Customer Service Claims Examiner

S. Idris Azeez

Columbus, OH 614-***-**** **********@******.*** LinkedIn Profile

Professional Summary

Dynamic and results-oriented Insurance Professional with extensive experience in claims management, risk assessment, policy development, and customer relationship building. Adept at handling high-volume work environments while maintaining efficiency and precision. Demonstrated expertise in complex claims evaluation, negotiation, and compliance with regulatory standards. Skilled in leveraging analytical thinking, problem-solving, and strategic planning to deliver measurable business outcomes. Recognized for leadership, customer service excellence, and improving operational workflows.

Core Competencies

Claims Management & Investigation

Risk Assessment & Mitigation

Policy Development & Compliance

Strategic Planning & Decision-Making

Leadership & Staff Mentoring

Customer Service & Relationship Building

Data Analysis & Reporting

Multitasking & Organizational Skills

Proficiency in Technical Tools (Microsoft Office Suite, SQL, Adobe, PeopleSoft)

Professional Experience

Contracted Claims Examiner

Robert Half Staffing Agency – Columbus, OH

November 2023 – October 2024

Prioritize and manage claims workload efficiently, ensuring deadlines are consistently met.

Investigate and resolve claim discrepancies through collaboration with internal departments, including Underwriting and Quality Assurance.

Process appeals for denied claims while adhering to company policies, applicable laws, and regulations.

Communicate effectively with customers via phone and written correspondence to provide timely resolutions.

Accurately document claim status and maintain detailed records in the system.

Senior Claims Examiner

Crawford & Company – Columbus, OH

January 2022 – March 2023

Increased customer satisfaction to 97% by creating tailored solutions and providing proactive communication for total loss claims.

Investigated and settled complex claims, issuing accurate payments and ensuring compliance with company policies.

Delivered actionable recommendations for process improvements to streamline claims handling.

Mentored junior staff and contributed to team success by sharing best practices and innovative ideas.

Disability Claims Specialist

Sedgwick Workforce Management – Dublin, OH

January 2019 – January 2022

Managed 275–315 concurrent cases, excelling in FMLA, STD, and LTD leave administration.

Achieved an 87% pass rating on quality reviews, contributing to the team ranking as a top-performing group.

Leveraged active listening and problem-solving skills to ensure superior customer experiences.

Claims Examiner

Westfield Insurance Group – Columbus, OH

August 2018 – January 2019

Processed and closed over 2,100 claims in just four months while conducting comprehensive investigations into liability, coverage, and damages.

Collaborated with claimants, agents, attorneys, and vendors to deliver exceptional service and timely resolutions.

Mentored team members and coached associates in claims handling best practices.

Catastrophic Claims Adjuster

American Strategic Insurance – St. Petersburg, FL

January 2017 – January 2018

Increased claim closure rates to 97% and earned "Adjuster of the Month" recognition multiple times.

Investigated complex claims by interviewing parties, consulting law enforcement, and inspecting property damages.

Composed settlement and denial letters while ensuring compliance with state statutes and insurance codes.

Claims Adjuster

State Farm Insurance – Lafayette, IN

January 2015 – January 2017

Reviewed claims for coverage, liability, and damages; issued payments and facilitated total loss settlements.

Supported litigation investigations by recording statements and preparing comprehensive reports.

Improved customer retention and satisfaction through attentive and empathetic service.

Education

Master of Business Administration (MBA)

Keller Graduate School of Management, DeVry University – Columbus, OH (April 2004)

Bachelor of Arts and Science

The Ohio State University – Columbus, OH (January 2000)

Certifications

Life, Accident, Health, Property & Casualty Insurance, Ohio (#966939)

Key Achievements

Boosted customer satisfaction rates to 97% in multiple roles by providing attentive and personalized service.

Successfully processed and closed high volumes of claims while maintaining quality and accuracy.

Improved operational workflows by offering actionable recommendations to management teams.

Recognized as “Adjuster of the Month” at American Strategic Insurance and earned “Employee of the Month” awards twice.

Technical Proficiencies

Microsoft Office Suite (Excel, Word, PowerPoint)

SQL, Visual Basic, HTML, CSS

Adobe PeopleSoft

QuickBooks, Microsoft Project, Visio

Volunteer Experience

Contributed services to United Way and American Food Bank, supporting community programs and initiatives.

Languages

English: Native/Bilingual Proficiency

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