Claims Adjuster Customer Service

CPC CARLTON P. COMEAUX

CLAIMS ADJUSTER, CUSTOMER SERVICE, OPERATIONS MGMT

***************@*****.*** ARLINGTON, TX

SKILLS

● IVU SYSTEM

● GSP SYSTEM

SKILLS

● JURIS PROGRAM

● VISTACLAIM

● SNAPSHEET

● COPART PORTAL

● VERICLAIM

● ARMS RENTAL

MANAGEMENT SYSTEM

EXPERIENCE

CLAIMS ADJUSTER AMERICAN EXPRESS FINANCIAL

TELEPERFORMANCE TEXAS CENTRAL REMOTE OCT 2022- FEB2023

● ADJUDICATE PURCHASE PROTECTION CLAIMS FOR AMERICAN EXPRESS CLIENTS FINANCIAL LOST ACCORDING TO THE BENEFITS GUIDE.

● REQUEST FILES PERTINENT TO ADJUDICATE CLAIM LIKE POLICE REPORT, PURCHASE RECEIPTS, & DAMAGE PICTURES

● VERIFY PURCHASES IN GSP BY AMERICAN EXPRESS CLIENTS

● REPORT SUSPICIOUS ACTIVITY TO SIU WHEN TRANSACTIONS WARRANT INVESTIGATION PROCESS PURCHASE PROTECTION CLAIMS UTILIZING IVU SOFTWARE

COMMERCIAL CLAIMS ADJUSTER

SEDGWICK TPA LAS CALINAS, TX OCTOBER 2020-PRESENT

● ASSESS LIABILITY AND RESOLVE CLAIMS WITHIN EVALUATION FOR AMAZON FLEET

● ANALYZE AND PROCESS COMPLEX PD AND GENERAL LIABILITY CLAIMS BY INVESTIGATING AND GATHERING INFORMATION TO DETERMINE EXPOSURE ON THE CLAIM

● NEGOTIATE SETTLEMENTS OF CLAIMS WITHIN DESIGNATED AUTHORITY

● MANAGE THE LITIGATION PROCESS; ENSURE TIMELY AND COST-EFFECTIVE CLAIMS SOLUTIONS

● COORDINATE VENDOR REFERRALS FOR ADDITIONAL INVESTIGATION AND/ OR LITIGATION MANAGEMENT

● PREPARE NECESSARY STATE FILINGS WITHIN STATUTORY LIMITS

● CALCULATE AND PAY BENEFITS DUE; APPPROVE AND MAKE TIMELY CLAIM PAYMENTS AND ADJUSTMENTS; AND SETTLE CLAIMS WITHIN DESIGNARED AUTHORITY LEVEL

● COMMUNICATE CLAIM ACTIVITY AND PROCESSING WITH THE CLAIMANT AND THE CLIENT; MAINTAIN PROFESSIONAL CLIENT RELATIIONSHIPS

● ENSURE CLAIMS ARE PORPERLY DOCUMENTED AND CLAIMS CODING IS CORRECT

● LEAD ROUND TABLE DISCUSSIONS ON CLAIM REVIEW

● READ, UNDERSTAND, AND PROCESS SUBROGATION DOCUMENTS WARDROBE CONSULTANT, OPERATIONS MANAGER

MEN’S WEARHOUSE • ARLINGTON, TX • JULY 2016 – AUG 2020 AWARDS

● Most Custom Suits

● Sold-Men’s Wearhouse

● Most Men’s Shoes Sold

in Division 4-Men’s

Wearhouse

● Most Menswear

Concepts Sold in

Multiple

Transactions-Men’s

Wearhouse

SKILLS

● Sales and customer

service expert

● Store management

● Community relations

and partnership

development

● Marketing

● Client relationship

management

● Recruitment and

hiring, staff

development

● QuickBooks

● Microsoft Excel

● Microsoft Access

● Build menswear concepts for clients in heavy sales-driven environment in $2.5 million volume store

● Create sales orders, manage inventory reports, and book client appointments in Oracle

● Contact potential and existing customers regarding sales promotions

● Represent company at major formalwear industry events; experienced in public speaking, community relations, and partnership development

● Brought in additional revenue by landing accounts for Texas Christian University’s senior banquet and annual Davey O’Brien Awards sports recognition event

● Led “Dress for Success” seminars in local high schools STORE MANAGER

TUXEDO JUNCTION • ARLINGTON, TX • MARCH 2010 – JUNE 2016

● Oversaw sales, merchandising, operations, recruitment and hiring, and staff development for two formalwear stores totaling $1.7 million in store volume

● Represented company at bridal and formalwear events

● Led formalwear school campaigns for prom season

● Contacted 200 potential clients weekly to build sales EDUCATION

ASSOCIATE’S DEGREE • NORTH HARRIS COMMUNITY COLLEGE HOUSTON, TX

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