Customer Service Insurance Claims

OB Orville Barrington Wright

Alabaster, AL ***** 205-***-**** **********@***.***

Bold Profile

PROFESSIONAL

SUMMARY

Dedicated Independent insurance ADJUSTER professional with diverse cross functional background coupled with an excellent record in investigating and processing insurance claims. Proficient in interpreting policies, negotiating settlements and takes pride in providing exemplary customer service. SKILLS Claims Handling and

Investigations

Policy Interpretation and

Evaluation of Liability Exposure

Claims Evaluation

Litigation Management

Policy Interpretation

Liability Analysis

Settlement Negotiation

Hail, wind and flood damage

specialist

Coverage Determination

WORK HISTORY INDEPENDENT CLAIMS/CAT ADJUSTER 02/2016 to 09/2023 Pilot Catastrophe Services, REMOTE

Performed field investigations to handle catastrophic claims including wind, hail and flood losses

Documented information gathered in field and uploaded data to company database for efficient processing using Guidewire/Enterprise Claims System..

Ensured regulatory compliance in handling claims by adhering to state laws, insurance policies, and company guidelines.

Completed total loss evaluation of claims and ensure prompt and equitable payment to policyholders.

Identified insurance coverage limitations with thorough examinations of claims documentation and related records.

Investigated and assessed damage to property and reviewed property damage estimates.

Investigates and evaluates damage and/or liability; estimates damages, losses, or total indemnity; sets and maintains reserves; and/or negotiates and settles claims.

FILE/PROPERTY CLAIMS EXAMINER 04/2011 to 06/2021

E. A. RENFROE & COMPANY REMOTE

Conduct evaluation of total losses and handle decision making in line with claims and local laws

Investigates, analyzes and interprets policy to determine coverage and payment.

Negotiated fair settlements with policyholders and contractors to achieve equitable resolutions for all parties involved.

Manages inventory of claims to evaluate compensability/liability. Establishes action plan based on case facts, best practices, protocols, regulatory issues and available resources.

Plans and conducts investigations of claims to confirm coverage and to determine liability, compensability and damages.

Assesses policy coverage for submitted claims and notifies insured's of any issues; determines and establishes reserve requirements, adjusting reserves, as necessary, during processing of claim, refers claims to Subrogation group or Special Investigations Unit as appropriate. Assesses actual damages associated with claims and conducts negotiations, within assigned authority limits, to settle claims. CONTRACT MEDIATOR 01/2005 to 06/2011

Florida Department Of Financial Services Tallahassee, FL Devised and implemented dispute resolution processes for companies, enabling fast resolution of disputes.

Resolved conflicts by applying mediation techniques and fostering open communication between disputing parties.

Maintained up-to-date knowledge of industry trends, laws affecting mediation practice, and professional ethics standards through continual professional development activities.

Created safe and neutral environment for parties to openly discuss their concerns, promoting constructive dialogue.

Used mediation techniques to facilitate communication between disputants, to further parties' understanding of different perspectives and to guide parties toward mutual agreement.

Assisted clients in drafting agreements that accurately reflected negotiated terms and conditions of settlements.

EDUCATION Master of Science Business Administration 10/2001 Columbia Southern University, Orange Beach, AL

Bachelor of Science Business Administration 12/1999 Columbia Southern University, Orange Beach, AL

CERTIFICATIONS Training in Basic and Advanced Mediation and Arbitration Certification from FINRA and the USPS REDRESS Program.

Licensed as an Independent Adjuster in AL, AR, AZ, GA, FL, KY, LA, MS, MI, MN, MT, OK, TX, SC MTR VEH appraiser, SC, NC, WA, WV. SKILLS ADDITIONAL Able to use Microsoft Windows computers including Excel, Word, Access, Outlook.

State Farm Enterprise Claims System, Mitchell, and Audatex

Contact this candidate