concise reports.
• Established an effective system for tracking and monitoring claims from initial report to final resolution, ensuring timely updates were provided to all relevant parties.
• Enhanced customer satisfaction by efficiently managing auto claims and providing prompt resolutions.
• Provided exceptional customer service at all stages of the claims lifecycle while adhering to strict confidentiality guidelines regarding sensitive client information.
• Utilized strong negotiation skills to settle disputed liability cases in a fair and reasonable manner, ultimately minimizing company exposure to financial risk.
• Mitigated potential litigation risks through careful attention to detail in documenting evidence gathered during investigations and claim evaluations.
• Conducted thorough investigations of auto accidents to accurately determine liability.
• Identified suspicious claims, escalating issues to supervisor for further investigation and analysis.
• Successfully negotiated settlements with claimants and insurers.