Service-oriented Claims Adjuster skilled at applying creative approaches to solving complex problems. Adept at developing profitable and quality-focused processes.
Overview
2
2
years of professional experience
1
1
Certification
Work History
Claims Adjuster, Automobile and Casualty
Pilot Catastrophe Services
St. Petersburg, United States
08.2021 - 04.2022
Evaluated insurance policies and analyzed damages to determine coverage.
Substantiated legitimate claims and denied unjustified claims.
Answered questions posed by insured and attorneys.
Verified insurance claims and determined fair amount for settlement.
Maintained claims data in ECS systems.
Maintained contact with claimants and attorneys to determine treatment status.
Negotiated total loss settlement agreements to resolve disputes.
Followed up with insured individuals regarding premium and deductibles payments.
Handled incoming calls from customers and other stakeholders about total loss processes.
Prepared prosecution packages and restitution proposals.
Catastrophe Claims Adjuster
Pilot Catastrophe Services
Memphis, TN
03.2021 - 06.2021
Exercised proper judgment and decision making to analyze and settle over 14 onsite claims per week.
Investigated and determined coverage onsite of loss and adjusted all elements of property loss claims of moderate-high severity.
Organized, documented and researched materials dealing with c
Catastrophe Claims Adjuster
Sedgwick Claims Management
Biloxi, MS
12.2020 - 02.2021
Verified insurance claims and determined fair amount for settlement.
Negotiated claim settlements and recommended litigation when claims could not be settled.
Completed virtual property inspections.
Catastrophe Claims Adjuster
Pilot Catastrophe Services
Lafayette, LA
09.2020 - 12.2020
Examined claims forms and other records to determine insurance coverage.
Prepared sketch of floor plan and roofline and entered data into Xactimate to develop line-by-line item costs of damages.
Developed effective techniques to mitigate losses.
Coordinated and managed field investigations, outside engineers, contractors, and cause and origin experts.
Conducted day-to-day administrative tasks to maintain information files and process paperwork.
Developed and maintained working relationships with independent adjusters and contractors to assist in prompt claims handling.
Delivered exceptional customer service to policyholders by communicating important information and patiently listening to issues.
Reported to management on customer problems, field conditions, safety issues and policy problems.
Licensed Health Insurance Agent
USHEALTH Group
Tampa, FL
05.2020 - 08.2020
Verified insurance coverage by telephone and online to guarantee proper reimbursement of benefits and estimate patients' financial responsibilities.
Performed needs analysis to obtain information required to make appropriate health insurance product recommendations.
Scanned, received and sent faxes to insurance claims, co-pay assistance information and patient documentation.
Finalized sales and collected necessary deposits.
Determined financial needs by assessing existing coverage and aligning new products and services with long-term goals.
Identified and solicited sales prospects in agency databases.
Education
No Degree - Alternative And Complementary Medicine And Medical Systems