Samuel Copeland Jr (Jay)
Huntersville,NC
Summary
Dedicated and ambitious professional with proficient knowledge of insurance and technology platforms. Seeking a position that enhances my current skill set and contributes to the success of the workplace. Organized and detail-oriented Investigator dedicated to improving efficiency, productivity and profitability through continuous process improvement. Analytical thinker skilled at developing innovative solutions to complex problems. To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills.
Overview
7
7
years of professional experience
Work History
Commercial Claims Adjuster II
CSAA Insurance Group
03.2025 - Current
- Manage the full lifecycle of first- and third-party auto and property damage claims through investigation and settlement.
- Review and confirm period determination for ride-share drivers.
- Review for fraudulent activity, and assign SIU if needed.
- Compose reservation of rights, denial, acknowledgement and claim applicable letters.
- Analyze reserve levels for assigned cases, and adjust them based on changing circumstances.
- Review legal documents related to claims for compliance with regulatory requirements.
- Maintained an organized inventory of pending claims while responding to inbound customer inquiries.
- Negotiate damage estimates and supplements for effective claim resolution.
- Arrange, resolve, and provide necessary services such as towing, storage, and rental vehicles.
Claims Examiner
Athens Administrators
04.2024 - 02.2025
- Evaluating insurance claims submitted to Athens Administrators, determining their validity, and deciding on the appropriate compensation amount to be paid to the policyholder and other parties by reviewing policy coverage, damage assessments, and supporting documentation.
- Handled sensitive information with discretion, ensuring confidentiality of personal and financial details for claimants throughout the claims examination process.
- Utilized analytical skills to evaluate bills for accuracy and appropriateness of charges before approving payments as part of the claims process.
- Achieved streamlined communication between departments by collaborating closely with underwriters, agents, and other stakeholders throughout the claims handling process.
- Participated in cross-functional team meetings to address organizational challenges related to claims management and develop solutions collaboratively.
- Enhanced customer satisfaction by promptly addressing inquiries and providing accurate information on claim status.
- Maintained detailed records of all claims activities, ensuring compliance with regulatory requirements and company policies.
Commercial Claims Adjuster
Progressive Insurance
12.2021 - 04.2024
- Manage claims from customers with small businesses or commercial product policies
- Supporting customers needs while determining the extent of the company's extent of liability and damages
- Investigate policy coverage, exclusions, endorsements and potential misrepresentation
- Adjust claims on heavy equipment vehicles such as semi- trucks, trailers, buses, specialized vehicles, cement mixers, construction equipment etc
- Address appropriate reserving
- Settle Total losses and handle payments to customers and or lien-holders
- Investigate to determine fault for applicable parties involved in an accident
- Set up substitute transportation in accordance with state and policy guidelines for insured or non policy holders
- Evaluating documentation pertaining to the claim
- Review files for potential injuries exposure appropriate reserving
- Negotiate settlements with other carriers & parties involved
- Verified insurance claims and determined fair amount for settlement.
- Read over insurance policies to ascertain levels of coverage and determine whether claims would receive approvals or denials.
- Resolved complex, severe exposure claims using high service oriented file handling.
Claims Adjuster
Metropolitan Property and Casualty/Farmers Insurance Group
11.2019 - 12.2021
- Conducted thorough interviews with witnesses and claimants to gather critical information.
- Reviewed police reports and physical damage records to assess liability extent.
- Established strong relationships with clients and insurance companies for effective claims resolution.
- Resolved complex exposure claims through diligent file management practices.
- Negotiated settlements with claimants, attorneys, and insurers to reduce financial risks.
- Examined claims forms to verify insurance coverage accurately.
- Ensured timely follow-up on open cases, providing regular status updates to stakeholders.
- Executed special projects assigned by management, completing tasks efficiently within deadlines.
Benefits Administrator
Alight Solutions
10.2018 - 10.2019
- Managed employee benefits program, collaborating with vendors and providers to maintain comprehensive insurance and retirement options.
- Reviewed benefits paperwork for accuracy and compliance with regulations.
- Oversaw continuous enrollment processes and annual enrollment periods effectively.
- Directed 401K, medical, dental, and vision benefit packages to optimize employee offerings.
- Maintained records and documentation in strict accordance with federal and state regulations.
Education
Bachelor of Science - Business Administration, Management
North Carolina Central University
Durham, NCSkills
- Property and casualty adjuster license
- Coverage analysis
- Communication skills
- Claims management
- Time efficiency
- Regulatory compliance
- Customer relationship management
- Problem solving
- Liability analysis
Timeline
Commercial Claims Adjuster II
CSAA Insurance Group
03.2025 - Current
Claims Examiner
Athens Administrators
04.2024 - 02.2025
Commercial Claims Adjuster
Progressive Insurance
12.2021 - 04.2024
Claims Adjuster
Metropolitan Property and Casualty/Farmers Insurance Group
11.2019 - 12.2021
Benefits Administrator
Alight Solutions
10.2018 - 10.2019
Bachelor of Science - Business Administration, Management
North Carolina Central University