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Experience Claims/Operations Leader

Location:
Queen Creek, AZ
Posted:
March 24, 2020

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Resume:

K. Jake Derden

Cell: 951-***-****) - Email: adcfma@r.postjobfree.com

Experienced leadership in the management and administration of multi-line, multi-office claims operations. Established record of developing and implementing strategic solutions that result in increased productivity and overall quality. Proven ability to capitalize on opportunities that improve profitability, performance, and engagement while leading a large diverse team to achieve key objectives.

Customer Service & Satisfaction

Developing & Retaining Talent

Policy & Coverage Interpretation

Strategic & Operational Planning

Personnel Management

Budget Analysis & Management

Loss Severity & Expense Control

Authority & Decision Making

Quality & Regulatory Compliance

PROFESSIONAL EXPERIENCE

ESURANCE 2017-2020

Senior Claims Manager-Mesa, AZ

Managed claims operations, monitored performance and worked with management team to achieve stated goals, managed all QA activities, monitored workflow, staffing, and directed the training needs of office personnel.

Managed the reports on claims branch performance against the stated performance and quality standards.

Created action plans in response to file audits and/or directives.

Worked with management staff to ensure proper workflow and process management.

Coordinated activities with the SIU and MD to ensure proper process, direction and training is given to the staff.

Managed and monitored all high-exposure and complex files and works with the litigation management for

monitoring.

Ensured best practices are followed and continually seeks improved processes.

Monitored and participated in quality control and reviews.

Managed expenses to plan and allocated loss adjustment expense

Participated in the establishment of department goals and for implementing procedures and performance

standards to achieve these goals; Manages, coordinates, monitors and evaluates the activities of department

staff directly or through subordinate supervisors.

Responsible for the employment, promotion, associate performance evaluation, training, motivation, counseling, and discipline of assigned associates.

AMERIND RISK 2015-2017

Underwriting Manager—Albuquerque, NM

Oversaw and managed the risk and underwriting operations to ensure that policies are properly processed and rated. Analyze statistical data and construct probability tables to forecast risk and liability for payment of future claims. Ascertained premium rates required and cash reserves necessary to ensure payment of future claims.

Communicated goals, objectives, policies and procedures in accordance with applicable tribal, federal, state, and local laws, rules and regulations.

Managed book of business, drove new business and retention of current clients.

Resolved customer complaints regarding sales and service.

Hosted regular staff meetings to ensure communication between personnel and departmental activities.

Achieved financial objectives by preparing and administering annual budget; presenting and justifying budget recommendations.

NEW MEXICO STATE RECOVERY 2013-2015

Owner/Operator--Albuquerque, NM

Repossession of property from buyers who have defaulted on payments.

Area includes States of New Mexico, Colorado, Arizona

Sales conferences with lending institutions to gain new business.

Manage day to day operations of a small business.

FARMERS INSURANCE EXCHANGE 1997 – 2013

Claims Service Center Manager – Fresno, CA & Riverside, CA 2007-2013

Lead the handling and adjustment of personal lines (auto and homeowners) and commercial auto claims within large geographical territory with $150,000 indemnity authority. Directs all phases of a Claims Service Center. Including Auto Physical Damage and Liability. Managed 100+ staff.

Prepared and controlled budget, quarterly operations and strategic business plans for multi offices operations.

Oversaw the hiring, training and development of all employees. Coaching focused on behavior, technical ability and overall employee engagement to ensure job satisfaction and sustainment of staff.

Oversight and direction for the day-to-day operations of the center and liaison between the center and up line management.

Responded to all Department of Insurance complaints and market conduct examination inquiries.

All operational responsibilities, including managing fleet of 50 to 60 company vehicles.

Field Claims Manager, Ventura, CA 2005-2007

Directed all phases of a Field Claims Office, including Auto Physical Damage and Liability. Prepared and controlled budget, quarterly operations and strategic business plans for office of six supervisors, forty claims representatives and four clerical staff.

Field Claims Supervisor, Albuquerque, NM 2002-2005

Provided leadership and support for the day-to-day adjustment and administration of complex claims. Monitored performance and prepared statistical analysis reports for management review. Conducted quality assurance audits while leading a successful team to exceed company expectations.

CRN User Counsel Member 2/03 to 2/06. Team Leader 5/05 to 2/06.

Liability/Auto Charter Group 2004 Field Claims Supervisor Best Practices Team

West Zone field trainer for Standard Claims Review

Liability Portal Administrator 8-04 to 1-06

HelpPoint Staff Claims Supervisor/Claims Trainer, OKC, OK 2000-2002

Developed/created training material for and instructed training classes in CRN/Siebel, OCR Specifics, Auto Physical Damage, Liability, Basic Insurance, Network and APPS/FPPS. Classes ranged from up twenty-eight claims representatives and lasted six weeks. Supervised staff of one.

Senior Claims Representative, Phoenix, AZ 1997-2000

Responsible for investigating and effectively negotiating personal lines automobile and homeowners claims within established authority towards resolution while focusing on delivering exceptional customer service to all internal and external customers. Attended small claims court hearings, superior court trials, arbitration hearings, and settlement conferences while working to accurately adjust and handle claims towards a fair and amicable resolution. Successfully handled first and third party injury (BI, UM & UIM) and property damage claims.

CERTIFICATIONS & PROFESSIONAL DESIGNATIONS

AINS, AIS, AIC

AICPCU IIA – Courses: INS 21, 22, 23 & Ethics 311, AIS 25, AIC 33, 34, 35, 37

Includes extensive study in Insurance Operations (Marketing, Underwriting and Claims), Insurance Contracts, Loss Exposure, Risk Management and Personal/Commercial exposures.

New Mexico Producers License- NM Life, Accident and Health Insurance and NM Property, Vehicle and Casualty Insurance

EDUCATION

New Mexico State University Las Cruces, NM

Bachelor of Criminal Justice 1995

https://www.linkedin.com/in/jakederden



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