Experienced Senior Claims Adjuster specializing in property and casualty loss damage. Dedicated to delivering exceptional customer service through peaceful negotiations, fairness, thoroughness, trustworthiness, and dependable service. Skilled in accurate assessment and evaluation of claims for precise settlements. Adept at fostering strong client relationships and collaborating with stakeholders for optimal outcomes. Committed to prompt and efficient resolution of claims while upholding professionalism and integrity.
Overview
16
16
years of professional experience
1
1
Certification
Work History
Adjuster/Desk Examiner
TheBest Claims Solutions
10.2022 - Current
Reviews dispute documentation submitted by attorneys and public adjusters
Works with defense counsel on high exposure and/or claims in litigation to achieve favorable outcomes
Negotiates and drafts legal releases for agreed upon compensation
Determines extent of company liability
Estimate cost of repair, replacement, or compensation
Identified and communicated potential underwriting concerns, SIU involvement, and subrogation potential
Prepared settlement letters, denial letters, Reservation of Rights, and other letters as needed
Produced estimates for exterior and interior damages using Xactimate
Reviewed water and mold invoices for accuracy
Researched Policy Provisions; Process Payments, File Maintenance, File Review, supplemental and coordinated claims
Oral and written communication skills, problem analysis, planning and organizational skills, claims handling involving public adjusters and attorney's offices, General Liability, Prepared and reviewed personal claims
Auto Liability Adjuster
Allstate (Nat Gen/Esurance)
04.2020 - 10.2022
Works claims holistically from beginning to end addressing insured's needs
Provides services to customers that include but is not limited to appraisal assignment, tow assignment, rental car support, benefit explanation, and liability explanation
Obtains facts of loss to determine liability and exposures for handling
Identifies higher level exposures and refers files or features to management for triage
Sends necessary correspondence as it relates to the claim and department of insurance regulations
Uses Esurance systems to properly document files and process claims
Promptly identifies and transfers total loss features to the Total Loss Unit for settlement handling
Identifies referrals, completes proper summaries and forwards files to subrogation for collection in a timely manner
Evaluated claim for possible subrogation
Oral and written communication skills, problem analysis, planning and organizational skills, claims handling involving public adjusters and attorney's offices, General Liability, Property Insurance, Business Interruption Insurance, Commercial Auto Insurance
Large Loss Adjuster
One Call Claims (FedNat)
06.2017 - 12.2019
Reviewed and analyzed suspicious and potentially fraudulent insurance claims
Evaluated all evidence with the ultimate goal of creating positive outcomes for client's claims
Followed up on potentially fraudulent claims initiated by claims representatives
Reviewed new files to determine current status of claim in order to develop a plan of action
Answered questions posed by insured and attorneys
Followed up with the insured individuals regarding premium and deductibles payments
Answered customer questions regarding deductibles
Maintained contact with claimants and Contractors to determine claim status
Substantiated legitimate claims and denied unjustified claims
Evaluated insurance policies and analyzed damages to determine coverage
Provided Exceptional Customer Service
Determined Coverage & Liability of Claims
Negotiations involving claims policy decisions
Completed review of roofing estimates, reviewed estimates for interior damage due water and mold, Research Policy Provisions; Process Payments, File Maintenance, File Review, supplemental and coordinated claims
Oral and written communication skills, problem analysis, planning and organizational skills, claims handling involving public adjusters and attorney's offices, General Liability, Property Insurance, Business Interruption Insurance, Commercial Auto Insurance
Catastrophe Claims Adjuster
Pilot Catastrophe Services (Allstate)
02.2011 - 06.2017
Reviewed and analyzed suspicious and potentially fraudulent insurance claims
Evaluated all evidence with the ultimate goal of creating positive outcomes for client's claims
Followed up on potentially fraudulent claims initiated by claims representatives
Reviewed new files to determine current status of claim in order to develop a plan of action
Answered questions posed by insured and attorneys
Followed up with the insured individuals regarding premium and deductibles payments
Answered customer questions regarding deductibles
Maintained contact with claimants and Contractors to determine claim status
Substantiated legitimate claims and denied unjustified claims
Evaluated insurance policies and analyzed damages to determine coverage
Provided Exceptional Customer Service
Determined Coverage & Liability of Claims
Negotiations involving claims policy decisions
Provided Exceptional Customer Service
Determined Coverage & Liability of Claims
ALE coverage decisions, mold desk adjuster, water mitigation, Negotiations, theft claims, virtual claims, Research Policy Provisions; Processed Payments, Contractor Negotiations, Compose & Edit, MSB, Estimates in Xactimate; Maintain File Updates in Next Gen and CPT, File Review, supplemental and coordinated claims
Ladder Assist (logistics)
Catastrophe Management Solutions
11.2008 - 01.2011
Scanned documentation and entered into the database
Obtained scanned records and uploaded them into the database
Produced daily scheduled maps using advanced Excel spreadsheet functions
Added new material to file records and created new records
Reviewed and updated claims files and scheduling database
Outlined the appropriate process and procedures necessary to fulfill and complete inquiries
Assisted outside adjusters with scheduled inspection times as well as mapping out locations
Daily logistics
Education
Associate - Culinary
Virginia College
Mobile, AL
Skills
Mitchell Estimating Software
Mold Remediation
Analysis skills
Word
Negotiation
Research
Symbility
MS Office
Excel
Customer service
Guidewire
Microsoft Office
Xactimate
NextGen
CCC One
Certification
Driver's License
Military Service
United States Air Force, United States, E2
Timeline
Adjuster/Desk Examiner
TheBest Claims Solutions
10.2022 - Current
Auto Liability Adjuster
Allstate (Nat Gen/Esurance)
04.2020 - 10.2022
Large Loss Adjuster
One Call Claims (FedNat)
06.2017 - 12.2019
Catastrophe Claims Adjuster
Pilot Catastrophe Services (Allstate)
02.2011 - 06.2017
Ladder Assist (logistics)
Catastrophe Management Solutions
11.2008 - 01.2011
Associate - Culinary
Virginia College
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