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Claims Adjuster Customer Service

Location:
Columbus, OH
Salary:
62500
Posted:
July 30, 2023

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Resume:

Viveca (viv) Wallace Columbus, Ohio 317-***-**** adyl33@r.postjobfree.com

Results oriented professional with proven ability to manage and operationalize concepts while providing excellent administrative support. Readily takes initiative. Resourceful with strong sound judgement. Performance driven team player or individual contributor. Excellent interpersonal, written and oral communication skills, with expert customer service skills. Strong attention to detail optimally using all communication channels to assist operational areas. I worked as a property adjuster for 7 months before I attended and graduated from Nationwide property school in 2016. I used Xactimate, XactAnalysis, Crawford Connection, Nationwide policy library, plus several other applicable claims systems during my time as a Property Claims Adjuster III. I have expert knowledge in utilizing Guidewire systems for Claims. I have licenses in all states for Claims Adjusting, and my home state has been updated from Texas to Ohio due to my Commercial License while with Gallagher. I also hold a designation as a CLCS (Commercial Lines Coverage Specialist). I am a Claims Adjuster III and have 8 years as an experienced Adjuster. I’m also a strategic and creative thinker. Superb problem solver with a solid background in delivering decisive, action driven leadership. Cross functional experience in commercial lines coverage, property and casualty claims, hotel management and accounting. Global Licensed Claims Adjuster. Financial Specialist with expertise and skills in Construction, Medical, Music, Property Management and Hospitality industries. Unique talents include wearing many hats while working both efficiently and smartly. Expert skills in Microsoft Office, Word, Excel and PowerPoint.

Education Indiana Wesleyan, Indianapolis, Indiana – Masters of Science Degree with concentration in Business Management

Professional experience

Client Service Manager Gallagher Insurance (Dublin, Oh) 2021 – Present

CLCS/Commercial Lines Coverage Specialist Designation / Experience in personal lines account management

Lines of business supported include: Workers Compensation, General Liability, Property, Inland Marine, Auto Liability and bolt-on Cyber on a supporting Package, GL or BOP policy.

Experienced with EPIC management systems, managed a book of business of key and high revenue-producing accounts. Provided professional insurance guidance, expertise, and service to clients. Developed and maintained professional and collaborative relationships with carrier representatives, underwriters, and business partners.

Performed accurate and thorough reviews of client coverages, exposures and pricing, and communicated recommendations to customers in a timely manner. Developed new business from existing accounts and assigned leads as well as assisted the broker production goals.

Provided regional “concierge” level assistance on the servicing and management of the accounts in my book of business. Developed new business from existing accounts and assigned leads, also contributed to meeting broker production goals. Identified opportunities for cross-sell and up-sell of other broker products and services where appropriate. Utilized my industry experience and in-depth knowledge of insurance markets, policy provisions, business environment, and risk mitigation, applying independent and discretionary judgment to make decisions independent of manager approval on books of insurance business. Including non-routine coverage issues and questions, renewal strategies for key accounts, and interpretation of provisions of insurance contracts. Recognition of clients’ business and insurance objectives and critically analyzed and compared insurance plans to determine suitability.

Led resolution of escalated complex service issues between clients and insurance carriers that require policy interpretation and experience-based judgment to resolve.

Maintaining accurate client and policy data and documents within the Gallagher systems. Policy prep, creation and maintenance. CSR24, endorsement processing requests and maintenance.

Claims Adjuster III Safelite Group 2017 – 2021

3rd party for USAA Auto Claims-Columbus, OH: Globally Insurance licensed. Initiating the first notice of loss. Investigate, evaluate, and settle insurance auto claims. Determine whether the insurance policy covers the loss claimed. Then decide the appropriate amount the insurance company should pay. Investigate whether a claim maybe fraudulent, using industry standards. Contact claimants’ medical providers, or employers to get additional information on questionable claims. Confer with legal counsel on claims when needed. Negotiate settlements. Authorize payments when necessary.

Property Claims Adjuster III Nationwide Insurance 2015 – 2017

Responsible for first notice of loss with property policyholders thru till the completion of claim approval or denial process. I worked as a property adjuster for 7 months before I attended and graduated from Nationwide property school in 2016. I used Xactimate, XactAnalysis, Crawford Connection, Nationwide policy library, plus several other applicable claims systems during my time as a Property Claims Adjuster. utilizing Guidewire, which I have expert knowledge of.I have all state licenses for Claims Adjusting, and my home state has been updated from Texas to Ohio due to my Commercial License while with Gallagher. I also hold a designation as a CLCS (Commercial Lines Coverage Specialist). I am a Claims Adjuster III and have 8 years as a experienced Adjuster.Claims investigation requires interviewing policyholders, claimants and witnesses. In many cases, other members of the community need to be interviewed by the claims adjuster as well. Police officers, physicians, lawyers, accountants and other professionals often have to conduct recorded statements during the claims investigation process. Other information that a claims adjuster may have to collect include hospital records, photos of property damage, videos of physical damage and other pertinent information required to fully evaluate a claim. Licensed with National Association of Independent Insurance Adjusters (NAIIA.), in all 50 states.

Insurance Claims Service Representative Liberty Mutual 2013 – 2015

First point of contact after accidents arise to assist all callers in filing claims. Assess policy coverage, contact insured, determine and establish reserve requirements. Review and set-up all P&C claims in the tracking system and describe the loss to reflect actual circumstances. Plan and conduct investigations (including but not limited to interviewing parties involved, collecting and evaluating documentation and securing evidence and protecting the chain-of-custody) to analyze coverage, determine liability, compensated ability and damages of claims. Evaluate claims for potential fraud. Assess actual damages associated with claims and conduct negotiations to settle claims. I have also been involved with litigation whenever necessary.

Hotel General Manager ACCOR NA 2007 – 2011

Leading, developing, training, and motivating high-performing teams. Identifying and developing team members for future leadership roles. Managing team member performance with clear feedback, recognition, reviews, coaching/teaching, and corrective discipline. Maximizing sales and profits by upholding sales and successful customer service techniques in order to ensure a great guest experience. Exhibiting ways to delight guests in order to deliver an excellent guest experience. Increasing sales and maximizing profit by ensuring that all P&L items are controlled and that all company objectives are successfully achieved.

*References available upon request

*Relocation is optional



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