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Customer Service Claims Specialist

Location:
New York, NY
Posted:
March 08, 2024

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Resume:

Shola T. Azeez

Columbus, OH m: 614-***-**** ad37ec@r.postjobfree.com linkedin.com/in/sholaazeez/

Claims Specialist

Career Profile

Accomplished and versatile insurance claims professional with 20+ years of experience spanning claims management, insurance investigations, settlement guidelines, customer service, employee development, and more. Results-focused leader adept at motivating teams, building strong client relationships, and creating innovative solutions to complex insurance problems. Communicate easily with people of all ages and backgrounds; collaborate effectively at all operational levels. Organized and a keen eye for detail, with demonstrated ability to manage multiple projects simultaneously. Thrive in fast-paced, deadline-driven environments that demand excellence and reward ingenuity.

Core Competencies

Auto Liability Claims Adjustment

Property Claims Adjustment

Commercial Liability Claims

Litigation Claims Handling

Customer Service & Support

Xactimate Utilization

Project Management

Budget Management

Strategic Planning

Decision Making

Problem Solving

Leadership

Professional Experience

Crawford & Company, Columbus, OH, (Remote), 2022 to 2023

SENIOR CLAIMS EXAMINER

Engaged with clients to build rapport, identify needs and pain points, and create customized insurance solutions that drove retention and trust; boosted customer satisfaction rate to 97% for total loss claims.

Analyzed claims to ensure alignment with settlement guidelines; settled total loss claims with customers, communicating proactively to acquire needed information.

Issued payments to involved parties, reviewed estimates to ensure damages were consistent with facts of loss, and tracked pending tasks to streamline claims processing.

Investigated complex claims, recorded statements to assist with litigation investigation, and reviewed files to ensure proper claims handling.

Balanced multiple clients and claims simultaneously while meeting tight deadlines and strict quality standards; prioritized claims to handle critical issues promptly.

Identified innovative ways to improve processes and workflows; offered actionable recommendations to the management team.

Sedgwick Workforce Management, Dublin, OH, 2019 to 2022

DISABILITY CLAIMS SPECIALIST

Excelled as a primary contact for clients, concurrently managed 275 to 315 cases; handled leave of absence administration (FMLA, STD, LTD) as determined by each client.

Communicated proactively with clients and claimants via phone and/or written correspondence; answered questions and explained the claims process clearly and thoroughly.

Achieved 87% pass rating on all quality reviews, helping the team achieve status as one of the top two teams in the department; recognized as a top team player on multiple occasions.

Leveraged strong active listening and problem-solving skills to create memorable customer experiences; completed all tasks by or before the deadline.

Westfield Insurance Group, Columbus, OH, 2018

CLAIMS EXAMINER

Processed and closed more than 2,100 claims in four months; investigated coverage, liability, legal climate, potential exposure, and damages to obtain relevant facts pertaining to assigned claims.

Led inspections to ascertain the cost of damage to property, vehicles, and individuals; compiled and reviewed all necessary documentation to support claim evaluation.

Built positive relationships with claimants, agents, attorneys, insurance companies, vendors, and internal stakeholders; delivered exceptional service and support to customers.

Monitored case development, drafting reports to ensure appropriate documentation throughout the claim lifecycle; relayed key updates and information to claimants and stakeholders.

Navigated intricate settlement negotiations, escalated claims to various specialists, and assisted the Unit Leader with staff management and training.

Coached associates in all aspects of the company’s claim process; mentored team members with a focus on continuous improvement and professional development.

American Strategic Insurance, St. Petersburg, FL, 2017 to 2018

CATASTROPHIC CLAIMS ADJUSTER

Completed 100% of claims assignments, increasing company closure rate to 97%; consistently met deadlines and was recognized as “Adjuster of the Month” on several occasions.

Interviewed insured parties and witnesses, consulted law enforcement, and inspected property damage to approve/adjust estimates of damage and loss, determine the extent of liability, and set case reserves.

Documented investigation findings and forwarded information to appropriate parties, composed settlement letters, denial letters, reservation of rights, and diary notes.

Managed clients and vendors, following up as needed to acquire information and expedite the claim process; answered questions and distilled complex information into easy-to-understand terms.

Applied in-depth knowledge of state statutes, including the insurance code of ethics, rules, regulations, and guidelines to drive claim resolution and ensure legal compliance.

State Farm Insurance, Lafayette, IN, 2015 to 2017

CLAIMS ADJUSTER

Facilitated comprehensive claims management, serving as a contracted vendor for various clients; assessed claims, reviewing estimates, police reports, and medical records; issued payments and assisted the following clients:

Crawford Catastrophe Claims (2017): Investigated claims, recorded statements to assist with litigation investigation, and reviewed files to ensure proper claims handling; issued payments to involved parties and reviewed estimates to ensure damages were consistent with the facts of loss; tracked and monitored pending tasks to streamline claims processing; ensured alignment with settlement guidelines, settling total loss claims with customers; boosted customer satisfaction rate to 97% for total loss claims.

Eberls Claims Services (2015 to 2016): Identified total loss threshold prior to settlement; explained total loss threshold and settlement process to customers and vehicle owners; assessed damage, provided settlement offers, and aided with settlement offer approval; increased customer retention by 45% through attentive, prompt, and empathetic service.

Renfroe Claims Services (2015): Oversaw liability investigations for bodily injury claims; determined negligence and liability; reviewed policy reports and medical records for attorneys, submitted severe incident reports and other documents to claims management, and coordinated with SIU and Subrogation to identify fraud.

The Best IRS Claims (2015): Served in Auto Claims department and managed a portfolio of over 125 cases across all lines of coverage; gathered claims data, interviewing claimants and witnesses and communicating with various parties, agencies, and experts; documented findings, determined extent of liability, and negotiated claim settlements; helped adjusters update activities; played key role on Diversity Committee, promoting workplace diversity through various programs and activities.

State Auto Insurance, Columbus, OH, 2013 to 2014

CLAIMS ADJUSTER

Appraised, evaluated, documented, and resolved auto claims; researched policy status and coverage for claims, interpreting information for customers.

Assigned field adjusters, internal appraisers, and independent appraisers to inspect damages; prepared and issued settlement checks in a timely manner.

Previous Experience

Nationwide Insurance, 2009 to 2012

FIELD MATERIAL DAMAGE CLAIMS SPECIALIST, 2012

SENIOR MATERIAL DAMAGE CLAIMS REPRESENTATIVE, 2009 to 2011

Safe Auto Insurance, Columbus, OH, 2007 to 2009 MULTI-LINE CLAIMS REPRESENTATIVE

JPMorgan Chase, Columbus, OH, 2006 to 2007 PERFORMANCE CONSULTANT

Education and Credentials

Master of Business Administration, 2004; Keller Graduate School of Management, DeVry University – Columbus, OH

Bachelor of Arts and Science, 2000; The Ohio State University – Columbus, OH

Licensure: Life, Accident, Health, Property & Casualty Insurance in the State of Ohio (966939)

Certificates:

Certified Financial Planning License, In Progress

Securities License, In Progress

Awards and Honors

Employee of the Month, American Family Insurance

Employee of the Month, Safe Auto Insurance

Volunteerism

United Way

American Food Bank

Additional Information

Technical Proficiencies: Windows, Mac OS, Microsoft Exchange, Active Directory, Microsoft Office Suite, Microsoft Project, Visio, Access, servers, routers, wireless LAN, SAP, Visual Basic, QuickBooks, HTML, CSS, SQL, Adobe PeopleSoft

Interests: Table-tennis, basketball, golfing, photography, literature



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