Customer Service Claims Adjuster
Resume:
Dovie Harrison
Chandler,Arizona Ph:UponRequest *****.**@*****.***
Professional Summary
Dynamic and results-driven Licensed Claims Adjuster and Fraud Investigator with a proven track record in uncovering fraud and managing complex claims. Eager to leverage my analytical skills, meticulous attention to detail, and passion for justice in a challenging role that safeguards organizational integrity and customer trust. Ready to bring my expertise in risk assessment and exceptional customer service to a forward-thinking company committed to excellence and innovation in claims management.
Professional Skills
●Claims Processing
●Document management
●Data Analyst/ Analytical Thinking
●Risk Assessment
●Claims Investigation
●Damage Assessment/ Exposure analysis
●AML Compliance
Employment History
Clearcover Insurance- Chicago, IL September 2022- April 2024
Claim Associate/Express Licensed Claims Adjuster (Remote)
●Conducted comprehensive investigations into injury and physical damage claims, meticulously gathering and analyzing evidence, statements, and police reports to accurately determine liability and coverage.
●Utilized expertise in medical terminology and injury claims to assess the reasonableness and necessity of medical expenses, ensuring fair and timely settlements through negotiations with claimants, legal representatives, and medical professionals.
●Proactively identified and flagged potential fraud during claims investigations, applying critical thinking and attention to detail to protect the company’s financial interests while maintaining compliance with all relevant regulations.
●Delivered exceptional customer service by guiding policyholders through the claims process, resolving complaints promptly, and maintaining open, empathetic communication to build sustainable relationships and trust.
●Efficiently managed a high volume of customer interactions via email, chat, text, and phone, ensuring accurate documentation and contributing to the team’s Knowledge Base to improve process and product information.
●Coordinated seamlessly with appraisers, body shops, and other involved parties to ensure accurate repair estimates, negotiate fair terms, and resolve disagreements, resulting in efficient claim settlements and high customer satisfaction.
Early Warning Service LLC - Scottsdale, Az October 2018- September 2022
Consumer Services Analyst II - Fraud Operations (Remote)
●Expertly identified, investigated, and mitigated potentially fraudulent activities during customer interactions, employing analytical skills and technical knowledge to protect user accounts and transaction integrity.
●Conducted comprehensive research and investigations into user transactions, utilizing various technologies and data analysis techniques to detect patterns, identify trends, and make informed decisions to mitigate fraud risks.
●Reviewed and analyzed OFAC (Office of Foreign Assets Control) and Memo Screening Reports to ensure compliance with regulatory requirements, accurately clearing false positives and reporting confirmed matches.
●Provided exceptional technical guidance and customer support in a high-volume, metrics-driven call center environment, maintaining engagement and empathy while addressing complex issues involving fraud, technical support, and customer inquiries.
●Demonstrated strong problem-solving abilities and sound judgment in navigating unstructured customer interactions, ensuring appropriate outcomes while upholding the company's risk management policies and protecting system confidentiality.
DCFP JPMORGAN CHASE- Tempe, AZ January 2014 –March 2016
Fraud Specialist I&II / Development Coach
●Developed and implemented advanced strategies to detect emerging trends in financial crimes, utilizing data analysis and monitoring transaction activities to identify potential violations and suspicious patterns.
● Conducted thorough investigations of suspicious transactions and customer accounts, gathering and analyzing information to assess financial crime risks, determine the occurrence of illicit activities, and recommend corrective actions.
●Advised upper management on policy changes and recommended improvements to internal controls, reducing the risk of financial crime exposure and ensuring compliance with relevant laws, regulations, and guidelines.
●Provided comprehensive training and coaching to new hires and existing staff, enhancing performance levels and ensuring adherence to procedures and protocols, while leveraging e-learning platforms for effective remote content delivery.
●Collaborated with management to identify organizational training priorities, designed assessments to measure skill improvement, and evaluated the effectiveness of training sessions, contributing to the development of a highly skilled and compliant workforce.
●Monitored and reviewed customer account activities for signs of money laundering and other illicit behaviors, utilizing various software tools and databases to gather and analyze pertinent information, ensuring timely reporting to management and authorities.
JPMORGAN CHASE
MERCHANT SERVICES
July 2017- October 2018
Tempe, AZ
● Class room training for pega and cst systems
● Working refunds for Merchant accounts/locating offset transactions
● Resubmitting refunds for Merchant accounts
● Reviewing transactions/refunds to see if they’re eligible to be refunded
● Managed client relationships by providing ongoing support and communication.
● Educated clients on fraud prevention strategies and tools available through their
merchant services account.
● Maintained knowledge of industry trends and changes to stay current with best practices.
● Provided support during high-volume periods or staff shortages as needed.
● Class room training for pega and cst systems
● Working reforMerchant accounts/locating offset transactions/recovering funds
● Able to identify risk and trends
● Resubmitting refunds for Merchant accounts
● Reviewing transactions/refunds to see if they’re eligible to be refunded.
Education
International Commerce High School- Tempe, Arizona
High School Diploma December 2011
Kaplan Financial
Texas Property & Casualty Adjuster December 2022
●Adjuster P&C DHS TX
(Reciprocal in multiple States)
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