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Customer Service Workers Compensation

Location:
Riverview, FL
Salary:
100,000 - $150,000
Posted:
February 07, 2024

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Resume:

Allison Hunte ad3gcl@r.postjobfree.com

***** *** **** ** *********, FL 33579 813-***-****

SUMMARY OF QUALIFICATIONS

A dedicated and hardworking professional with over 20 years of property, causality, workers compensation, liability, ocean and inland marine insurance adjusting skills, customer service skills, and loan processing skills. Proven track record in investigating and adjusting moderate to large residential commercial property and ocean marine claims presented by the insured to ensure claim validity and settlement value. Recognized as visionary and creative thinker adept at providing the highest level of customer service. Capable of confirming coverage, reviewing various property insurance coverage forms, explaining procedures, and answering inquiries for adjusting property claims. Proven ability in providing quality claims handling and superior customer service on assigned claims while engaging in indemnity and expense management. Promptly makes required assignments to independent adjusters, appraisers, and engineers; provided them with needed direction. An innovative problem solver and effective insurance claims adjuster who maximizes productivity and controls cost. Outstanding leadership skills with the ability to develop long lasting, trusting, and profitable relationships.

Areas of Expertise:

• Acurity

• Citizen Certified

• ClaimCenter

• CMS

• Facts

• File Track

• Guidewire

• Handling EUO Claims

• Handling Mediation Files

• Image Right

• Xact Analysis

• Xactimate 28

• Island

• SIMS Claims

• Symbility Estimation

EDUCATION

Krishna College Guyana, South America

Public Relation Management June 1993

Florida School of Insurance Brandon, FL

Hillsborough Community College Tampa, FL

LICENSES AND CERTIFICATIONS

Florida- Home State E-144607

Georgia - 8288125

Hawaii - 8288125

Indiana - 782593

Kentucky- 640596

Louisiana - 512446

Michigan - 8288125

Minnesota - 40014107

New York - 1371246

South Carolina - 8288125

Texas - 1388843

NFIP 30002746

440 License CSR

Currently in pursuit of AIC license.

PROFESSIONAL EXPERIENCE

AllCat Claims Services/Multiple Carries Remote location. General Adjuster for Commercial and Residential August 2016 – January 2024

• General Adjuster (multi-states) middle market commercial losses involving golf courses, retail, restaurants, petroleum jobber, law firms, long term care, dental/medical municipalities, Inland Marine

(large equipment, valuable papers).

• Responsible for investigating, determining appropriate coverage and settling property (building and business personal property) and business interruption claims.

• Handled wind, hail, flood, freeze, foundation, wildfires, theft, water vandalism and various types of catastrophe and non-cat losses.

• Liability Med pay claim, bodily injuries and lost wages.

• General knowledge of legal process handling Worker compensation claims-

• Managed Medical Only and Lost time claims, the Federal Employers Liability Act (FELA) for interstate railroad workers, U.S. Longshoremen and Harbor Workers Compensation, for loader, unload, builder, and repair ship crew.

• Handle The Jones Act and Merchant Marine Act claims for injured sailors by the negligence of others. United Property and Casualty Insurance Company Remote Location MillsMehr – Claim Examiner Aug 2015 – Aug 2016

• Offsite Claim Examiner handling property claims in multiple states (19 states) including, but not limited to Florida.

• Policy interpretation of various homeowner’s policies included Florida Citizens. Responsible for investigating, determining appropriate coverage and settling claim.

• Handle contents, ALE, SIU, subrogation and salvage.

• Negotiate settlement with Insured, Public Adjuster and/or Attorney. CNA Insurance Denver, CO / Metairie, LA

Commercial Property/Ocean Marine - Claim Adjuster December 2012- April 2015

• Demonstrated expertise in managing a case load of 150 on diary and various kinds of commercial policies, such as: builder risk, precision policy, heavy equipment, package policy, and fiduciary, apartment complex, condo/homeowners association, lessor's risk, motels/hotels, including: resorts and casinos, office buildings, restaurants, bars, and taverns, shopping centers, vacant property, churches, day care, golf courses, schools, and new construction under Inland Marine Financial Institution.

• Recognized and referred claims to the subrogation department and potential fraudulent claims to the SUI department. Handled daily claims for theft, vandalism, employee dishonesty, water, fire etc.

• Experienced in handling total losses and determining coverage for contents, spoilage, business interruption, dependent property, off premise power, tools & equipment, trees and shrubs, signs, etc. Reviewed bids and estimates from contractors. Disputed claims with Attorneys, Adjuster, and contractors.

• Adjusted hull and machinery, cargo, liability and recreational marine insurance. State Farm Insurance Companies Various Locations

Auto Claim Adjuster October 2011 – August 2012

• Obtains information and maintains records of accidents or personal property losses for policyholders and claimants through telephone and written reports. Arranges and reviews appraisal reports while communicating with policyholders, claimants, physicians, medical providers, attorneys, and repair shops.

• Secures essential facts about accidents, assesses liability and compensability, negotiates settlements, as well as explains denials to policyholders and claimants. Duties include registering claims, updating status notes, establishing target dates, scheduling appointments, and releasing payments on automated system.

• Actively trains new members in the support unit developing strong leadership and mentoring skills.

• Adjusts claim types, inspects damaged property and vehicles, and determines claims related damage.

• Reviews requests and policy issuance information for completeness and compliance with guidelines.

• Verifies completion and validity of claims forms and documents for transactions to ensure quality control.

• Investigates the insurance company’s liability concerning personal, casualty, or property loss and damages.

• Prepares reports of findings and calculates benefit payments of claims within a certain monetary limit.

• Management recognized for ability and perseverance to recover large sums of money on invalid claims. Homewise Insurance Tampa, FL

Homeowner Claims Adjuster December 2009 – August 2011

• Handled daily claims for 3 states for all perils while preparing denial and partial denial letters as needed.

• Consistently examined adjusters’ reports to ensure adherence to client and company standards.

• Conducted training with adjusters on customer guidelines as well as policy and coverage issues.

• Worked closely with client management for large losses and denials. Assigned experts as needed to determine cause of loss. Negotiated claims settlement within authority of Public Adjusters and Attorneys. Handled all litigation and appraisal files.

United Property and Casualty Insurance Company Saint Petersburg, FL FreeState Staffing – Claim Examiner May 2009 – September 2009

• Maximized updated knowledge in handling appraisal, EUO, and mediation file from beginning to end.

• Researched, analyzed, and interpreted the latest approved state law as it applies to submitted claims.

• Maintained advanced understanding of all company policy coverage. Worked with insured, Public Adjusters, Attorneys, and business partners regarding the handling and/or disposition of claims and other issues.

• Routinely negotiated and participated in planning strategy and negotiating within scope of authority. Zurich North America Tampa, FL

Multi-Line Claim Examiner for Commercial Claims September 2008 – January 2009

• Demonstrated expertise in managing a case load of 150 on diary and various kinds of commercial policies, such as: builder risk, precision policy, heavy equipment, package policy, and fiduciary, apartment complex, condo/homeowners association, lessor's risk, motels/hotels, including: resorts and casinos, office buildings, restaurants, bars, and taverns, shopping centers, vacant property, churches, day care, golf courses, schools, and new construction under Inland Marine Financial Institution.

• Recognized and referred claims to the subrogation department and potential fraudulent claims to the SUI department. Handled daily claims for theft, vandalism, employee dishonesty, water, fire etc.

• Experienced in handling total losses and determining coverage for contents, spoilage, business interruption, dependent property, off premise power, tools & equipment, trees and shrubs, signs, etc.

• Reviewed bids and estimates from contractors. Disputed claims with Attorneys, Adjuster, and contractors. Assurant Scottsdale, AZ

Homeowner Claims Adjuster January 2008 – September 2008

• Managed daily claims in 49 states for all perils. Examined Adjusters’ reports to ensure adherence to standards.

• Reviewed Adjusters’ estimates by using MSB and XactAnalysis platform to consistently ensure compliance with company guidelines and policy provisions, and recommended payment over authority limit.

• Conducted training with Public Adjusters on client guidelines as well as policy and coverage issues.

• Monitored sinkhole claims. Reviewed Engineer’s report to determine if there is sinkhole activity and recommended payment for cosmetic damages and grouting. Prepared denial and partial denial letters.

• Worked closely with client management to identify possible resolution for large losses and denials.

• Assigned qualified experts as needed to determine cause of loss and shape resolution to eliminate loss.

• Successfully negotiated claims settlement within authority and with Public Adjusters and Attorneys. Zurich North America Schaumburg, IL

Multi-Line Claim Examiner for Commercial Claims September 2005 – November 2007

• Handled daily and catastrophic claims resulting from Hurricane Dennis, Ophelia, Katrina, Rita, and Wilma.

• Managed various kinds of commercial claims, such as: builder risk, precision policy, heavy equipment, package policy, and fiduciary, apartment complex, condo/homeowners’ association, lessor's risk, motels/hotels, including resorts and casinos, office buildings, restaurants, bars, and taverns, shopping centers, vacant property, churches, day care, golf courses, schools, new construction processes.

• Determined coverage for contents, business interruption, dependent property, off premise power, tools and equipment, trees and shrubs, signs, etc. Experienced in handling total losses for both contents and building.

• Reviewed bids and estimates from contractors. Disputed claims with Attorneys, Public Adjuster, and general contractors. Referred claims to the subrogation department and potential fraudulent claims. Apple One/Crawford and Company Tampa, FL

Property/Ocean Marine Claims Adjuster August 2004 – September 2005

• Adjusted hull and machinery, cargo, P&I, liability and recreational marine insurance.

• Consistently inspected commercial and residential properties for wind, water and sinkhole damages.

• Handled daily and Hurricane claims while inputting measurements and sketching building structure into Xactimate. Experienced in processing procedures for claims using AS/400 system and Xactimate.

• Responsibilities included: writing estimates and photographing properties, reviewing appraisals and estimates, comparing estimates with photos, paying total losses, and assisting in the Billing Department.

• Compiled and coordinated results of findings, and recognized cases based on severity assessment protocols.

• Demonstrated ability in securing all client files in accordance with legal regulations and company policies.

• Performed estimates on cost of parts, materials, and labor needed to restore vehicle to their pre-loss condition by negotiating damage settlements and accurately determining conclusions to total loss vehicles. Paymap, Inc. Tampa, FL

Customer Service Representative (Appleone) January 2003 – August 2004

• Enrolled customers into biweekly mortgage payment program to meet weekly enrollment of 45 or more.

• Financially consulted with customers about the current status of their loans or mortgage payments.

• Recorded and documented all conversations with clients and processed mortgage applications accordingly.

• Provided superior customer service by servicing customer needs and addressing concerns efficiently.

• Dealt with various difficult and escalated account maintenance customer issues on their accounts. JP Morgan Chase Bank New York, NY

Loan Processing December 1999 – October 2002

• Conversed with brokers and applicants concerning loan status and specified documentation for approvals.

• Processed and ordered title certificates, flood certificates, MI certificates, mortgage insurance, and appraisals.

• Regularly scheduled closings and worked as a liaison between builder, title company, and borrowers.

• Demonstrated ability in handling procedures in the performance of various duties relating to Mortgage Loan Servicing, such as: data entry consisting of fully processed submission packages, and automated LP systems as well as coordinating all applications, files, and entered onto a mainframe system.

• Deeply experienced in preparing closing documents for Senior Closers and Funders; scheduled closings.

• Prepared monthly reports and timesheets while reconciling and updating billing and account information. EquiServe Bank (Archer Management Services) New Jersey City, NJ Loan Processor May 1996 – December 1999

• Conducted processing of Refer loans by ordering verifications of employment, deposits, rentals, and mortgages.

• Responsibilities included: underwriting Conventional and FHA Accept loans by fully processing of Brokered/Investor loans, maintaining reports and loan status, analyzing credit reports, ordering supplements and all verifications, and maintaining good customer service ethics with a score of above 3.50.

• Processed all FHA, VA, and Conventional loans according to program guidelines in a timely manner.

• Developed exceptional organizational skills in performing administrative and clerical duties. Utilized strong data entry skills and ordered appraisals, title commitments, insurance, and wiring instructions.



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