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Customer Service Claims Adjuster

Location:
Tampa, FL
Salary:
75,000
Posted:
March 14, 2024

Contact this candidate

Resume:

Charwin Diggs

TAMPA, FLORIDA

813-***-****

ad4b59@r.postjobfree.com

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PROFILE

Experience and self-motivated property and auto claim adjuster. Professional with 15 years industry experience. Bringing forth a proven track record of successfully managing basic, complex and represented claims effectively and efficiently. Ability to handle all negotiations and settlement offers with attorneys and public adjusters. Ability to handle multiple coverage exposures. Extensive knowledge of FEMA/ NFIP Program. EDUCATION

Adjuster Licenses: Active FL, TX, LA, SC, NC, MS, NV, NM, AL and GA Strayer University - Charlotte, NC — Master of Public Administration AUG 2007 - MAY 2010

The University of North Carolina at Charlotte – Charlotte, NC AUG 2004 - MAY 2007

EXPERIENCE

The Best Claims Solutions: St. Petersburg, FL 11/2022 – 12/2023 Sr. Property Claims Adjuster/Represented Claims Unit

Analyzed potential litigation risks and provided strategic advice to leadership on mitigating and resolving disputes.

Maintained all Key Performance Indicators (KPIs) average throughout assignment with Progressive Home.

Committed to a high level of customer service while responding to incoming calls and supplemental claim review requests.

Review estimates for accuracy and maintain constant communication with field adjusters to ensure smooth transition with public adjusters and attorneys.

Negotiated with contractors on scope of damages and cost of repair.

Determined if tile/shingle roofs are damaged due to submitted cause of loss.

SKILLS

Proficient Microsoft Suite

NFIP Certified FCN70006104

Xactimate, Xactanalysis

Communication Skills

Policy Interpretation

Training and Presentations

Budgeting and Analysis

FEMA Badge Holder

Conflict Resolution

State Farm Auto Certified

State Farm Property Certified

Knowledge

Litigation Administration

FEMA Contractor – Federal

Emergency Response Official,

Zone Field Adjusting

Desk Adjusting

CAT Claim Handling

Assignment of Benefits

NFIP Certified

Attended and successfully defended in Arbitration and Appraisal.

Compass Adjusting Services: Sarasota, FL 03/2021 - 11/2022 Sr. Property Claims Adjuster

Review and investigate coverage for assigned claims.

Maintained an 85% overall Key Performance Indicators (KPIs) average throughout career with carrier Universal Insurance.

Maintained a high level of customer service while responding to incoming calls and supplemental claim review requests.

Review estimates for accuracy and maintain constant communication with field adjusters to ensure smooth transition with the customer.

Assisted customers in finding vendors in areas where program vendors are not available.

Closed claims to the satisfaction of the customer and the carrier as per best claims practices.

Responded to assigned claims by making initial contacts, setting up mitigation, remediation and general contract vendors to assist insured in navigating the claims process.

Ensured appropriated claims with fraudulent indicators are referred to SIU department.

Progressive Home/American Strategic Ins: Tampa, FL. 3/2018- 03/2021 Water/Fire Property Claims Adjuster

Maintained an 80% overall Key Performance Indicators (KPIs) average throughout career with carrier.

Conducted prompt and thorough investigations to determine policy coverage.

Evaluated facts of the loss and interpreted state, local and federal laws and regulations.

Carefully reviewed all claim information to ensure accuracy and avert fraudulent claims.

Provided customer service to policyholders, third-party administrators, and public adjusters.

Collaborated with field and independent adjusters to assess damages.

Produced documents throughout the claims process.

Negotiate claims settlements using expertise and research- based judgments.

Solve problems and brainstorm solutions to reach the best claim practices and financial outcomes.

Charter Catastrophe Services, Inc.: Houston, TX 9/2017 – 1/2018 Site Inspector

Conducted site inspections: validated infrastructure damage; recorded detailed damage descriptions, scopes of work and cost estimates. Evaluated projects for compliance with applicable laws, regulations, policies and NFIP/FEMA guidelines.

Identified and reviewed special consideration issues and Submitted findings to various insurance companies for their review and approval and/or corrections. Completed field reviews for FEMA.

Managed numerous projects at once while identifying damages, interpreting risk potential for mitigation measures and developing cost estimates for repair.

Reviewed Damage Descriptions and Dimensions (DDD), scopes of work and cost and ensured that all damages identified by the Write Your Own (WYO) carriers are addressed.

Facilitated review of the Disaster Operating Profile (DOP) developed which assisted in forecasting resource

requirements.

BrightClaim: Atlanta, GA 8/2016- 8/2017

Homeowners Property & Litigation Specialist

Reviewed and Investigated coverage for assigned claims after initial contact and information gathering from insured, attorney or public adjuster.

Took necessary steps to properly investigate liability, including obtaining statements from parties involved and reviewing reports.

Reviewed claims for potential fraud indicators.

Escalated complex issues to the appropriate department or supervisor as needed.

Responded to incoming mail, emails and phone calls in a timely manner. Minimizing escalation.

Accurately recorded and document customer interactions, transactions, and feedback in the company's database.

Provided excellent customer service to both policyholders and claimants.

Other duties as assigned.

EA Renfroe: Birmingham, AL 7/2014 – 6/2016

External Claims Specialist State Farm

Maintained a 90% overall Key Performance Indicators (KPIs) average throughout career with carrier.

Interacted with customers via phone, email, chat, or in-person to address inquiries, provide information, and resolve claim issues.

Maintained a professional and friendly demeanor while representing the company.

Identified and analyzed customer concerns and provided appropriate solutions in a timely manner.

Escalated complex issues to the appropriate department or supervisor as needed.

Developed a deep understanding of the company's products or services to effectively address customer questions and concerns.

Accurately recorded and documented customer interactions, transactions, and feedback in the company's database.

Provided clear and concise information about products, services, and company policies including coverage evaluation and liability determination.

Ensured that customer service standards are consistently met or exceeded.

Worked closely with other departments to address customer concerns that require cross-functional collaboration. Nationwide Mutual Insurance Company: Raleigh, NC 1/2011 – 7/2014 Desk Claims Adjuster

Maintained an 80% overall Key Performance Indicators (KPIs) average throughout career with carrier.

Investigated, evaluated and settled insurance claims for both property and automobile Bodily Injury (BI) claims.

Ensured that claims are reviewed for fraud indicators. Referred to Special Investigation Unit (SIU) as needed.

Contacted claimants’ employers and doctors for additional information if the claim is questionable.

Identified and analyzed customer concerns and provided appropriate solutions in a timely manner.

Conferred with legal counsel when needed on coverage determination and liability decision.

Negotiated settlements and authorized payments up to extended reserve payments limits.

Utilized analytical skills to evaluate coverage determination via a thorough coverage investigation.

REFERENCES

Julian Sutton from Progressive Home Insurance

ad4b59@r.postjobfree.com/ 813-***-****

Justun Vickers from Compass Claims Solutions

ad4b59@r.postjobfree.com/ 214-***-****



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