Claims Adjuster Customer Service
Resume:
CERTIFICATION
EDUCATION
Highly skilled and dedicated Professional Claims Adjuster who is detail-
oriented and able to handle multiple tasks simultaneously, while maintaining a high level of customer satisfaction. An experienced team player adept at working within company policies to coordinate and negotiate with multiple policyholders and contractor. P ROFESSIONAL EXPERIENCE
P ROFILE
Mobile, AL 36609
**********@*****.***
MALESIA
R I C H A R D
CONTACTS
HEALTH INFORMATION MANAGEMENT
Alabama State University
2001
MEDICAL RECORDS TECHNICIAN
Bishop State Community College
1998
Adjuster All Lines Certification
State Farm Auto Adjuster Certification
Property Adjuster Certification
PROPERTY ADJUSTER / Pilot Catastrophe
December 2022 –November 2023
• Worked with insure to interpret policy, write damage estimate of property damage, and communicating coverage details.
• Provided excellent customer service to policy holders after suffering a loss by working closely with internal departments to decide and apply proper coverage.
• Identified potential fraud and subrogation opportunities.
• Settled third-party property liability claims, along with property damage, theft, and jewelry claims.
• Developed and delivered training to employees within the unit.
• Worked and negotiated with various vendors to oversee replacements and repairs.
• Collaborated with contractors, technicians, and vendors on complex losses.
• Prepared comprehensive reports used to negotiate purchase price or repair of properties.
TEAM LEAD AGENT ADVOCATE / Pilot Catastrophe
August 2021 –November 2022
• Conducted coverage and liability investigations on assigned claims.
• Maintained direct contact with insured claimants, witness, agents, attorney, and repair facilities.
• Maintained up-to-date knowledge of claims settlements procedures, current state regulations, and policy changes.
• Determined responsibility and negotiating settlements with insured or claimants.
• Processed property damage and additional expense payment.
• Handled and resolved customer complaints.
• Collaborated with claims department and industry anti-fraud organization to resolve claims.
• Assessed claim damages for hail claims, collision claims, CAT claims, and property claims.
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EXPERIENCE c o n t i n u e d
SALES ASSOCIATE / Dillard’s
October 2019 – August 2021
• Greeted customers in a timely fashion while quickly determining their needs.
• Recommended merchandise to customers based on their needs and preferences.
• Maintained knowledge of current sales and promotions, policies regarding payment and exchanges and security.
• Cleaned, stocked, and organized tasks in the assigned sales area.
• Built relationships with customers to increase the likelihood of repeat business.
PATIENT FINANCIAL REPRESENTATIVE / GetixHealth
June 2018 – October 2019
• Inputted data entry and detailed documentation of scheduled health care services used for billing.
• Collected of monies due for non-covered portion of hospital services.
• Notified insurance companies of hospital authorization of medical services and collections.
• Followed all federal, state and payer specific regulations and policies pertaining to documentation and billing practices to ensure all work follows established guidelines.
INSIDE AUTO ADJUSTER / Pilot Catastrophe
August 2017 – June 2018
• Conducted coverage and liability investigations on assigned claims.
• Maintaining direct contact with insured claimants, witness, agents, attorney, and repair facilities.
• Maintained up-to-date knowledge of claims settlements procedures, current state regulations, and policy changes.
• Determined responsibility and negotiating settlements with insured or claimants.
• Processed property damage and additional expense payment.
• Handled and resolved customer complaints.
• Collaborated with claims department and industry anti-fraud organization to resolve claims.
S K I L L S
Analytical Thinking
Strong Communication
Accuracy
Detail- Oriented
Organization
Prioritization
Problem Solving
Team Leadership
Microsoft Suite
Interpersonal
Customer Services
Policy & Procedures
Xactimate
Negotiation
Policy Knowledge
Nextgen, CC1, Audatex
MALESIA
R I C H A R D
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