Kimberly Sholes
Mobile
Summary
Results-driven Independent Adjuster with over a decade of experience optimizing claims processes and leading teams. Expertise in assessing property damage, reviewing estimates, and ensuring policy compliance. Seeking role as Staff Adjuster to conduct inspections, deliver effective solutions, and enhance Adjusting Processes.
Overview
13
13
years of professional experience
1
1
Certification
Work History
Associate Vendor Manager/Manager
State Farm
Mobile
10.2014 - 05.2025
- Claims Team Supervisor: Directed and supported team of adjusters, ensuring effective and efficient claim handling through guidance and oversight.
- Claims Workflow Coordinator: Assigned claims to optimize workload distribution, monitored progress, and ensured timely resolutions within policy and regulatory guidelines.
- Conducted quality assurance reviews for claims processing
- Performance and Development Coach: Conducted weekly coaching sessions to enhance team performance and deepen understanding of relevant claim scenarios.
- Regulatory Compliance Specialist: Addressed Department of Insurance inquiries and resolved agent and customer complaints, ensuring strict adherence to state regulations.
Senior Claims Adjuster
State Farm
Mobile
05.2012 - 05.2025
- Medical Claims Assessment Specialist: Reviewed Independent Medical Exams and Utilization Reviews to verify injury severity and ensure appropriate treatment plans for equitable settlements.
- Complex Auto Liability Investigator: Conducted investigations into complex auto liability claims involving multiple vehicles and coverage limit issues.
- Homeowners Property Claims Specialist: Resolved moderately complex homeowners' property claims related to hail, fire, and water damage, ensuring fair settlements for clients.
- Claims Documentation Expert: Created comprehensive documentation using photographs, measurements, and recorded interviews to support subrogation and litigation efforts.
- Remote Damage Assessment Coordinator: Collaborated with onsite vendors and insured parties using advanced imagery and video technology for accurate damage evaluations and estimates.
- Insurance Policy Coverage Analyst: Determined coverage by evaluating policy terms and issuing approvals or denials, maintaining compliance with company policies.
- Set reserve amounts, negotiated settlements, and escalated high-value claims to supervisors for approval.
- Claims Operations Manager: Oversaw claims workload and expense management to achieve timely resolutions in line with organizational and regulatory requirements.
- Risk Mitigation and Claims Evaluator: Conducted thorough investigations and collaborated with relevant parties to assess claims and minimize potential risks effectively.
- Conducted quality assurance for claims processing
Education
Some College (No Degree) - Business Management
University of South Alabama
Mobile, ALSkills
- Claims Management
- Team leadership
- Claims Strategy
- Property/Auto Claims
- Liability Exposure Evaluation
- Risk mitigation
- Policy Management
- Insurance Regulations
- Vendor Relations
- Team Management
- Resource Optimization
- Procedure Improvement
- Desk Examination
- Cost Analysis
- Desk review
- Disaster response
Certification
- Microsoft Office
- Xactimate
- XactAnalysis
- Claim Xperience
- CCC
- Alabama
- Arizona
- Florida
- Oklahoma
- Texas
Timeline
Associate Vendor Manager/Manager
State Farm
10.2014 - 05.2025
Senior Claims Adjuster
State Farm
05.2012 - 05.2025
Some College (No Degree) - Business Management
University of South Alabama