Rusty Russell
Spokane,WA
Summary
Claims professional with robust background in resolving high-stakes claims and ensuring compliance with regulatory standards. Known for fostering team collaboration and driving results, adaptable to changing circumstances while maintaining focus on key priorities. Excels in risk assessment, customer relations, and problem-solving. Experienced with handling intricate claims and dispute resolutions. Uses analytical skills to assess risks and ensure compliance with industry regulations. Track record of fostering customer satisfaction and enhancing operational efficiency. Experienced claims professional prepared to drive impactful results in field. Proven track record in managing complex claims processes, ensuring compliance, and fostering team collaboration. Strong analytical skills, adept at problem-solving, and flexible in adapting to changing needs. Known for reliability, effective communication, and commitment to achieving organizational goals. Senior Claims Representative with 28 years of industry experience. Successful at meeting customer and company needs with fair and equitable approach to claims process. Detail-oriented, systematic, and skilled in identifying exposures and proposing actionable solutions.
Overview
26
26
years of professional experience
Work History
Senior Claims Representative Field Claims
Cincinnati Insurance Companies
12.2022 - Current
- Improved team productivity by providing ongoing training and support to junior claims representatives.
- Reduced backlog of pending claims by introducing an effective triage system based on priority levels.
- Collaborated with legal and medical professionals to gather necessary information for claim assessments.
- Analyzed complex claims data, identifying trends, and recommending improvements to reduce future risks.
- Enhanced customer satisfaction with timely and accurate resolution of claims disputes.
- Recommended and set reserves based on expected payouts.
- Streamlined claims documentation process, ensuring completeness and accuracy for faster approvals.
- Conducted investigations into complicated mid- and high-exposure claims.
Independent General Large Loss Adjuster
Self Employed
03.2020 - 12.2022
- Handled multiline claims both in property and casualty personal lines and commercial losses
- I have handled Commercial large loss files and large loss Farm exposures including heavy equipment
- Travel to multiple states to handle storm claims and large loss exposures
- I have handled total loss house fires and commercial large loss building losses due to fire, water, theft and vandalism along with other loss types
Property and Casualty claims Manager
Topa Insurance Company
12.2019 - 03.2020
- Manage a staff or casualty and property adjusters handling commercial and personal lines claims in multiple states
- Responsible for reviewing all denial letters, authority requests and releasing of large payments
- Oversee day to day operations of claims staff handling commercial losses on property and liability
- Answer and handle complaints
- Respond to any Insurance commissioner office complaints
- Currently living in California and my wife and children and family are in Eastern Washington
Independent Large loss adjuster
Crawford and Company
08.2019 - 12.2019
- Handled complex commercial – residential property and casualty claims and large injury claims
Property Claims Representative III
Grange Insurance Association
06.2017 - 08.2019
- Handle complex multi-state large losses fire, farm, farm equipment, total loss fires and storm
- Crop large loss and agriculture claims
- Manage a large volume of incoming claims files and remain on top of them and provide outstanding customer service
- Work closely with outside Agents to help get the best results for the insured and their clients and for the company
- Handle large loss property claims, water, fire, theft, wind and hail
- I am able to organize and multitask daily moving from homeowners, total loss house fires, to heavy equipment and a wind or water loss
- Write closing, status, and denial letters and Reservation of rights
- Work with contractors and vendors and build relationships with achieve win - win for the customer and company
- Make sure reserves are timely and accurate
- Review, handle and close claims files as quickly as possible
- Review all estimates and correspondence
- Make sure payments are accurate and timely
- Work multiple files and claims at once, while maintaining focus and multi-tasking to achieve the best results
- Leading in open to close % ratio and in the number of days from open to close
- Leading the department in customer service thank you’s and kudos along with the most positive after claims survey results
- I have several large files with very happy customers and letters and emails endorsing my level of knowledge and professional service with a personal touch and empathy for what they are going through
- Maintained a great working relationship with Insureds and their contractors during the process and try to make it as seamless as possible
- Able to reach good solid and fair agreed cost of repairs on small loses to total loss rebuilds
- Work if needed when called upon or during heavy volume times
- I understand the where to focus and the need
- If we need to travel and help other areas I will be there when called upon without complaint
- Focus on my work and the customer, making sure I am doing right by them and the company
- Work well with everyone in the office environment and outside of the organization, direct management, peers, agents and contractors, vendors, and customers
- Comply with all State regulations and statutes regarding claims handling
- Licensed adjuster in multiple states
Claims Manager, Property Field Adjuster
PEMCO Insurance
01.2016 - 10.2016
- Responsible for managing, negotiating, and settling water, theft and fire claims less than 200K
- Personally investigate, evaluate and resolve multi-line property claims within PEMCO’s guidelines
- Examine claim forms, policy, and other records to determine insurance coverage
- Open, close and adjust reserves in accordance with company practices designed to ensure the reserve adequacy
- Recommend Special Reserves where necessary
- Maintain current knowledge of insurance and applicable product/services; court decisions which may impact the claim’s function; current guidelines in the claims function; and policy changes and modifications
- Stayed up to date current knowledge of local industry repair procedures and local market pricing
- Submit severe incident reports, reinsurance reports and other information to claims management as needed
- Partner with SIU and Subrogation to identify fraud and subrogation opportunities
- Assist and prepare files for suit, trial, or subrogation
- Initiate and conduct follow-ups via proficient use of the claims systems and other related business systems
Multi Line Claims Manager Supervisor
PEMCO Insurance
05.1999 - 01.2016
- Led a team of up to 15 core workers including 4 general or senior level property adjusters, 3 Intermediate casualty adjusters, 4 Senior casualty adjusters and 3 inside property / total loss adjusters
- Wrote the duty guidelines for the afterhours claims call duty plan
- Listed the outline for handling losses and who to call in what area
- Gave the basic property claims outline on coverages and what to do when faced with different types of claims
- Who to call if you needed help
- What contractors to call for different types of losses and what claims to escalate and who to call if you needed help
- Ensured that the Claims Department achieves optimum accuracy, efficiency, and productivity in claims administration and adjudication
- Participated in department claims audits of all lines and sizes of claim files
- Collaborated with peers and superiors to make sure we were all on the same page
- Participated on the team that put together the action plan for areas in need of improvement
- Provided feedback to Executive and senior management on all claims staff performance, including compliance with best practices and regulatory and statutory requirements for annual performance reviews
- Conducted regular audits of adjuster claim administration outcomes; prepared audit and analytical reports related to claim adjuster statistics and outcomes
- Reviewed claim files for required documentation and verified that invoices have been properly audited before claim payments are presented to the claim’s manager for issuance of checks
- Led implementation of new programs with external vendors, and in development of in-house programs geared toward enhanced savings and quality of services
- Vendor management of Xactimate and the company fleet
- Led software conversions and the implementation of new or enhanced technical configurations
- Handled implementation and enforcement of departmental operational standards (benchmarks), procedures, and policies to achieve and increase target production goals
- Recommended initiatives and programs to optimize and improve the department’s profitability; and advised the management on possible performance enhancing technology and procedures
- Led development, coordination, and implementation of strategic goals related to claims
- Ran unit meetings and participated in many large-scale companywide meetings on a Company leadership team
- Received excellence award and the PEMCO leadership award for outstanding performance and leadership skills based upon the Cat team’s response and successful handling of both fire storms and windstorm catastrophes
- Gave updates to senior management on CAT losses and storms
- Provided team leadership and management and planning for these occasions with outstanding results and feedback
- Rated Exceeds Expectations for 10 of 15 years
- Outstanding once and meets four times
Education
Associate of Arts - Information systems and Cyber security
Spokane Falls Community College
Spokane, Washington06.2024
AA degree - General Business
Spokane Falls Community College
Spokane, Washington06.1992
AA Communications Certificate - Communications
Spokane Falls Community College
Spokane, Washington06.1992
High School Diploma - undefined
Mead Senior High School
Spokane, Washington06.1987
Skills
- Customer service – Expert
- Xactimate - Advanced
- Xactimate Sketch - Advanced
- Claims Management and handling –Advanced
- Communication - Advanced
- Risk management –Advanced
- Claim resolution and Negotiation - Advanced
- Multi-tasking –Advanced
- File QA review –Advanced
- Reserving and forecasting -Advanced
- CAT loss planning and claims handling – Advanced
- Team management - Advanced
- Team management - Advanced
- Understanding of the Insurance business -Advanced
- Working with experts and vendors – advanced
- Team management - Advanced
- Understanding of the Insurance business -Advanced
- Working with experts and vendors – advanced
- Coverage verification
- Claims investigation
- Claims analysis
- Claims processing
- Team management - Advanced
- Understanding of the Insurance business -Advanced
- Working with experts and vendors – advanced
- Coverage verification
- Claims investigation
- Claims analysis
- Claims processing
- Team management - Advanced
- Understanding of the Insurance business -Advanced
- Working with experts and vendors – advanced
- Coverage verification
- Claims investigation
- Claims analysis
- Claims processing
Timeline
Senior Claims Representative Field Claims
Cincinnati Insurance Companies
12.2022 - Current
Independent General Large Loss Adjuster
Self Employed
03.2020 - 12.2022
Property and Casualty claims Manager
Topa Insurance Company
12.2019 - 03.2020
Independent Large loss adjuster
Crawford and Company
08.2019 - 12.2019
Property Claims Representative III
Grange Insurance Association
06.2017 - 08.2019
Claims Manager, Property Field Adjuster
PEMCO Insurance
01.2016 - 10.2016
Multi Line Claims Manager Supervisor
PEMCO Insurance
05.1999 - 01.2016
AA degree - General Business
Spokane Falls Community College
AA Communications Certificate - Communications
Spokane Falls Community College
High School Diploma - undefined
Mead Senior High School
Associate of Arts - Information systems and Cyber security
Spokane Falls Community College
Similar Profiles
Thamesis Nicole SilverioThamesis Nicole Silverio
Call Center Representative at Cincinnati Insurance CompaniesCall Center Representative at Cincinnati Insurance Companies
RALPH ODELLRALPH ODELL
Surplus Lines Underwriter at Cincinnati Insurance CompaniesSurplus Lines Underwriter at Cincinnati Insurance Companies
Kaitlyn LemaireKaitlyn Lemaire
MANAGED CARE COORDINATOR at Cincinnati Insurance CompaniesMANAGED CARE COORDINATOR at Cincinnati Insurance Companies