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Claim Adjuster

Location:
Atlanta, GA
Posted:
April 23, 2024

Contact this candidate

Resume:

SUMMARY

Experienced insurance professional with *5-year career assessing properties,

determining liabilities and negotiating settlements. Detail-oriented, observant and knowledgeable with excellent interpersonal and documentation skills. Efficiently handle high case volumes with accuracy and care.

EXPERIENCE

Mutual Of Enumclaw Insurance - Claim Adjuster

Remote, GA • 02/2020 - Current

Pekin Insurance - Multi Line Sr. Claim Adjuster

Phoenix, AZ • 05/2016 - 02/2020

CONTACT

***********@*****.***

520-***-****

Williamson, GA 30292

SKILLS

LANGUAGES

Spanish:

Native/ Bilingual

Diana Valencia

• Reviewed, evaluated and adjusted claims to promote fair and prompt settlement. Negotiated and settled claims according to information presented through reports, research and data verification.

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• Identified and obtained evidence to ascertain claim value.

• Completed required investigations on referred files within established timeframes.

• Obtained necessary information to complete proper evaluation of injury claims.

• Communicated with personnel and legal counsel on claims involving litigation.

• Decreased loss ratios through fair and timely claim processing.

• Reduced loss ratios through fair and prompt processing of claims.

• Reviewed, evaluated and adjusted claims to promote fair and prompt settlement. Negotiated and settled claims according to information presented through reports, research and data verification.

•

Investigated claims, conducted field audits, determined losses and reported findings.

•

• Obtained necessary information to complete proper evaluation of injury claims.

• Gathered information from various third parties to determine claim acceptability. Drafted statement of loss to summarize damages, payments and underlying policy coverage.

•

• Communicated with personnel and legal counsel on claims involving litigation.

• Decreased loss ratios through fair and timely claim processing.

• Reduced loss ratios through fair and prompt processing of claims.

• Interviewed claimants, medical specialists and employers to determine pertinent

• Rules of Evidence

Workers' Compensation

Claims

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• Automobile Appraisals

• Insurance Fraud Expertise

• Title Examination

• Case Presentation

Property Owner

Representation

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Legal Documentation and

Reporting

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• Vehicle Damage Assessment

• Complex Mathematics

• Property Damage Assessment

• Medical Coding

• Sales Background

Medical Terminology

Specialist

•

National Lloyds - Sr. Claim Adjuster

Waco, TX • 05/2016 - 07/2020

claim information.

• Reviewed, evaluated and adjusted claims to promote fair and prompt settlement. Negotiated and settled claims according to information presented through reports, research and data verification.

•

Investigated claims, conducted field audits, determined losses and reported findings.

•

• Identified and obtained evidence to ascertain claim value.

• Investigated questionable claims to determine payment authorization. Drafted statement of loss to summarize damages, payments and underlying policy coverage.

•

• Communicated with personnel and legal counsel on claims involving litigation.

• Decreased loss ratios through fair and timely claim processing.

• Reduced loss ratios through fair and prompt processing of claims. Interviewed claimants, medical specialists and employers to determine pertinent claim information.

•



Contact this candidate