Customer Service Claims Adjuster
Resume:
NATHAN
R. SNEED
**********@*****.***
Detroit, MI 48204
Bold Profile
Knowledgeable insurance professional with solid background in analyzing claims and determining coverage. Successfully managed complex cases with focus on thorough investigation and timely resolution. Demonstrated proficiency in negotiation and customer service skills ready to handle complex claims with precision and efficiency. Proven track record in thorough investigation, accurate assessment, and effective negotiation.
Skilled in investigating and analyzing liability concerning property loss. Proven history of leveraging excellent negotiation skills to facilitate settlements. Excellent communication skills demonstrated through 10 years of experience.
PROFESSIONAL SUMMARY
SKILLS
• Claims investigation
• Damage assessment
• Policy interpretation
• Property valuation
• Critical thinking
• Active listening
• Decision-making
• Claims processing
• CCC reports
• Advanced computer skills
• Caseload management
• Coverage assessments
Advanced oral and written
communication skills
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• Highly motivated
• Customer service
• Problem-solving
• Attention to detail
Verbal and written
communication
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• Data entry
• Claims file documentation
• Call center experience
• Problem resolution
• Complaint handling
• Follow-up skills
CURE Insurance - PD Adjuster
Detroit, MI • 10/2023 - 09/2024
Maintained strong relationships with policyholders, agents, and colleagues by consistently demonstrating professionalism, empathy, and effective communication skills.
WORK HISTORY
Ensured compliance with state regulations and company policies by diligently reviewing all claim-related materials.
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• Negotiated subrogation settlement agreements to resolve disputes.
• Maintained claims data in CCC systems.
Investigated and assessed property damage and reviewed property damage estimates.
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Reviewed police reports, medical treatment records, and physical property damage to determine the extent of liability.
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• Contributed to team success by participating in regular Examined claims forms and other records to determine insurance coverage.
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Negotiated fair settlements on behalf of the company for property damage claims while mitigating financial risk exposure.
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Leveraged strong negotiation skills to resolve claim disputes, resulting in favorable settlements for the company and policyholders.
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Enhanced client satisfaction by providing timely updates and effectively resolving claim disputes.
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Verified insurance claims and determined a fair amount for settlement.
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• Prepared summaries of damage, payments, and policy coverage. Negotiated with policyholders and claimants to reach mutually satisfactory resolutions.
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Conducted day-to-day administrative tasks to maintain information files and process paperwork.
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Negotiate and settle claims within the authority level and properly escalate higher value claims for review and approval to the department supervisor
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• Refer and answer subrogation demands for recovery or payment
• Settlement negotiation
• Liability assessment
Xavier University of Louisiana
New Orleans, LA
No Degree: Education
Wayne State University
Detroit, MI
No Degree: Education
University of Detroit Jesuit HS
Detroit, MI • 05/1991
High School Diploma
EDUCATION
Meemic Insurance - Claims Adjuster II
Auburn Hills, MI • 01/2013 - 09/2023
ADITYLA VIRLA MINACS, - Case Manager/ Chrysler
Southfield, MI • 09/2011 - 01/2013
Negotiated favorable settlements with claimants, attorneys, and other insurance carriers to minimize financial risk for the company.
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Examined claims forms and other records to determine insurance coverage.
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Verified insurance claims and determined fair amount for settlement.
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Maintained compliance with state regulatory requirements through meticulous documentation and adherence to company policies.
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Conducted thorough investigations of complex insurance claims, gathering evidence and analyzing relevant documentation.
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Achieved cost savings through successful subrogation efforts, recovering funds from responsible parties in various claims scenarios.
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• Prepared summaries of damage, payments, and policy coverage. Provided exceptional customer service during emotionally difficult situations for policyholders following accidents or natural disasters.
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Achieved high customer satisfaction ratings by providing clear and timely communication throughout the claims process.
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Reviewed police reports, medical treatment records, and physical property damage to determine extent of liability.
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• Answered customer questions regarding deductibles. Evaluated coverage accurately by interpreting complex insurance policies and applying them to specific claim scenarios.
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Improved claim resolution times by efficiently managing a caseload of 50+ claims per month.
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Identified potential fraud indicators early in the investigation process, protecting company assets from potential losses due to fraudulent activity.
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Negotiated with policyholders and claimants to reach mutually satisfactory resolutions.
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Mentored junior adjusters on best practices and industry regulations, contributing to their professional growth and development.
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Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
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Conducted day-to-day administrative tasks to maintain information files and process paperwork.
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• Maintained claims data in Mitchell and native systems.
• Manage claim from FNOL to settlement or referral to total loss loss Conducted thorough assessments of clients'' situations, identifying issues, goals, and necessary interventions.
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Monitored ongoing cases closely, adjusting case management strategies as needed based on evolving circumstances or new information.
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Advocated for client rights when interacting with external agencies or institutions, ensuring fair treatment at all times.
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Enhanced customer satisfaction by addressing and resolving complex issues efficiently.
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Provided exceptional customer service to high-volume customer base, resolving issues, answering inquiries and providing product
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HELM INC - Customer Service Representative
Highland Park, NJ • 02/2010 - 09/2011
information.
Listened to customers in actively to assess issues and provide accurate information.
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Managed multiple priorities effectively while ensuring a high level of accuracy and attention to detail in all tasks performed.
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Generated higher customer loyalty by consistently meeting or exceeding service-level agreements and performance metrics.
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Acted as liaison between displaced customers and Chrysler dealerships
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Evaluated customer concerns and found effective ways to resolve issues surrounding manufacturing defects.
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Conducted service history reviews to manage and monitor customer concerns.
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Researched and resolved account and service problems with friendly, knowledgeable support.
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Maintained accurate documentation on all cases, ensuring compliance with regulations and confidentiality requirements.
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Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
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Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
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Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.
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Responded to customer requests for products, services, and company information.
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Increased customer satisfaction by addressing and resolving complex issues effectively.
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Managed high call volume, ensuring timely response and effective resolution to all customer concerns.
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English
Native or Bilingual
Spanish
Elementary
LANGUAGES
Dawn Boscarino 586-***-**** Co-worker
Katherine Sprague-Lubrano 810-***-**** Supervisor
Ellen Goodnoe 989-***-**** Co-worker
Shanice Haynes 630-***-**** Personal
Cameron Caruthers 313-***-**** Personal
REFERENCES
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