Summary
Overview
Work History
Education
Skills
Certification
Additional Information
Work Availability
Timeline
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Trisha Fall

Trisha Fall

Newton Falls,OH

Summary

Hard-working Manager with exceptional experience leading teams, delivering results and exceeding expectations. Creative and motivated leader adept at utilizing exceptional design and planning strengths to accomplish complex projects. Skilled in teaching new concepts and best practice strategies.

Overview

18
18
years of professional experience
1
1
Certification

Work History

Supervisor/Trainer

  • For peers
  • Identified and treated life-threatening illness or injuries in high stress situations.

Senior Resolution Manager

04.2022 - Current
  • Litigation
  • Exercise proper judgment and decision making to analyze the claims exposure, to determine the proper course of action and to appropriately settle the claim
  • Interacts extensively with various parties involved in the claim process
  • Able to clearly communicate concise action plans, and present plans for moving the case to conclusion
  • Demonstrate knowledge of claim file process through presentation of actions and responses to client questions
  • Processes claims consistent with clients' and corporate policies, procedures and "best practices" and also in accordance with any statutory, regulatory and ethics requirements
  • Ability to comply with carrier reporting and threshold requirements
  • Able to recognize and pursue excess insurance recoveries
  • Incumbents will have the ability to handle a full case load, with proven ability to handle cases of increased severity

Claims Examiner

Sedgwick Insurance Company
04.2021 - 04.2022
  • Complex
  • Investigate, evaluate and effectively resolve complex bodily injury claims to include multiple fractures, surgical care and fatally injured parties
  • Prepare and present documentation for reserve and settlement authority in excess of $100,000
  • Effectively communicate next actions with management and client for large exposure claims
  • Examine service instructions, insurance policies and other records to determine applicable coverage
  • Interviews with client, claimants and witnesses via telephone and written correspondence
  • Notify excess insurance carriers based on service instruction protocols
  • Communicates timely with appropriate claim parties to maintain professional relationships
  • Ensures proper documentation and claims coding

Adjuster

Allstate Insurance Company
11.2016 - 04.2021
  • Unrepped/Repped UM/UIM Severe/ Complex, -Litigated/Unmitigated Claims
  • Interpret and apply coverage and liability decisions in complex auto accident claims often involving multiple parties and determining their proportionate share of such limits per the policy wording
  • Properly and fairly evaluate Injury claims for settlement which involves detailed review of medical records and billing to place a fair value for settlement of the claim
  • Negotiate the settlement until resolution is achieved to close the exposure to the liable policyholder
  • Achieve Allstate quality file reviews ensuring that all files are properly handled to ensure there is no financial impact directly related to all handling of each claim
  • Conduct productive sit-a-longs with new hires to provide my insight during their training process
  • Work with insureds and attorneys to resolve claims quickly
  • Unrepresented Claims Casualty Adjuster – Summit MCO
  • Negotiate and Settle moderately complex claims
  • Professional empathetic connection with the customer during claim process, with positive customer feedback
  • Investigate moderately complex auto accidents, document a claim file with notes, evaluations and decision-making process
  • Time management and organizational skills by managing a low pending and cycle time lower than peers
  • Foster a learning environment by providing training sit a-longs with new adjusters
  • Leveraged prior EMS and Police training to assist peers with proper claim handling
  • Inside Property Claims Processor - Central Specialty Office (CSO)
  • Allstate specific systems – XactContents, NextGen, Mainframe
  • Implemented and developed an out of office backup position, which led to a full-time position in the CSO enabling customers to be serviced while their claims adjuster was out of the office, leading to an improved customer experience
  • Consistently achieved high results and positive feedback on customer experience surveys
  • Recognized by peers for collaboration and teamwork for helping with their work
  • Early adapter to continuous improvement management
  • Leveraged prior detective experience to assist peers in loss investigation
  • Identified process improvements that lead to efficiencies with immediate team

Detective/Police Officer

City of Windham Ohio
12.2012 - 02.2017
  • Patrol city, performing security check on buildings and residences
  • Selected to be Supervisor/Training Officer
  • Strong problem solving and conflict resolution skills that allowed officers to go home safe
  • Investigated accident scenes, took pictures and issued citations as needed
  • Supervised new recruits while on calls
  • Required to observe and take appropriate action in the event of suspicious activity
  • Investigated suspects and witnesses
  • Administer CPR and Frist Aid procedures
  • Dispatching

Officer Emergency Medical Technician

Evidence
03.2005 - 01.2015
  • Highest ranking on EMS calls

Education

Bachelor of Science - Criminal Justice

University of Phoenix
Tempe, AZ

Skills

  • Strong
  • Microsoft Office Suite skills, Excel, Outlook, Word, PowerPoint
  • Safe Work Methods
  • Training and Development
  • Supervising Employees
  • Complex Problem-Solving
  • Team Assignments
  • Resolving Complaints
  • Workflow Monitoring
  • Administration and Reporting
  • Productivity Performance
  • Morale Improvements
  • Negotiation
  • Mentoring
  • Leadership

Certification

Special Training in communicating with the public Officer of the Year Award 2015 AED Certified Emergency Assistance Training Court Documentation Training Traffic Law Enforcement Knowledge Training in handling child abuse/neglect and sexual assault cases Internal Information

Additional Information

  • Achievements/Skills/Qualifications , 2019: North Central CSA Leadership Award (not every office has this) 2017: 2nd Quarter Leading with Purpose Award for Leadership Principle - We Win Together

Work Availability

monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Timeline

Senior Resolution Manager

04.2022 - Current

Claims Examiner

Sedgwick Insurance Company
04.2021 - 04.2022

Adjuster

Allstate Insurance Company
11.2016 - 04.2021

Detective/Police Officer

City of Windham Ohio
12.2012 - 02.2017

Officer Emergency Medical Technician

Evidence
03.2005 - 01.2015

Supervisor/Trainer

Bachelor of Science - Criminal Justice

University of Phoenix

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Trisha Fall