LaKesha Pipkins
Spring,USA
Summary
Skilled, ambitious, and motivated insurance professional with a record of success in customer relations and claims management. Ability to communicate effectively, efficiently, and synergize with others to achieve desired goals. Highly organized professional with the capability to excel in a fast-paced environment.
Overview
18
18
years of professional experience
1
1
Certification
Work History
SR. INJURY ADJUSTER
USAA
11.2021 - Current
- Work within defined guidelines and framework, responsible to adjust attorney involved moderately complex bodily injury to include confirming coverage, determining liability, investigation, evaluating, negotiating, defending, and settling claims in compliance with state laws and regulations
- Accountable for delivering a concierge level of best-in-class member service through setting appropriate expectations, proactive communications, advice, and compassion
- Identifies and manages existing and emerging risks that stem from business activities and the job role
- Ensures risk associated with business activities are effectively identified, measured, monitored, and controlled
- Follows written risk and compliance policies, standards, and procedures for business activities
- Adjusts attorney involved moderately complex bodily injury claims with demonstrable injuries (e.g. torn meniscus, broken bones, disc herniations), as well as all auto physical damage associated with those claims
- Identifies confirms, and makes coverage decisions on moderately complex bodily injury and property damage claims
- Investigates loss details, determines legal liability, evaluates, negotiates, and arrives at claim settlement within appropriate authority guidelines
- Clearly documents thought process, investigation, evaluation, negotiation, and settlement decisions
- Prioritizes and manages assigned claims workload to keep members and other involved parties informed, providing timely claims status updates
- Collaborates and supports team members to resolve issues and identify appropriate matters for escalation
- Partners and/or directs vendors and internal business partners to facilitate timely claims resolution
- Supports workload surges and/or Catastrophe Operations as needed
- May act as an informal resource for team members with less experience
FULLY BLENDED CLAIM PROFESSIONAL
TRAVELERS
11.2014 - Current
- Resolves First Party Medical, PIP/MP, Auto Liability, Bodily Injury, and Property Damage for Commercial and Personal Lines Auto claims
- Investigates coverage and facts of loss to determine at fault parties to resolve claims in a time efficient manner
- Analyzes and processes claims by investigating and gathering information to determine the appropriate exposures for the claim
- Calculates and assigns timely and appropriate reserves to claims, monitors reserve adequacy throughout the life of the claim
- Evaluates, processes, and issues payment for moderate complexity third party claims working towards an early and timely resolution
- Maximize PMOI usage when setting appraisal and auto repair services for insured and claimants
- Manages claims through well-developed action plans to an appropriate and timely resolution
- Provides quality handling throughout the claim life cycle
- Communicates with relevant parties while maintaining a high degree of professionalism and customer service
FIELD ACTION ADJUSTER
INFINITY INSURANCE
09.2013 - 11.2014
- Handling of Commercial and Auto policy losses
- Investigate coverage, liability, injury, and the resolution of auto claims
- Prioritize and utilize time management skills while handling claims investigations
- Damage/Risk Assessment and mitigation
- Evaluation of liability exposure
- Policy interpretation
- Confidential records management
- Effectively schedule and manage appointments/meetings surrounding and resulting in early settlements and resolution
- Examine property damage and injuries reported
- Interview all parties involved for investigative purposes
- Prepare investigation findings and reports
- Gather evidence to confirm liability findings
- Negotiate fair settlements with internal and external parties
- Address customer queries and ensure to meet their needs
CLAIMS GENERALIST INTERMEDIATE
PROGRESSIVE
12.2007 - 09.2013
- Handling of Commercial and Auto policy losses
- Investigate coverage, liability, injury, and work claim through resolution
- Prioritize and utilize time management skills while handling claim investigations
- Damage/Risk Assessment and mitigation
- Evaluation of liability exposures
- Policy interpretation
- Confidential records management
- Effectively schedule and manage appointments/meetings surrounding and resulting in early settlements and resolution
- Examine property damage and medical records for proper and timely resolution
- Interview all parties involved for investigative purposes
- Gather and prepare investigation findings and reports
- Negotiate fair settlements with internal and external parties
Education
Bachelor of Business Administration - Business Administration, Management
Sam Houston State University
Skills
- Over 17 years of auto insurance adjusting experience
- Deep knowledge and understanding of the auto claims contract as well as application of case law and state laws and regulations
- Proficient negotiation, investigation, communication, and conflict resolution skills
- Demonstrated time management and decision-making skills
- Proficient knowledge of human anatomy and medical terminology associated with bodily injury claims
- Ability to exercise sound financial judgment and discretion in handling insurance claims
- Proficient knowledge of coverage evaluation, loss assessment, and loss reserving
- Acquisition and maintenance of insurance adjuster license within 90 days and designated number of attempts
Accomplishments
- Average bodily injury disposition recognition (30 day)
- Multi-month member satisfaction recognition
- Multi-month productivity and closures recognition (30 day)
- Timely and accurately setting reserves
Certification
- 2007 - Present
- AR, CT, DE, IA, IL, IN, FL, KS, KY, LA, MS, MN, ND, NE, NC, NH, NM, OK, RI, SD, SC, TN, TX, VT, WI, WY
Timeline
SR. INJURY ADJUSTER
USAA
11.2021 - Current
FULLY BLENDED CLAIM PROFESSIONAL
TRAVELERS
11.2014 - Current
FIELD ACTION ADJUSTER
INFINITY INSURANCE
09.2013 - 11.2014
CLAIMS GENERALIST INTERMEDIATE
PROGRESSIVE
12.2007 - 09.2013
Bachelor of Business Administration - Business Administration, Management
Sam Houston State University