Summary
Overview
Work History
Skills
Timeline
Generic

Melanie C. Burns

Licensed P&C Adjuster
Aubrey,TX

Summary

Team Leader experienced in directing activities of workgroups. Develops strategies, provides training, sets goals and obtains team feedback. Excellent interpersonal and communication skills. Big picture focus with excellence in communicating goals and vision to succeed. Problem solver, networker, and consensus builder. Leveraged analytical and leadership skills to enhance claims processing efficiency and team performance, through policy and claim investigations, and fostering client trust.

Overview

16
16
years of professional experience

Work History

Casualty Liability Claims Team Lead

Sedgwick
10.2023 - Current
  • Improved claims processing efficiency by streamlining workflows and implementing best practices.
  • Facilitated smooth communication between all parties involved in claims process – from clients to adjusters – resulting in efficient resolutions without undue delays or setbacks.
  • Promoted positive work environment by fostering teamwork, open communication, and employee recognition initiatives.
  • Worked with claims adjusters and examiners to expedite processing in alignment with procedures.
  • Enhanced overall team performance by providing regular coaching, feedback, and skill development opportunities.
  • Established clear performance metrics for team which helped in tracking progress towards set targets effectively.
  • Coached team members in techniques necessary to complete job tasks.
  • Reduced claim resolution time with thorough investigations and effective negotiation techniques.
  • Maintained strong relationships with clients, fostering trust and loyalty through excellent communication skills.
  • Negotiated favorable settlements for clients, maintaining a high success rate in claim resolutions.
  • Resolved complex claims, utilizing expert knowledge of policy coverage and industry regulations.
  • Trained new hires on claims procedures, ensuring seamless transition into their roles as Claims Consultants.

Auto Property / Casualty Adjuster

Liberty Mutual Insurance
06.2018 - 07.2023
  • Investigated claims by reviewing policy contracts to determine claim coverage based on cause and facts of loss.
  • Carefully reviewed claim information to verify accuracy and analyzed suspicious and potentially fraudulent insurance claims.
  • Collecting and reviewing facts of loss, obtaining recorded statements from all parties involved, reviewing, and assessing damages, and determining coverage and liability.
  • Reviewed police reports, medical treatment records, and physical property damage to determine extent of liability.
  • Negotiated bodily injury and total loss settlement agreements to resolve disputes.
  • Maintained contact with claimants and medical providers to determine treatment status.
  • Reviewed new files to determine current status of injury claim and to develop plan of action.
  • Directed claims negotiations within allowable limit of $15,000 and supported successful litigations for advanced issues

Business Analyst

Centene
06.2008 - 08.2017
  • Generated ad-hoc reports to evaluate specific business requirements.
  • Developed customized reports, summarizing and presenting data in visually appealing format.
  • Analyzed data to identify root causes of problems and recommend corrective actions.
  • Applied honed problem-solving skills to analyze and resolve issues impacting business operations and goal achievement.

Skills

Claims Investigation

Performance Management

Strategic Decision-Making

Insurance industry knowledge

Personal Auto & Casualty Loss Handling

Policy investigations & Coverage determination

Excellent analytical, interpersonal, communication, organizational, customer service internal and external, critical thinking, detailed orientated, and problem-solving skills

New Hire Mentoring

Timeline

Casualty Liability Claims Team Lead

Sedgwick
10.2023 - Current

Auto Property / Casualty Adjuster

Liberty Mutual Insurance
06.2018 - 07.2023

Business Analyst

Centene
06.2008 - 08.2017

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Melanie C. BurnsLicensed P&C Adjuster