W

Levere

Wilson

323-***-****

ad39h2@r.postjobfree.com

SUMMARY

Thorough Property Claims Adjuster with hands-on experience performing home damage repair estimates, including wind, hail, fire and water damages. Dedicated to ensuring complete customer satisfaction and serving as a liaison between agents. Adept at negotiating payment arrangements and recommending settlement offers. Fair Property Claims Adjuster with 7-year background in the property claims adjustment field. First-rate verbal and written communication skills to type over 50 wpm. Sound knowledge of insurance policies and settlement offers. Dedicated to conducting prompt and thorough investigations to ensure all parties involved are satisfied. Enthusiastic client services professional with strong background directly interfacing with industry customers. Well-versed in products, services and consumer trends. Dependable achiever committed to holding highest ethical standards and maintaining customer trust.

SKILLS

Risk Assessment

Workers' Compensation Claims

Rules of Evidence

Property Claims

Claims Processing

Property Adjusting

Policy Investigations

Data Analysis

Best Practices Implementation

Interviewing Techniques

Highly Motivated

Coverage Assessments

Advanced Computer Skills

Medical Coding

Medical Terminology Specialist

Strong Interpersonal and

Communication Skills

Claims File Management Processes

Report Writing

Database Management

Sales Background

Allocating Claims

Risk Management

Claims Investigations

Marketing

Regulatory Compliance

EXPERIENCE

Claims Adjuster

Fort Worth, TX

E A Renfroe and Company/ Oct 2017 to Nov 2023

Investigated insurance claims, reviewed coverage and liability, prepared reports, and recommended payment or denial of claims.

Researched relevant laws, regulations, legal decisions, and precedents to determine the appropriate course of action.

Interpreted policy language to determine coverage for insureds under various lines of business.

Reviewed medical records, police reports, and other documents related to claim investigations.

Analyzed facts of loss including photographs, diagrams, and other evidence to identify potential sources of recovery.

Negotiated settlements with claimants or their representatives in order to resolve disputes quickly and economically.

Determined reserves for each claim based on estimated costs of settlement or defense. Developed relationships with attorneys, experts, and vendors in order to ensure prompt service when necessary.

Investigated questionable claims to determine payment authorization. Gathered information from various third parties to determine claim acceptability. Maintained accurate documentation of all claim activity within the designated system. Field Interviewer

Los Angeles, CA

Westat/ Feb 2012 to Oct 2017

Conducted in-depth face-to-face interviews with survey participants. Accurately recorded data from survey responses and entered into database. Assessed the accuracy of collected data to ensure quality control. Provided clear instructions to survey respondents regarding interview process. Maintained positive relationships with clients while ensuring compliance with research protocols.

Developed a comprehensive understanding of research objectives, methods and procedures.

Verified respondent contact information and details prior to conducting interviews. Traveled extensively throughout assigned geographic area for field work. Tracked daily activities using provided software applications or mobile devices. Followed strict safety protocols at all times when visiting homes or businesses. Asked questions in accordance with instructions to obtain person's name, address and age.

Disability Claims Specialist

Los Angeles, CA

Spherion Staffing/ Apr 2006 to Feb 2012

Reviewed and analyzed disability claims to determine eligibility for benefits. Provided assistance and guidance to claimants regarding the completion of paperwork and forms related to their claim.

Investigated medical records and gathered evidence in support of approved or denied claims.

Drafted letters of notification for approved or denied claims. Assisted in developing strategies for resolving complex cases involving multiple disabilities, long-term illnesses, or conflicting medical opinions. Ensured that all decisions were made in accordance with applicable laws, regulations, and policies.

Maintained accurate records and files containing detailed information on each claim processed.

Researched state and federal laws related to disability benefits eligibility requirements. Assisted claimants, providers and clients with problems or questions regarding claims. Called insurance companies to ascertain pertinent information regarding policies and payment benefits for patients.

Assisted new policyholders with processing claims. Signed payment approvals accepted claims.

Examined claims, records and procedures to grant approval of coverage. EDUCATION AND TRAINING

Health Information Technology

Ashford University Aug 2014

San Diego, CA

CERTIFICATIONS

AL

AK

DE

FL

GA

IN

KY

LA

MN

MS

NM

NY

NC

OK

OR

SC

TX - home state all lines adjuster license.

PRIOR SKILLS

7 years experience in telesales experience multiple products and services 10 plus years experience customer service experience in both call center environments and regular settings engaging with customers.

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