Seeking a remote full-time position with the potential for growth and advancement with a pleasant work atmosphere. Skilled Property Claims Specialist with background in assessing, negotiating, and settling property claims. Strengths include strong analytical skills for accurate claim evaluation, comprehensive understanding of insurance policies, and ability to effectively communicate with policyholders. Have made significant impact by streamlining claims processes and improving customer satisfaction in previous roles.
Overview
29
29
years of professional experience
1
1
Certification
Work History
Property Claims Specialist
Raphael and Associates, Inc.
02.2012 - Current
Receive, review and set up new insurance property claims to include loss of use claims, contents claims, and business interruption claims with forensic accountant assistance
Request scene investigations, photographs, police / fire reports, and recorded statements
Request experts such as engineers, forensic accountants, building consultants, cause and origin etc
Review insurance policies for coverage determination and/or coverage issues
Dictate and /or type reports to various insurance carriers for their review and coverage determinations to include reservation of rights letters and partial to full disclaimer letters
Receive and review reports from independent adjusters and compare to coverages in the policy
Receive and review various documents from insureds in reference to their claim; contents inventory, receipts, invoices, photographs, etc
Prepare proof of loss forms with cover letters and forward to insureds
Prepare check transmittals for claim payments
Receive and make phone calls to insureds, cause and origin experts, engineers, water mitigation companies, insurance agents, attorneys, public adjusters, appraisers to discuss various aspects of a claim and reached agreed settlements for covered damage accordingly
Prepare various letters during the claim process such document request letter, letters of restitution, contact letters, releases etc
Receive and review forced proof of losses and prepare proof of loss rejection letters for same
Review reserves and set / update reserves per claim file
Ability to approve my reports to various carriers and within authority for claims up to $100,000.00
Ability to approve settlements for my claims handling up to $100,000.00
Assist managers when needed for reviewing / approving of reports, reserves and settlements
Assist in training of new examiners
Ability to handled large loss claims to include losses exceeding $7,000,000.00 on commercial and $4,000,000.00 on homeowners’ properties
Ability to handle high value homeowners claims and work closely with carrier(s) on same
Image Right, File Handler and Claim Pilot program experience
Microsoft Teams, Word, Excel & Outlook experience
Claims Adjuster
Central Adjustment Company f/k/a G & H Claims Professionals, Inc.
09.1995 - 02.2012
1995-2003 and 2005 to 2012
Green & Hester, Inc. was purchased by G & H Claims Professionals, Inc. who was purchased by Central Adjustment Company.
Started at Green & Hester Inc. as clerical and worked my up to office manager. In 2006, I got my Alabama Adjuster's License and started working, handling claims myself.
Desk and field adjusting auto, liability, loss of income and product liability claims since 2006
Accounts Payable and Accounts Receivable-Quickbooks Pro 2008 for Windows
Maintained Checkbook in Quickbooks along with making bank deposits for the company
Payroll-Quickbooks Pro 2008 for Windows
Secretarial duties include dictation, faxing, filing, answering phones, designing forms, setting up files, ordering office supplies and equipment, keeping up maintenance on office equipment, scanning and emailing documents, copying, setting up monthly casino claims committee meetings, summarizing and transcribing recorded statements, training new employees, requesting official records, mailing out collections letters monthly, doing research on various projects, backing up the computers every morning and opening the office
Assigned auto appraisals out to adjusting companies in the Montgomery and Birmingham area
Opened, maintained and closed files for the Montgomery location
Designed and maintained logbook of claims in Excel 2003 for office
Q & A 4.0-Running loss run reports for the casino clients
Installed various computer programs for company along with upgrades, i.e
Norton Anti-Virus and Quickbooks
Installed new computer accessories along with their software for company, i.e
Digital cameras, scanners and printers
WordPerfect 6 for Windows along with Windows 95, 98 & XP Professional experience
Microsoft Word 2003, Publisher 2003, Excel 2003 & Outlook 2003 experience
Designed company brochure booklet and tri-fold marketing handout using Publisher 2003 and designed company’s new business cards along with other various marketing items
Claims Evaluator/Trainer
Worley Catastrophe Response
07.2010 - 10.2011
Deep Horizon Oil Spill in Gulf of Mexico, BP/Gulf Coast Claims Facility (GCCF) Project
Claims Evaluator in Large Loss Department handing vacation condominium/commercial loss of income claims while under the direction of BP
Claims Evaluator/Trainer in various claim handling procedures while under the direction of the Gulf Coast Claims Facility (GCCF)
Supervisor/Trainer while working in the Claimant Communication Center while under the direction of the Gulf Coast Claims Facility (GCCF)
This position was the supervising and training of other Claims Evaluators on the procedures of taking phone calls from claimants and handling phone calls from dissatisfied claimants
Claims Evaluator working in a Site Office handling the intake of claims, accepting additional documentation, accepting releases and answering questions for claimants while under the direction of the Gulf Coast Claims Facility (GCCF)
Claims Coordinator
J. R. Prewitt & Associates
01.2003 - 11.2004
Obtained loss/lawsuits/accident information from clients/insureds, typed Acord Loss Notices and forwarded the information to all the appropriate insurance carriers
Set up and maintained claim files
Posted payments to claim files in computer using The Agency Manager/Applied Systems, Version 7.1.0 software
Verified insurance coverage for insureds
Obtained claim status from insurance adjusters and from online sites of insurance companies for producers and insureds
Received Employer’s First Report Of Injury from employers/insureds and reported to the workers compensation insurance carrier
Received and faxed medical records/bills to worker’s compensation carriers
Requested loss runs from various insurance companies for producers/insureds
Designed forms for office use and for various clients/insureds
Completed SR-13 forms for insureds and mailed to the Driver License Division in Montgomery, Alabama
Obtained scene photos on claims
Education
Associate in Claim (AIC) Designation
American Institute For CPCU And
Insurance Institute Of America
01-2009
20th Century Business School -
20th Century Business School
Mobile, Alabama
01-1990
Graduate -
Mary Montgomery High School
Semmes, Alabama
01-1986
Skills
Able To Work Independently
Team Training
Settlement Negotiations
File and Record Management
Coverage Assessment
Claims Processing
Claims Investigation
Policy Interpretation
Policy investigations
Organizational Skills
i
Certification
Adjuster’s License – Alabama
Adjuster’s License – Mississippi
Adjuster’s License – Florida
Adjuster’s License – Louisiana
Adjuster’s License – Texas (Resident)
Adjuster’s License – New York
Adjuster’s License – Oklahoma
Adjuster’s License – Arkansas
Continuingeducation
American Institute for CPCU and Insurance Institute of America, Associate in Claim (AIC) Designation Completed
Attributes
Honest
Reliable
Quick learner
Self-motivated
Hard worker
Timeline
Property Claims Specialist
Raphael and Associates, Inc.
02.2012 - Current
Claims Evaluator/Trainer
Worley Catastrophe Response
07.2010 - 10.2011
Claims Coordinator
J. R. Prewitt & Associates
01.2003 - 11.2004
Claims Adjuster
Central Adjustment Company f/k/a G & H Claims Professionals, Inc.
Certified Surgical Technologist at Yale New Haven Hospital Saint Raphael CampusCertified Surgical Technologist at Yale New Haven Hospital Saint Raphael Campus