Experienced Claims Specialist with expertise in claims processing, settlement preparation, and high-profile claims resolution. Diplomatic and personable professional accustomed to handling sensitive, confidential information and investigating high dollar liability claims. Committed to maintaining client satisfaction and contributing to company success.
● Assess and evaluate injury and general liability claims by determining coverage, liability and litigation potential for exposures up to, but not limited to, $2,000,000.00.
● Conduct thorough investigations while assigning and coordinating with venue-specific defense counsel to strategize settlement
● Negotiate settlements before and during legal motions for injuries spanning from soft tissue injuries to high profile fatality cases
● Strictly adhere to all answer deadlines to avoid any possible default judgments and retaining rapport with plaintiff counsels
● Research and collaborate with expert witnesses, such as accident reconstruction specialists or medical professionals to build defense case
● Investigates liability for Bodily Injury claims for minor to moderate injuries
● Consults with doctors, police and witnesses to determine liability and risk
● Coordinate with SIU for any potential fraudulent claims and providers
● Setting accurate expectations and maintaining thorough communication, written and verbal, with all related parties
● Schedule repairs, rentals and answer questions related to total loss claims
● Investigated liability for Bodily Injury claims of varying complexities
● Consulted with attorneys, doctors, police and witnesses to determine accurate injury information to maintain claim integrity
● Negotiate with attorneys varying within 15 states and their respective venues to result in reasonable settlements
● Coordinate with Uber Technology or Lyft Inc. when high risk exposures become a possibility or aggravating factors, such as news coverage, become present
● Setting accurate expectations and maintaining thorough
communication, written and verbal, with all parties
-Served as back-up supervisor when management was on vacation or leave. Handled escalations, managerial survey responses, and performance plan follow-ups
-Communicated methods for positive customer relations and phone etiquette to department through internal committee
-Managed specialized team of temporary adjusters to
handle high risk claim tasks and close files. This project was so successful that the contract for the temporary adjusters was extended twice
-Directed and facilitated analysis project to better understand value driving factors in injury claims
● Exclusively managed team for new employees to learn and adjust to company standards and policies
● Handles escalations and immediate resolutions for situations that exceed adjusters' authority or ability
● Approves all payments, denial requests and rental assignments for all files assigned to team of 7-10 adjusters
● Controls and manually assigns claims that suit particular adjusters' skill levels, aptitude & familiarity with venue
● Leads daily huddles with team to discuss metric-based goals and best practices for desk management
● Designs job aids and tools to assist adjusters in the claims process
● Audits claim files for accuracy and procedure while recording
individual adjuster progress and behaviors
● Writes performance statuses and comprehensive action plans for employees that require a different approach for development
● Investigates liability for Bodily Injury claims for minor to moderate injuries
● Consults with doctors, police and witnesses to determine liability and risk
● Coordinate with SIU for any potential fraudulent claims and involved
providers
● Setting accurate expectations and maintaining thorough communication,
written and verbal, with all related parties
● Schedule repairs, rentals and answer questions related to total loss claims
● Investigated auto property damage and total loss claim exposures
● Determined liability by collecting statements, photos, police reports, and any other piece of evidence that can support an accurate decision
● Resolving property damage and scheduling applicable services to ensure an expedient and positive claims experience
● Maintaining thorough communication with each claimant and returning all correspondence within one business day to reinforce peace of mind that each claim is being handled with care
● Remained active and attentive to every call and the specific needs their claim required
● Filed First Notice of Loss claims as well as attended to status calls on existing claims to relieve call volume from active claim adjusters
● Determined coverage, scheduled services and set proper expectations to ensure a “one call claim”
Property & Casualty License
License# 2052248 - Exp 7/31/24