Results-driven Claims Specialist with a strong focus on negotiation, conflict resolution, and customer service. Proven ability to manage challenging claims and deliver effective solutions.
Overview
6
6
years of professional experience
Work History
Casualty Senior Claims Specialist
Liberty Mutual Insurance Company
2021.08 - Current
Manage, investigate and evaluate coverage, liability and damages, in order to effectively negotiate and settle minor/moderate claims within prescribed authority levels.
Plan and conduct investigations of claims to analyze and confirm coverage and determine liability, compensability and damages.
Effectively utilize tools to evaluate claims. Determine need for, and request authorization to engage independent adjusters, cause and origin experts and independent medical examiners.
Ensure adequacy of reserves.
Present cases to senior leadership for reserves and evaluation authority as required by preset value ranges.
Accountable for security of financial processing of claims, as well as security information contained in claims files.
Handle the claim file through various phases of litigation. Develop litigation strategy and action plans after thoroughly reviewing the initial complaint and any amended actions. Review the applicability of coverage and civil law as well as local statutes. Recognize coverage issues and what policy language and facts should be considered. Attend mandatory and court ordered litigation events.
Communicate with various parties associated with the claim. Respond to written and verbal inquiries in a timely and professional manner, ensuring compliance within all company and statutory guidelines.
Prepare detailed and comprehensive initial reports and follow up reports with concise and effective action plans designed to move the claim towards resolution.
Identify potential suspicious claims and refer to the Special Investigation Unit and identified opportunities for third party subrogation.
Negotiate settlements with attorneys, claimants, and/or co-defendants. Involved in special projects and mentor and assist with training of others.
Customer Service/Sales Associate
Home Depot
2020.03 - 2021.08
Provided exceptional customer service by addressing inquiries and resolving issues promptly.
Assisted in maintaining inventory accuracy through regular stock checks and updates.
Trained new associates on product knowledge and sales techniques to enhance team performance.
Managed returns, exchanges and refunds in accordance with store policy.
Maintained calm demeanor and professionally managed issues in busy, high-stress situations.
Helped customers locate products and checked store system for merchandise at other sites.
Solved customer challenges by offering relevant products and services.
Participated in team meetings and training sessions regularly for continuous professional development within the retail industry.
Education
Bachelor of Science - Kinesiology
Texas Tech University
Lubbock, TX
2020-08
Skills
Claims management expertise
Team work and Collaboration
Verbal and written communication
Time management
Negotiation and Conflict Resolution
Customer Service
Accomplishments
Earned the Liberty Mutual Circle of Excellence Award in February 2023 which honors excellence in customer sales, service and claims across Personal Insurance. The award recognizes top-performing professionals who consistently provide Liberty Mutual customers with outstanding service and expert advice.