Ruth Appia
Riverview,FL
Summary
15 years as a licensed USAA Auto Claims Adjuster and Customer Service Professional; steady track record of achievements, advancements, and growth. Focused on meeting compliance and regulatory standards. Highly persuasive communicator with the ability to cultivate strong customer relations and provide a consistently high level of customer satisfaction. Excellent analytical and negotiating skills. Effectively manage, monitor, and control claim risk. Recognized for ability to understand member needs, think strategically, and de-escalate situations; transparent, innovative team player.
Overview
22
22
years of professional experience
1
1
Certification
Work History
Auto Adjuster II: Third-Party Casualty
USAA (United Services Automobile Association)
01.2017 - Current
- Promoted to handle a full cycle of moderately complex third-party injury claims (2017-present) in nine states
- Highlights include: Settlement of Bodily Injury claims for non-attorney represented 3rd party claimants (2021-current). Negotiations and settlement of bodily injury demands for attorney represented claimants (2017-2021)
- Consistently meet / exceed early-settlement goals of a minimum 6 per month on third-party injury claims, conducting negotiations with non-represented claimants
- Search ISO database of past claim history of claimants to rule out fraudulent claims
- Articulate settlement decisions to claimants and successfully negotiate claims to closure.
Auto Adjuster II: First-Party Injury
USAA (United Services Automobile Association)
01.2015 - 01.2017
- Reviewed USAA policies for applicable Florida Personal Injury Protection (PIP) coverage or Medical Payments (MP)
- Paid medical bills within coverage limits for members
- Ensured correct audits and compliance with policies and regulations
- Scheduled Independent Medical Examinations (IMEs) as needed
- Proficient with AIS / MBA program: Reviewed EORs, ensuring compliance with medical procedure codes and audit requirements for provider payments
- Settled First Party Pre-Suit Demands in a timely manner, potentially saving USAA millions of dollars in interest, penalties, and further litigation
- Consistently meet / exceed early-settlement goals on third-party injury claims, conducting negotiations with non-represented claimants
- Designated team Champion for Auto Injury Solutions (AIS) / Medical Bill Audit (MBA) Program; serve as team subject-matter expert
- Present cases in Impasse: Work with litigation team on value and liability disputes
- Articulate decisions, technical knowledge, and policies to LCAs, staff counsel and management representatives via Impasse Roundtable.
Auto Adjuster III
USAA (United Services Automobile Association)
01.2008 - 01.2015
- Investigated, reviewed, evaluated, negotiated, and adjusted auto claims from first notice, through determination of liability, to settlement and close
- Increased individual and team referrals: Created and shared referral strategy (“Deepening Suggestions”: scripts & tips) with 12 team members
- Referrals grew quickly
- Designated Champion after only six months
- Exceeded all audit goals for accuracy, quality of documentation, legal / contractual compliance, and timely closing of claims
- Chosen for several key training positions including High Performance and PTO Assist Team (2014), Introductory Non-Injury Adjuster Training (INAT) Program (2015) and Claims Intern mentor (summer 2015)
- Collaborated with senior management to reduce high pending in MST via the use of VPN OT
- Served on team of 15 to eliminate workload surge, closing 20,000 identified exposures in a single weekend.
Customer Service Representative
PROGRESSIVE INSURANCE
01.2003 - 01.2008
- Provided customer service for automotive insurance through inbound calls
- Responded to 25+ calls per shift
- Evaluated client policies and identified insurance needs.
Education
Master of Business Administration -
St. Leo University
01.2015
Bachelor of Art in History/Political Science -
College of Saint Rose
01.1996
Skills
- Insurance policy knowledge
- Through claims investigation
- Vehicle Inspection best practices
- Knowledge of ISO and LexisNexis reports
Certification
Florida, USAA: Licensed 620 Property & Casualty Adjuster (all lines), Progressive: 440 Customer Service Representative (five years; currently inactive)
Technologyskills
- MS Office Suite (Word, Excel, PowerPoint, Outlook)
- ISO ClaimSearch
- LexisNexis
Languages
Spanish
Professional Working
Timeline
Auto Adjuster II: Third-Party Casualty
USAA (United Services Automobile Association)
01.2017 - Current
Auto Adjuster II: First-Party Injury
USAA (United Services Automobile Association)
01.2015 - 01.2017
Auto Adjuster III
USAA (United Services Automobile Association)
01.2008 - 01.2015
Customer Service Representative
PROGRESSIVE INSURANCE
01.2003 - 01.2008
Master of Business Administration -
St. Leo University
Bachelor of Art in History/Political Science -
College of Saint Rose
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