Melanie Sadkowski
Amherst,New York
Summary
Service-oriented Claims Adjuster who applies creative approaches to solving complex problems. Adept at developing profitable and quality-focused processes. Detail-oriented Examiner with 24 years of experience. Strong command of conflict resolution and negotiation combined with excellent reporting and research skills. Thorough understanding of claims process and general liability claims practices.
Overview
25
25
years of professional experience
Work History
Senior Account Claims Representative
PMA Companies
02.2024 - Current
- Worked productively in fast-moving work environment to process large volumes of claims.
- Improved customer satisfaction by providing timely and accurate information on claim status and resolution.
- Reduced turnaround time for claim settlements by prioritizing tasks and managing deadlines effectively.
- Maintained compliance with industry regulations by adhering to established procedures and guidelines in claims handling.
- Developed strong relationships with clients, facilitating trust and open communication during the claims process.
- Collaborated with legal team members to strategize defense plans and prepare for potential litigation proceedings.
- Negotiated fair settlements with claimants, maintaining professional relationships while protecting company interests.
Senior Claims Examiner
Sedgwick Insurance
10.2022 - 02.2024
- Analyzing and processing claims throught well-developed action plans to an appropriate and timely resolution by investiggating and gathering information to determine the exposure on the claim.
- Negotiating settlement of claims with in desginated authority.
- Communicating claim activity and processing with the claimant and the client.
- Reporting claims to the excess carrier and responding to requests of directions in a professional and timely manner.
- Worked with private investigators and attorneys on preparation of evidence, witness statements and other documentation in preparation for trial.
- Maintained contact with claimants and attorneys to determine treatment status.
Multi-line Claims Adjuster
Merchants Insurance Group
02.2018 - 10.2022
- Cultivate relationships with claims and other internal staff, policyholders, attorneys, agents and various service providers and experts all while working toward achieving the most optimal outcomes for
- Merchants and our policyholders
- Investigates coverage, liability and damages, as well as evaluating commercial 3rd party casualty claims
- Provides a high level of customer service while managing a portfolio of Commercial Auto and General
- Liability, with some responsibility handling Auto Property Damage and Collision claims occurring in NY
- NJ, PA, MA and MI
- Conducts and and directing timely and quality claim investigations, evaluations and equitable settlements of assigned claims
- Ensures timely and accurate reserves consistent with reserve philosophy.
Senior Bodily Injury Adjuster
National General Insurance
08.2007 - 02.2018
- Handle bodily injury/liability auto and homeowner's claims, initial investigation and first call settlements
- Conduct detailed coverage analysis of personal automobile policies in conjunction with auto accidents
- Communicate with internal and external customers by explaining the entire claims process
- Maintain contact with claimants and attorneys to determine treatment status
- Complete medical evaluations
- Negotiate and settle property and injury claims
- No
Fault Claim Representative
Tower Group Companies
10.2003 - 08.2007
- Conducted detailed coverage analysis of NYS No-Fault Regulation 68
- Communicated coverage and timelines to policyholders and medical providers
- Managed a high volume claim desk
- Worked on several different computer systems to process claims efficiently/effectively
- Medically manage files utilizing peer reviews, Independent Medical Examinations, nurse case management and accident reconstruction experts
- Participated in OneBeacon CAT team for homeowner property claims.
Licensed Claims Processor/Customer Service Associate
State Farm Insurance
08.1999 - 10.2003
- Initiated initial contacts with policyholders and claimants obtaining the facts of loss, injury information, property damage information, vehicle locations and lien holder information
- Initiated the set-up of vehicle inspections and rentals
- Handled a heavy volume of customer, vendor and co-worker's questions, problems and requests efficiently and effectively while maintaining confidentiality.
Education
Bachelor of Arts - Psychology, Human Resources
Buffalo - The State University of New York
Buffalo, NYundefined
University at Buffalo
Skills
- New York, Florida, and Texas adjusting licenses
- Fast learner
- Skilled multi-tasker
- Highly motivated
- Customer service-oriented
Timeline
Senior Account Claims Representative
PMA Companies
02.2024 - Current
Senior Claims Examiner
Sedgwick Insurance
10.2022 - 02.2024
Multi-line Claims Adjuster
Merchants Insurance Group
02.2018 - 10.2022
Senior Bodily Injury Adjuster
National General Insurance
08.2007 - 02.2018
Fault Claim Representative
Tower Group Companies
10.2003 - 08.2007
Licensed Claims Processor/Customer Service Associate
State Farm Insurance
08.1999 - 10.2003
Bachelor of Arts - Psychology, Human Resources
Buffalo - The State University of New York
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University at Buffalo