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Claims Adjuster Specialist

Location:
Lawrenceville, GA
Salary:
80000
Posted:
February 12, 2023

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Resume:

Deneen Marie Johnson

Lawrenceville, Georgia *****850-***-**** • advaa6@r.postjobfree.com

Professional Summary

Customer-oriented Claims Adjuster specializing in property and automobile with proficiency in evaluating losses and interpreting federal regulations and laws. Adept at carefully reviewing all claim information to avert fraudulent claims and ensure accuracy. Experience coordinating with other adjusters and professionals to assess damages. Over 15 years experience in adjusting, auditing, supervising, compliance, training, researching, developing and mentoring team members.

6-20 All Lines Adjuster

License States: Florida, Texas, Georgia, South Carolina, North Carolina, Virginia, Louisiana, Alabama, Mississippi

Canada Certification

Certifications

TWIA

Claims Specialist

NICTA

Xactimate

Federated National Field Certification

Lexis Nexis

California Fair Practices

Citizens

NFIP

Work History

Litigation/Subrogation Adjuster, 07/2021 to 11/2022 Bradley Stinson & Associates Inc – Jacksonville, FL Reviewed subrogation referrals from field adjusters to determine subrogation potential. Responsible for making payments to cover all expenses such as LAE and expert expense. Sent notice of intent to subrogate to Policyholder Verified insurance claims and determined fair amount for settlement. Evaluated insurance policies and analyzed damages to determine coverage. Reviewed police reports, medical treatment records and physical property damage to determine extent of liability.

Documented all investigation activity and presented reports to management. Answered questions posed by insured and attorneys. Investigated and assessed damage to property and reviewed property damage estimates. Substantiated legitimate claims and denied unjustified claims. Trained other claims staff members on proper handling and evaluation of injury claims. Partnered with legal counsel on litigation cases.

Collaborated with claims department and industry anti-fraud organizations to resolve claims. Created Donan request to examine appliances during operation to detect specific malfunctions such as loose parts or leaking fluid and handling of all evidence for testing of cause of loss Synthesized data into comprehensive quarterly written reports for management. Reconciled data in direct collection system with accounting system to address discrepancies. Testified on behalf of agency as part of criminal and civic proceedings. Resolved conflicts and negotiated mutually beneficial agreements between parties Used coordination and planning skills to achieve results according to schedule Remote Desk Adjuster, 06/2021 to 12/2021

Colonial Claims – FL

Initiated first contact, send work assignments and collaborations using Xactanalysis. File reviewer approving estimates, IA invoices, and formatting. Assisted homeowners by coordinating vendor services, emergency repair, cleaning and contractors.

Issued payments for claim to insured, emergency vendors, and or contractors. Carefully reviewed claim information to verify accuracy and avert fraudulent claims. Investigated claims by reviewing policy contracts to determine claim coverage based on cause and facts of loss.

Conducted thorough property investigations to identify and classify damages for customer claims.

Scoped and photographed properties for defects and damage. Used Microsoft Word and other software tools to create documents and other communications Remote Desk Examiner, 09/2020 to 12/2020

NC Claims Service – Florida

Reviewed new files to determine current status of property claim and to develop plan of action.

Prepared summaries of damage, payments and policy coverage. Initiated first contact, send work assignments and collaborations using Xactanalysis. File reviewer approving estimates, IA invoices, and formatting. Assisted homeowners by coordinating vendor services, emergency repair, cleaning and contractors.

Issued payments for claim to insured, emergency vendors, and or contractors. Responsible for reading over policies to confirm levels of coverage and then determine if claim would receive approval or denial by citing policy language in letter. Assigned Edjuster accounts to examine photographs and statements to settle contents. Residential Desk Adjuster, 05/2020 to 09/2020

Catastrophe Response Unit – Toronto, Canada

Initiated first contact, send work assignments using Xactanalysis, and policy review Assisted homeowners by coordinating vendor services, emergency repair, cleaning and contractors.

Clarified coverage of losses to policyholders and provided assistance in itemizing damages and finding alternative living arrangements.

Read over insurance policies to ascertain levels of coverage and determine whether claims would receive approvals or denials.

File reviewer

Process payments for approved estimates, contents, and emergency services File Reviewer, 08/2018 to 05/2020

Holland & Knight – Brandon, FL

Reviewer over 1,000+ files

Initiated first contact, scheduled appointments and return calls for adjusters to phone scope Effectively communicated with Independent adjusters, desk adjusters, attorneys, and other experts to gather pertinent information

Prepared files, letters and notices

Confirmed appraisal status and moved claim forward General AOB handling

Reviewed supplement damages and issued payments accordingly Tracked progress of all outstanding insurance claims Desk Examiner, 04/2017 to 08/2018

Groovers Insurance – Jacksonville, FL

Reviewed Claims in detail to assist in sorting appropriate litigation team Managed task and initial examining operations to assign to appropriate adjuster Negotiated settlements with named insured and/or their representative within policy limits Process daily flood claims and water mitigation claims when available QA non weather related losses

Handled over 4000+ claims to resolution

Initiated first contact

Review estimates and public adjuster demands

Claims settling and subrogation

Licensed Mortgage Loan Officer, 06/2015 to 04/2017 Navy Federal Credit Union – Alpharetta, GA

Held position as Senior Loan Officer and Branch Supervisor Developed prospects for new loans by conducting 150 cold calls weekly Recruited, interviewed, hired and trained many employees and implemented mentoring program to promote positive feedback and engagement Compiled database of loan applicants' credit histories, corporate financial statements and other financial information

Recommended loan approvals and denials based on customer loan application reviews Enhanced branch production rates by handling staff conflicts, evaluations, hiring/termination processes, coaching employees on company protocol and payroll operations Originated, reviewed, processed, closed and administered customer loan proposals Complied with regulatory requirements, including Bank Secrecy Act, Anti Money Laundering, OFAC, USA Patriot Act, Privacy Act and Community Reinvestment Act Guided clients from beginning to end of home buying process in choosing right property Independent Adjuster, 01/2013 to 06/2015

One Call Claims – Mobile, AL

Handled over 4000+ claims to resolution

Initiated first contact

Reviewed estimates and public adjuster demands

Negotiating appraisal and selecting appraisers

Property/Auto Desk adjuster

Property/Auto Field Adjuster

Examined properties with damages caused by wind and hail Resolutions team

Total Loss and Liability Handling

Appraisal reports, actual cash value, Depreciation, Subrogation reimbursements and payouts Age/Brittle test Slope Determination

Supplemental Damages

Original estimate reviews and issuing payments attached to the mortgagee Daily Claims

Claim settling and subrogation

Reviewed salvage and issued payments to insured's contractors, attorneys and public adjusters Skills

Claims auditing

Claims files management processes

Administering claims

Strong banking ethics

Strong organizational skills

Loan officer

Financial transactions expertise

Practiced at FHA loan process

Cash handling expertise

Human resources knowledge

Content valuation and management

Education

Pensacola State College - Pensacola, FL

Accredited Adjuster Course: State Licensing and Appointment Associate of Arts: Business Management Certificate The University of West Florida - Pensacola, FL

Bachelor of Arts: Business Leadership, 01/2012

Ashford University - San Diego, CA

Minored in Operational Management



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