Claims Adjuster with deep experience in confidential litigation claims. Superbly positioned to investigate, evaluate and settle complex claims. Excellent abilities to decipher fraudulent activities, analyze data, confer with legal counsel and communicate recommendations for handling and resolving claims.
Accurate Senior Claims Adjuster with a nine-year background performing complex and high exposure claims.
Excellent negotiation and organizational skills.
Talented in resolving claims to the satisfaction of all parties involved.
Excellent management and problem-solving traits.
Overview
9
9
years of professional experience
Work History
Senior Claims Adjuster
Berkshire Hathaway Direct Insurance, Companies
Omaha, NE
2022.01 - Current
Complied with company and insurance guidelines in the claims process from investigations to closing of a claim
Managed high caseload counts for multiple jurisdictions
Completed required investigations within established timeframes
Investigated potentially fraudulent claims with focus on thoroughness, quality, and cost control
Built and maintained professional relationships with both
Defense Counsel and Petitioner Counsel
Evaluate, Recommended, and or Negotiate settlement within authority
Mentored and develop new members of claims staff in proper procedures
Directed claims negotiations within allowable limit of $[Amount] and supported successful litigations for advanced issues.
Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
Evaluated original investigation reports and documents to resolve secondary concerns.
Reviewed new files to determine current status of injury claim and to develop plan of action.
Directed and coordinated various investigations conducted by field investigation team.
Resolved complex, severe exposure claims using high service oriented file handling.
Negotiated Both Full and Final as well as indemnity only settlement agreements to resolve disputes.
Delivered exceptional customer service to policyholders by communicating important information and patiently listening to issues.
Analyzed information gathered by investigation and report findings and recommendations.
Negotiate stipulations or settlement agreements to resolve disputes.
Researched claims and incident information to deliver solutions and resolve problems.
Prepared [Type] documents for managers or legal personnel.
Maintained contact with claimants and attorneys to determine treatment status.
Analyzed information gathered by investigation and reported findings and recommendations.
Claims Examiner
Sedgwick Claims Management Services
Philadelphia, PA
2021.02 - 2022.01
Senior Claims Adjuster
Berkshire Hathaway Guard Insurance
Wilkes-Barre, PA
2014.04 - 2021.02
Education
Bachelor of Science - Business Management & Marketing
Pennsylvania State University
MBA - Business Administration
Wilkes University
Skills
Claims file management processesundefined
Accomplishments
Served as Lead Adjuster for multiple complex claims.
Timeline
Senior Claims Adjuster
Berkshire Hathaway Direct Insurance, Companies
2022.01 - Current
Claims Examiner
Sedgwick Claims Management Services
2021.02 - 2022.01
Senior Claims Adjuster
Berkshire Hathaway Guard Insurance
2014.04 - 2021.02
Bachelor of Science - Business Management & Marketing
Pennsylvania State University
MBA - Business Administration
Wilkes University
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