Customer Service Claims Adjuster

Pamala Baker

Claims Supervisor

Phone Number 727-***-****

Email *************@*****.***

Address Ruskin, FL 33570

EXPERIENCE

Claims Supervisor

Progressive Home, St. Peterburg, FL Aug 2022 - Present Lead Claims Adjuster

Progressive Home, St. Peterburg, FL Aug 2021 - Present I am a reliable, experienced, and highly motivated Senior claim professional. My natural ability to communication to people from all walks of life, allows for excellent written and oral communication skills and building a rapport with both internal and external customers. My experience and solid work history includes over twenty years of excellent customer service skills. My career experience includes supervising a support staff of 5-8 adjusters, successful coach and mentor, high degree of negotiation skills, and ability to mediate claim matters successfully. I have successfully managed a complex and diverse caseload while maintaining compliance, efficiency, and claim resolution. I am committed to being a team player, mentor, and resource to my company while maintaining integrity and honesty in every interaction, both internally and externally.

Responsible for supervising and managing a staff of 5-8 adjusters including Independent Adjusters during catastrophic events.

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Educates and assist with continued upskilling of staff adjuster in relation to policy, development, customer service skills, and appropriate workflows. Develops a coaching plan and assists with brainstorming solutions to concerns.

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• Ensures employees understand company and department strategy and results.

• Analyze problems, develop alternatives and build a consensus for the solution of the problem. Establish job description standards and performance development guidelines to ensure team members have a clear understanding of their role, goals, and the requirements to progress to the next level.

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Collaborate with other departments, customers and insurance companies to resolve claims in an efficient and timely manner.

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• Maximize staff claim investigation capabilities with technical guidance for resolutions.

• Identify training needs to meet job standards, performance guidelines, goals, Company policies and procedures

• Evaluated assigned claims to properly handle or adjust procedures as needed.

• Determine appropriate claim settlement authority and delegated responsibilities to claims representatives.

• Assist with escalation and customer service calls to assist with customer aligned service levels

• Conduct timely reviews of claims to ensure accuracy and completeness of documentation.

• Qualified Substitute and stand in Supervisor based on business needs and in absence of supervisor

• Assisted as a Temporarily Team leader over a team of 6-8 Independent Adjusters in Temporary assignment to monitor daily activity, phone stats, and performance of staff and Independent Adjusters

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• Assisted with Senate Bill 76 in house business process and implementation

• Assist with pre-litigation to include CRN's, DOI complaints and Mediation Senior Claims Adjuster

Progressive Home, St. Petersburg, FL Jun 2019 - Aug 2021 Claim Adjuster

Progressive Home, St. Petersburg, FL Oct 2017 - Jun 2019 Senior Court Records Specialist

Progressive Home, Peterburg, FL Jul 2007 - Oct 2017

• Training and mentoring of peers

Collaboration with leadership and attendance on litigation and Process calls to continue process improvement of the Senate Bill 76 / Notice of Intent to Litigate process

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Investigates, researches, and evaluates complex claims with higher levels of exposure, which are PA/Attorney represented

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• Holistically manages dispute resolution situations with an advanced skill level Senior licensed adjuster on first party claims in the represented claims unit complex unit who handled high exposure loss claims over $100k

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Mediation and Corporate representative for Progressive assigned to mediate claims through the DFS, in relation to dispute and complaints

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• Responsible for review of Civil Remedy notices and Notice of Intent to Litigate and response letters Responsible for all aspects of claim handling related to policy review and interpretation including coverage determination, payments, supplement, claim correspondence

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Conducted interviews, gathered detailed information, evidence and completed field investigations to properly assess claim exposure adhering policy, procedure and guidelines

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• Ability to multitask and meet deadlines in compliance with state compliance and regulations Licensed 620 claims adjuster and file handler serving as Initial point of contact on first party claims from start to finish

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Responsible for obtaining all necessary information to complete proper evaluation of property claim to include all coverages

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Responsible for identifying claims involving liability, subrogation, and special investigations unit and referring when necessary

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• Ensuring proper reserves are set and remain in compliance with state regulations and compliance Properly identifying policy coverage, conditions, and exclusion to make a coverage determination and identify coverage damages

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Complying with company and insurance client's guidelines in claims processes, estimate writing and closing of claims, resulting in appropriate and effective claim processing

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Indemnifying both internal and external customers to include policy holder, vendors, and experts assigned on claim matters

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Responsible for drafting claim correspondence and statement of loss to summarize damages, payments, and underlying policy coverage

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• Responsible for daily written and oral communication

• Ability to negotiate and discuss settlement of claims Lead Employee and assistance supervisor over staff of 10 plus court liaisons to include but not limited to developing staff schedule, oversight, cashier and balancing

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• Prioritized quality control of inventories by regularly reviewing files of all formats.

• Sustained extensive file system by developing and submitting necessary reports. EDUCATION

Certificate in Insurance Adjusters License - 620

Central Florida School Of Insurance, FL Jan 2011

Associate of Arts

St. Petersburg College, FL Jan 2012

SKILLS

CERTIFICATIONS

• Adhered to organizational procedures by consistently performing clerical duties within guidelines.

• Excellent customer service skills High degree of Negotiation and problem-solving skills

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• Xactimate specialist • Ability to understand and interpret policy and law Ability to prioritize, organize, and strategically plan projects, task, and

• • Active listening skills

• Experience with mediations Experience with testing and implementing new business process in

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• Ability to follow through and complete assigned task

• All lines 620 Adjuster License

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