Customer Service Claims Adjuster
Resume:
SCOTT PYLE
**********@*****.*** 1-912-***-**** St Simons, GA 31522
Seasoned Insurance Adjsuter excels at working with individuals from diverse cultural and socioeconomic backgrounds.
Personable and resolution-focused. Energetic SUI Investigator successful at reducing company costs by employing resultsfocused problem solving techniques. Offers superior oral and written communication skills. Meticulous Claims
Investigator effective at collecting and analyzing data used to devise fair and cost-effective settlements.
Workers' Compensation Claims
Insurance Fraud Expertise
Property Adjusting
Rules of Evidence
Decision Making
Liability Determination
File and Record Management
Legal Documentation and Reporting
Critical Thinking
Frontier Adjusters St Simons, GA
Claims Adjuster
01/2010 - Current
Resolve Insurance Claims
Adhered to company and insurance client's guidelines in claims processes,
estimate writing and claim closures.
Recommended settlement offers and negotiated payment arrangements.
Conducted interviews, gathered detailed information and completed field
investigations.
Obtained necessary information to complete proper evaluation of injury
claims.
Reviewed data to verify validity of claims and determine case management
actions.
Drafted statement of loss to summarize damages, payments and
underlying policy coverage.
Completed required investigations on referred files within established
timeframes.
Identified and collected evidence and determined value to specific claim to
properly assess conditions.
Complied with company and insurance client's guidelines in claims
processes, estimate writing and closing of claims, resulting closed claims
files.
Analyzed first reports of loss and underlying file material to determine if
claim was suspect.
Contacted injured parties and legal representatives to negotiate final
settlements for claims.
Investigated potentially fraudulent claims with focus on thoroughness,
quality and cost control.
Investigated claims, conducted field audits, determined losses and
reported findings.
Summary
Skills
Experience
Interviewed claimants, medical specialists and employers to determine
pertinent claim information.
Obtained relevant evidence and information regarding suspicious claims.
Conducted claim and estimate re-inspections.
Lorillard Brunswick, GA
Sales Representative
02/1989 - 12/2009
Placed orders and answered customer questions in-person, through email
and over phone to maximize customer service.
Contacted new and existing customers to outline benefits of products.
Demonstrated product features to align with customer needs.
Adhered to company initiatives and achieved established goals.
Stayed up to date on company products and services to support sales
objectives.
University of Montevallo Montevallo, AL
Bachelor of Arts in Business Administration And Management
05/1983
Certified Claims Adjuster, Frontier Adjusters - 2010
Licensed Georgia Resident Property & Casualty Adjuster - 2010
Licensed Florida Non- Resident All Lines. - 2010
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