Oscar Adams
Charlotte,NC
Summary
Dynamic claims professional with over 10 years of progressive experience in the insurance industry. Expertise includes insurance sales, fraud prevention, and the investigation and processing of auto liability claims. Proven ability to analyze damages and causes, interpret coverage, and negotiate equitable payment solutions while maintaining client satisfaction and compliance with regulations.
Overview
12
12
years of professional experience
Work History
Senior Fraud & Claims Operations Representative
Wells Fargo
09.2023 - Current
- Identify and mitigate control failures in bank processes, procedures, and customer transactions to prevent fraud and recover losses.
- Provide feedback and implement process improvements to enhance fraud detection and claims handling efficiency.
- Conduct detailed reviews and verifications of customer transactions, resolving disputes and policy violations.
- Serve as a subject matter expert, offering procedural guidance to less experienced staff and collaborating with internal teams and external customers.
Commercial Liability Adjuster
Progressive Insurance
11.2021 - 12.2022
- Analyzed claims forms, policies, and endorsements to determine coverage.
- Conducted comprehensive investigations, including interviews and inspections, to assess physical damages and validate claims.
- Managed case load efficiently, establishing loss reserves, negotiating settlements, and ensuring compliance with federal and state regulations.
- Recommended litigation when necessary and represented evidence at legal proceedings.
Commercial Liability Adjuster
Kemper Insurance
12.2019 - 07.2021
- Managed full-cycle claims processing, from investigation to settlement, ensuring compliance with policy provisions.
- Handled specialty claims projects, closing files efficiently and equitably.
- Negotiated settlements and managed claims within stipulated monetary authority while maintaining company standards.
Auto Liability Adjuster
MetLife
12.2018 - 12.2019
- Investigated and resolved auto liability claims, managing new and pending cases efficiently.
- Conducted recorded interviews to determine claim facts and ensured proper documentation in accordance with state regulations.
- Delivered high-quality customer service and met organizational quality standards.
Licensed Sales Specialist
Allstate Insurance
02.2018 - 12.2018
- Built strong customer relationships through needs-based policy reviews and cross-selling additional insurance products.
- Generated new business through prospecting and providing tailored insurance solutions.
- Processed payments to bind policies and maintained a high level of customer satisfaction.
Claims Service Specialist II & Total Loss Specialist
Allstate Insurance
10.2013 - 02.2018
- Conducted claims processing and salvage follow-ups, ensuring timely resolutions and maximizing financial recovery.
- Led continuous improvement initiatives, facilitating training sessions to enhance team performance.
- Provided mentoring and compliance training to peers, ensuring adherence to service standards.
Education
Associate Degree - Computer Science
ITT Technical Institute
Charlotte, NC12.2009
Skills
- Microsoft Office Suite
- Guidewire
- ISO ClaimSearch
- DAT
- Visa
- CIV
- Hogan
- NextGen
- ARMS
- Arbitration Forums
- Continuous Improvement
- Fraud Detection
- Claims Negotiation
- Logistics management
- Process management
- Asset management
- Computer literacy
- Team collaboration
- Financial reporting
- Risk assessment
- Multitasking Abilities
- Insurance confirmation
- Project management
Timeline
Senior Fraud & Claims Operations Representative
Wells Fargo
09.2023 - Current
Commercial Liability Adjuster
Progressive Insurance
11.2021 - 12.2022
Commercial Liability Adjuster
Kemper Insurance
12.2019 - 07.2021
Auto Liability Adjuster
MetLife
12.2018 - 12.2019
Licensed Sales Specialist
Allstate Insurance
02.2018 - 12.2018
Claims Service Specialist II & Total Loss Specialist
Allstate Insurance
10.2013 - 02.2018
Associate Degree - Computer Science
ITT Technical Institute
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