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Customer Service Claims Adjuster

Location:
St. Simons, GA
Salary:
$55,000/year
Posted:
June 02, 2022

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Resume:

SCOTT PYLE

adq9np@r.postjobfree.com 1-912-***-**** St Simons, GA 31522

Seasoned Insurance Adjsuter excels at working with individuals from diverse cultural and socioeconomic backgrounds.

Personable and resolution-focused. Energetic SUI Investigator successful at reducing company costs by employing resultsfocused problem solving techniques. Offers superior oral and written communication skills. Meticulous Claims

Investigator effective at collecting and analyzing data used to devise fair and cost-effective settlements.

Workers' Compensation Claims

Insurance Fraud Expertise

Property Adjusting

Rules of Evidence

Decision Making

Liability Determination

File and Record Management

Legal Documentation and Reporting

Critical Thinking

Frontier Adjusters St Simons, GA

Claims Adjuster

01/2010 - Current

Resolve Insurance Claims

Adhered to company and insurance client's guidelines in claims processes,

estimate writing and claim closures.

Recommended settlement offers and negotiated payment arrangements.

Conducted interviews, gathered detailed information and completed field

investigations.

Obtained necessary information to complete proper evaluation of injury

claims.

Reviewed data to verify validity of claims and determine case management

actions.

Drafted statement of loss to summarize damages, payments and

underlying policy coverage.

Completed required investigations on referred files within established

timeframes.

Identified and collected evidence and determined value to specific claim to

properly assess conditions.

Complied with company and insurance client's guidelines in claims

processes, estimate writing and closing of claims, resulting closed claims

files.

Analyzed first reports of loss and underlying file material to determine if

claim was suspect.

Contacted injured parties and legal representatives to negotiate final

settlements for claims.

Investigated potentially fraudulent claims with focus on thoroughness,

quality and cost control.

Investigated claims, conducted field audits, determined losses and

reported findings.

Summary

Skills

Experience

Interviewed claimants, medical specialists and employers to determine

pertinent claim information.

Obtained relevant evidence and information regarding suspicious claims.

Conducted claim and estimate re-inspections.

Lorillard Brunswick, GA

Sales Representative

02/1989 - 12/2009

Placed orders and answered customer questions in-person, through email

and over phone to maximize customer service.

Contacted new and existing customers to outline benefits of products.

Demonstrated product features to align with customer needs.

Adhered to company initiatives and achieved established goals.

Stayed up to date on company products and services to support sales

objectives.

University of Montevallo Montevallo, AL

Bachelor of Arts in Business Administration And Management

05/1983

Certified Claims Adjuster, Frontier Adjusters - 2010

Licensed Georgia Resident Property & Casualty Adjuster - 2010

Licensed Florida Non- Resident All Lines. - 2010



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