Adrienne K. Ashley

*** ******** ****, ******, ** 30179 adwgeh@r.postjobfree.com

/ 404-***-**** / 404-***-**** /

KEY CAREER ACCOMPLISHMENTS

● Accomplished Program / Account Manager for domestic carriers and Lloyds of London residential, habitational, commercial property, and excess / surplus carriers.

● Lead, developed and mentored a team of six to seven in house and remote adjusters handling fast track to complex commercial and residential losses (up to $1,000,000+).

● Developed, implemented, and managed payment workflow process for both daily adjusters and CAT teams.

● Over twenty five years multi line claims handling experience investigating / adjudicating claims.

● Possesses the ability to comprehend and interpret various client contracts and policies.

● Successfully implemented processes and development guidelines for examiners resulting in improved customer service, file documentation, and overall quality scores from 47% to 92% within a twelve month period.

PROFESSIONAL WORK HISTORY

Engle Martin, Atlanta, GA, Claims Team Leader (Supervisor) May 2021 to Present

● Oversees day-to-day operations of a team of claims examiners and their respective programs.

● Established communication plan with both clients and internal senior leadership to address issues, identify trends and needs, and develop solutions.

● Assists claims examiners with inquiries, technical questions, and claim audits to assure accurate and timely adjudication of claims and serves as an escalation point of contact for customer and client resolutions.

● Reviews claims examiners files to assess ability regarding coverage analysis, damage assessment and proper reserving, coding and acceptable documentation is presented / attached to the claim file.

● Reports and evaluates team performance to the Claims Team Leader through key performance metrics.

● Recognizes and recommends process improvements for operation efficiency. Coordinates workflow to achieve expected departmental goals. Develops and provides appropriate examiner training to ensure compliance with client requirements.

● Assists with file audits to assure that Best Practices are consistently followed.

● Assists the Claims Team Leader in establishing and maintaining an effective employee management and staffing structure for the team. Submits requisitions for, Interviews, and completes the candidate selection process and orientation process for new team members.

● Establishes and maintains positive working relationships with other members of the organization across departments, divisions, and locations.

● Maintains the confidentiality of proprietary and sensitive information

● Adheres to all applicable State Insurance Regulations and requirements and other applicable laws, regulations, and standards. Collaborates on leadership and client reporting.

QBE, Atlanta, GA, Senior Property Adjuster –October 2019 to Present

● Manages multiline fast track to complex/ large loss exposures to ensure timely resolution of all assigned files.

● Investigates losses to identify claims which meet criteria for subrogation potential and SIU referral.

● Manages vendor partners to ensure their work meets expectations by reviewing external vendor reports and estimates.

● Maintains diary for follow up and documents claim activity to support the outcome of the claim.

● Supports other team members and management by training and mentoring junior examiners.

Peninsula Insurance Bureau, Apopka, FL, Account Manager, October 2018 to October 2019

● Responded to client inquiries as an Account Manager for a Third Party Claims Administrator for Lloyds of London Markets. Provided resolution on escalated matters arising from operations, claims handling, and customer concerns.

● Manages fast track to complex/ large loss claims to ensure timely resolution of residential and commercial property claims for excess and surplus lines, reinsurers, and domestic carriers.

● Completed internal investigations for desk adjustments as determined; drafted minor estimates as required.

● Appropriately interviewed policyholders, public authorities/personnel and contractors to determine cause, scope, damages, and subrogation potential in order to bring file to resolution.

● Manages vendor partners to ensure their work meets expectations by reviewing external vendor reports and estimates.

● Maintains diary for follow up and documents claim activity to support the outcome of the claim.

● Assisted in litigation management with Market / Carrier designated attorneys Engle Martin CAS, Atlanta, GA, Claims Manager, June 2016 to October 2018

● Simultaneously managed one or more claims handling and administrative teams ensuring timely and proper disposition of claims in accordance with client instructions and industry best practices.

● Supervise daily property claims team members (6); Catastrophic (CAT) team members

(4); CAT / administrative payment team members (3).

● Oversees inside desk adjusters as well as remote staff and field adjusters for vendor services handling residential and commercial property losses.

● Provides guidance to adjuster on fast track claims to complex losses to ensure complete claim investigations, sound coverage analysis, leading to successful resolutions in accordance with company and industry best practices, client service instructions and service level agreements.

● Completed intermittent audits as required by client Service Level Agreement (SLA).

● Responded to client inquiries and provided resolution on escalated matters arising from operations, claims handling, and customer concerns.

● Developed and implemented “fast track” training programs, property claims handling guidelines, and advanced payment schemas.

● Assisted finance management with the coordination of reserve reporting in an effort to maintain account funding and cash flow.

Crawford and Company, Atlanta, GA, Multi Line Adjuster, December 2014 to June 2016

● Evaluated and processed claims for multiple lines of business.

● Adjudicated accidental death claims, Short Term Disability (STD), Long Term Disability

(LTD), Permanent Disability, terminal illness, employer and travel disability claims for benevolent organizations and international institutions in accordance with company, client, and industry best practices.

● Performed client liaison duties for priority clients; served as a point of contact for priority customer service to clients and policyholders, offering my claims handling expertise.

● Maintained the security and confidentiality of sensitive account information while resolving disputes and consumer concerns through research and troubleshooting discrepancies.

● Member of the claims department action committee engaged in providing alternative work solutions for more efficient and productive operations flow.

● Developed process flow for terminal illness claims including management of nurse case workers.

● Supports team members and management by providing training and mentoring to new and junior claim examiners.

QBE, Atlanta, GA, Property Adjuster –February 2007 to May 2014

● Manages fast track to complex/ large loss claims to ensure timely resolution of all assigned files. Investigates and evaluates fast track to complex losses by interviewing policyholders, public authorities / personnel, and vendors / contractors to determine cause, scope, damages, and subrogation potential in order to bring file to resolution.

● Manages vendor partners to ensure their work meets expectations by reviewing external vendor reports and estimates.

● Maintains diary for follow up and documents claim activity to support the outcome of the claim.

● Supports other team members and management by training and mentoring junior examiners.

Sedgwick CMS, Atlanta, GA, Commercial Liability Adjuster, January 2005 to February 2007

● Ensure a thorough and timely investigation of property damage, bodily injury, and product liability claims to obtain pertinent information in order to determine coverage, preserve evidence/salvage which impacts claim strategy, and allows for resolution as quickly as possible.

● Ensures continued review and analysis of claim by establishing and executing an action plan outlining the strategy for controlling costs and moving claim to resolution.

● Ensures proper documentation and coding of all claim activity, developments, communications of any type and action taken by Adjuster or others are clearly summarized within system files.

Allmerica Financial (Hanover), Atlanta, GA, Auto Desk Adjuster, December 2003 to May 2004

● Investigated and evaluated first and third party auto property damage claims by interviewing involved parties and witnesses to assist in liability determination.

● Researched coverage issues and reviewed necessary documentation provided by agents, underwriters, appropriate authorities, and customers to support verifiable losses.

● Referred claims for further investigations by appropriate legal and/or subrogation departments or outside services that may assist with inside investigations. Assurant, Atlanta, GA, Property and Casualty Adjuster, January 1998 to December 2003

● Responded to initial telephone loss reports by setting up and assigning claims to appropriate field adjusters and vendors for inspection and investigation.

● Investigated claims by interviewing and corresponding with policyholders, claimants, and public authorities or contractors to gather information to support the loss.

● As lead examiner analyzed and evaluated GAP, ASI / VSI, and LPD claim losses for auto and

● mobile home losses.

● Assisted management in re-establishing and creating a more personalized working relationship for primary clients.

LICENSES

Home State: GA. Licensed in AK, AL, AR, AZ, CA, CT, DE, FL, HI, ID, IN, IA, KY, LA, ME, MD, MO, MS, MT, NC, NH, NM, NV, NY (A&H), OH, OK, OR, RI, SC, TX, TN, UT, VT, WA, WV, WY ADDITIONAL SKILLS

Excellent written and verbal communication skills / Proficient in Microsoft Office Suite (Word, Excel, Outlook) / Adobe Suite / Xactimate review / estimate development Currently enrolled in AIC Course for AIC-M (Associate in Claims - Management) designation in tandem with AIN coursework.

EDUCATION

Kennesaw State University, Kennesaw, GA, Human Services / Business Administration, 2011 to 2015

DeVry University, Atlanta, GA, Business Administration, Accounting, 2009 to 2010 References Available Upon Request

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