Post Job Free

Resume

Sign in

Quality Assurance Claims Examiner

Location:
Clearwater, FL, 33760
Posted:
October 18, 2023

Contact this candidate

Resume:

Robert Meyerhoff

**** ********* ****

#****

Clearwater, FL 33760

727-***-****

ad0gc4@r.postjobfree.com

Summary of Qualifications:

Over twenty years of experience in adjusting all lines of insurance claims. Carrier experience as well as lengthy Third Party Administrative programs. Experience includes Property Casualty, Complex Claims, Large Loss, and Quality Assurance. EXPERIENCE

2/2023-9/2023

Storm King

Senior Claims Examiner

9/2021-1/2023

Heritage Insurance Holdings Group

Senior Claims Examiner

Handled and processed high volume of Hurricane Ian Claims Handled complex Attorney and Public Adjuster represented claims Collabarated with vendors and other 3rd parties on estimate revisions Negotiatiated with vendors and Public Adjustes on property damage and repairs Maintained constant contact and educated insureds during claim process Evaluated all related reports and composed detailed claim summary notes for all files worked 1

8/2017 - 9/2021

Insurance Claims Unlimited

Complex Claim Account Manager/CAT Supervisor/QA analyst/trainer Set up and managed CAT team in Houston for Hurricane Matthew During Hurricane Irma responsible for coaching and training field adjusters, per client/carrier and company guidelines and best practices.

Reviewed and QA’d product from 200+ CAT adjusters thought Florida, Texas, South Carolina, Georgia, Louisiana, for Hurricane Matthew and Hurricane Irma. 12/2015 - 6/2017

Ryze Claims Solutions

Field Service Supervisor

Manage a team of 20+ Field Adjusters throughout the state of Florida for various insurance carriers.

Carries out supervisory responsibilities, in accordance with the organization's policies and applicable laws.

Assists in establishing, implementing and evaluating team goals and expectations. Reviews daily field services department reports for quality assurance. Issues written and oral instructions.

Responsible for coaching and training field adjusters, per client/carrier and company guidelines and best practices.

4/2013 - 11/2015

Citizens Property Insurance Company

Quality Assurance Field Technician

2

Played an integral role in the redesign of the quality assurance audit procedures and the implementation of new auditing software.

Assist the Claims Quality Assurance Program in developing and implementing quality improvement strategies. Conduct claim file audit reviews, field re-inspections throughout the state of Florida, field Quality Assurance trainings at remote locations, and other quality assurance projects as needed.

Provide feedback on claim quality audit results and make recommendations for improvements. Create, present, perform, participate and lead calibration Quality Assurance training sessions and assist Claims employees to increase knowledge and skills necessary to achieve improved results. This includes integrating and delivering property claims training programs in the context of Quality Assurance calibration exercises (e.g., policy, Estimatics, systems, workflows, statutes). Participated in co-inspections with staff and external business partners as needed. Interact face to face with customers, staff, and external business partners. Assisted the Claims Organization to assess the need for, and create specific Quality Assurance training for staff, independent adjusters and vendors within the Claims Organization. Served in the Team Lead role for various claims units when as needed. 3/2008 – 12/2012

Florida Peninsula Claim Services

Hillsborough, Pinellas Senior Field Adjuster

Settle claims and manage structural losses to include: file action plans, diary management and control, agreements in scope/estimates, reserving, hiring forensic and geotechnical firms, pending open inventory action plans and negotiations within scope of authority re-inspections and claims resolution, as well as report preparation for leadership. Evaluate claims by conducting investigations, performing coverage analysis, damage assessments, cause and origin determination, and escalate as necessary. Work with insured and external business partners regarding the handling and/or disposition of claims and other issues. Represent the company in legal proceedings as required. 3

06/2006 –2008

ARH Service Corp Clearwater, Florida

Warranty Claims Director

Manage all aspects of Arthur Rutenberg Homes, Inc’s warranty company; provide leadership to position the company at the forefront of the industry. Develop a strategic plan to advance the company's mission and objectives.

Oversee company operations to insure production efficiency, quality, service, and cost-effective management of resources. Approve company operational procedures, policies, and standards. Oversee the inspection of construction defect warranty claims including field inspection, bidding and hiring subcontractors; implementing subrogation and litigation of claim. Present company report to Board of Director meetings.

01/2005-06/2006

CatManDo Inc. Bradenton, Florida

Claims Supervisor– Catastrophe

On call and able to travel to storm areas within 48 hour notice for extended periods of time. Managing all aspects of deployed storm teams in various storm sites. Responsible for all communications between the insurance company and storm team

(Supervisors, Examiners, Re-inspector trainers).

2005/06 Supervised teams in SE & SW Florida and New Orleans LA. 08/2004-01/2005

Aplin Peer & Associates Bradenton, Florida

Claims Adjuster/ Estimator – Storm Team/Daily claims On call and able to travel to storm areas within 24 hour notice for extended periods of time. Investigated, evaluated, negotiated, and settled homeowner property and casualty insurance claims.

Responsible for all communications between the insurance company and the insured party. 4

Developed and analyzed claim data and interpreted, evaluated, and prepared the damage estimates.

Negotiated settlements with policyholders and their representatives. Maintained current knowledge of construction repair techniques, structural design, and satisfactory repair work in carpentry, roofing, electrical, plumbing, and painting. 01/2004–08/2004

WCI Communities Palm Beach Gardens, Florida

Purchasing Agent

Administer direct budget process. Negotiating best possible price with material and labor vendors thru bid process.

Developed budgets and takeoffs from blueprints and fieldwork for 5 product lines to include 50’, 65’, multi-family, and smaller single family. 26 different plans in total. Maintained pool of 65 vendors that supply material and labor for all mentioned product lines. Maintain specification and scope of work database. Ensure satisfactory communication flow between Sales, Purchasing, Construction, and AP departments. 05/2001–01/2004

US Home/Lennar Denver, Colorado/New Port Richey, Florida Purchasing Manager

Administer entire bid process. Administer direct budget process. Developed budgets and takeoffs from blueprints and fieldwork for the US Home Inaugural series. Maintained pool of 20 vendors that supply material and labor for Granite, Corian, Laminate, Ceramic Tile, Carpet, Vinyl, and Hardwood flooring. Headed up project to reduce flooring costs by 4% within a two-year period. Exceeded project goals by decreasing flooring costs by 6% within one year. Negotiating best possible price with material vendors thru bid process. Maintain specification and scope of work database.

Worked w/ team of 3 to manage Design Center option pricing, data, and material takeoffs for 5

77 individual floor plans.

Ensure satisfactory communication flow between Sales, Purchasing, Construction, andAP departments.

07/2000-05/2001

Valentine Construction Denver, Colorado

Insurance Restoration Division Supervisor

Oversee and supervise all aspects of the Division. Responsible for estimating homeowner property damage Negotiating with Adjuster, hiring Trade Partners, and overseeing all aspects of restoration to completion.

In addition, I was in charge of two Construction Superintendents and the Division budget. 1997-2000

PCH & Associates & NAS Associates Safety Harbor, Florida Field Claims Adjuster/ Estimator

Worked as an independent Insurance Adjuster for more than on independent company handling daily and storm claims for multiple carriers. I adjusted claims for:

Southern Oak Insurance

Universal Insurance

Poe Insurance

Citizens Property and Casualty

6

State Farm

Allstate

EDUCATION

1990, Southern Illinois University

ACCREDITATION

Licensed in Florida and Texas

Resident Independent 5-20 All Lines Adjuster License #D036519 JDE Edwards Purchasing training

USHome Builder Class

Florida Wind Pool Certification.

SOFTWARE

Xactinalysis QR

Xactimate estimating software Level I Cert

Inpoint Auditing

References furnished upon request.

7



Contact this candidate