Skilled desk adjuster with 7 years of claims experience, 3 years file review. Over 10-years of customer service experience.
Overview
9
9
years of professional experience
1
1
Certification
Work History
Liability Claims Adjuster
Dynamic Claims Services
09.2023 - 09.2024
Resolved disputes effectively through mediation efforts between involved parties as an alternative to litigation when possible; reducing costs associated with lengthy court proceedings.
Established rapport with policyholders through clear communication, empathy, and professionalism during difficult circumstances.
Managed a caseload of complex liability claims, maintaining organization and meeting deadlines consistently.
Reduced claims processing time by implementing efficient workflow strategies and prioritizing tasks.
Investigated liability claims thoroughly, analyzing evidence and interviewing involved parties to determine fault accurately.
Verified insurance claims and determined fair amount for settlement.
Property Desk Adjuster
Pacesetter Claims Service
02.2023 - 09.2023
Conducted thorough investigations of reported losses, gathering essential information from policyholders to accurately determine coverage eligibility.
Coordinated and managed field investigations, outside engineers, contractors and cause and origin experts.
Delivered exceptional customer service to policyholders by communicating important information and patiently listening to issues.
Managed a high volume of claims, prioritizing cases based on urgency and complexity to ensure timely resolution.
QA Specialist
Pacesetter Claims Service
08.2022 - 02.2023
Streamlined QA processes for increased efficiency and reduced time spent on redundant tasks.
Contributed to successful audits by consistently maintaining detailed documentation for each file reviewed.
perform a final file review insuring that the estimate is written within guidelines, photos have been organized and labeled, measurements are aligned with hover or eagle view, payments have been issued under correct coverages within policy limits and the correct deductible has been applied.
Provided a detailed report of what corrections are needed to the field/desk adjuster on the estimate or in the claim. And in some cases, making changes to the estimate myself and properly documenting file breaking down the correction
Large Loss Adjuster
Pacesetter
08.2022 - 01.2023
Handling claims for Citizens of Florida impacted from Hurricane Ian with a large scale of damage
Coordinating with a variety of experts to ensure the magnitude of damages had been accurately assessed
Arranging ALE for homeowners
Responsible for documenting file in detail ensuring to cover all damage at the loss location
Interpreted policy language accurately, ensuring appropriate coverage determination for each claim scenario.
Performing a final review of the estimate confirming that it accurately reflects scope of damages
Appraisal Adjuster
Tower Hill
01.2022 - 12.2022
Researched the market for comparable sales, found similar properties in the loss location or a similar product in comparison to the damaged personal property, and adjusted pricing to evaluate the value by examining the size, location, age, quality, and condition
Verified insurance claims and determined fair amount for settlement.
Clarified coverage of losses to policyholders and provided assistance in itemizing damages and finding alternative living arrangements.
Prepared summaries of damage, payments, and policy coverage.
Desk Adjuster / File Review
One Call Claims
01.2021 - 12.2022
My key responsibilities were to handle homeowner claims, verifying damages and finding coverage
Communicating with homeowners to document a thorough assessment of damages and in some cases confirm if ALE is needed
Communication with contractors, Public Adjusters, Agents and in some cases lawyers
I would perform a final file review insuring that the estimate is written within guidelines, photos have been organized and labeled, measurements are aligned with hover or eagle view, payments have been issued under correct coverages within policy limits and the correct deductible has been applied
Providing a detailed report of what corrections are needed to the field/desk adjuster on the estimate or in the claim
And in some cases, making changes to the estimate myself and properly documenting file breaking down the correction
Letter writing: denials, payments letters, contact letters, partial payments etc
Litigation Adjuster
One Call Claims
01.2021 - 12.2021
I was given the opportunity to work litigation claims for period of time during my deployment
My responsibilities were to review settled insurance claims to confirm that settlement payments had been made in accordance with state specifics, policy guidelines
Creating a report showing breakdowns of any overpayments, underpayments and any other irregularities found on claims
Providing clear instructions to desk adjusters on what is needed to make corrections to claim
Communicating with legal counsel on litigation claims
Desk Adjuster / File Review
Pilot Catastrophe Services
01.2019 - 12.2020
My key responsibilities were to handle homeowner claims, verifying damages and finding coverage
Communicating with homeowners to document a thorough assessment of damages and in some cases confirm if ALE is needed
Communication with contractors, Public Adjusters, Agents and in some cases lawyers
I would perform a final file review insuring that the estimate is written within guidelines, photos have been organized and labeled, measurements are aligned with hover or eagle view, payments have been issued under correct coverages within policy limits and the correct deductible has been applied
Providing a detailed report of what corrections are needed to the field/desk adjuster on the estimate or in the claim
And in some cases, making changes to the estimate myself and properly documenting file breaking down the correction
Letter writing: denials, payments letters, contact letters, partial payments etc
Virtual / Fast Track Desk Adjusting
Pilot Catastrophe Services
08.2017 - 12.2019
Virtual Desk Adjusting to fast track claims, turn around 24-48 hours
Virtually walk with Homeowners through a software that allowed me to virtually photograph the home and damages to the home to create a scope of repairs.
Addressing any supplements from the contractors, reviewing itemized estimates and making revisions to my scope as needed
Writing an estimate from what damages can be seen in photos provided by the Homeowner or Contractor
The purpose of this was to streamline a large quantity of claims to assist the homeowners as quickly as possibly.
Gathered cost and material data for accurate and up-to-date information on material and labor costs.
Negotiated favorable settlements as required
Claims Processor
Pilot CMS
01.2016 - 12.2017
Customer service representative
My duties were to be another point of contact for clients
Relaying messages to adjusters and updating contact expectations to defuse customer escalation complaints