Customer Service Claims Adjuster

OBJECTIVE

To obtain a position where I'm able to utilize my qualitative strategic thinking,

and problem-solving skills for the overall benefit of the company. Thorough Property Claims Adjuster with hands-on experience performing home damage repair estimates, including wind, hail, fire and water damages. Dedicated to ensuring complete customer satisfaction and serving as a liaison between agents. Adept at negotiating payment arrangements and recommending settlement offers. Experienced insurance professional with several-year career assessing properties, determining liabilities and negotiating settlements. Detail- oriented, observant and knowledgeable with excellent interpersonal and documentation skills. Efficiently handle high case volumes with accuracy and care. Highly-motivated employee with desire to take on new challenges. Strong work ethic, adaptability, and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills. Hardworking employee with customer service, multitasking, and time management abilities. Devoted to giving every customer a positive and memorable experience. SKILLS

•18 Active State Adjuster

License

•State Farm Flood Certified

•Customer/Consumer Relations

•Financial Analysis

•Strategic Planning

•Trend Analysis

•Market Assessment

•Team Leadership

•Xactimate

•Symbility

•Audatex

•CCC One

•Analytical-minded

•Understanding of insurance

policies

•Damage Assessment

•Claims Investigation

•Property Inspection

•Claims Processing

•Policy Interpretation

•Excellent time management skills

•Claims Evaluation

•Policy investigations

•Client Interviewing

•Decision-Making

•Settlement Negotiations

•Complex Mathematics

•Team Collaboration

•File and Record Management

•Critical Thinking

•Relationship Building

•Liability Determination

•Case Presentation

•Claim Form Analysis

•Coverage Assessment

•Workers' compensation claims

•Self Motivation

•Building construction knowledge

•Multitasking

•Report and Records Review

•Automobile appraisals

•Reliability

•Risk Management

Trillion K. Jefferson

CONTACT

***************@*****.***

702-***-**** Las

Vegas, NV 89131

EDUCATION

01/2010

Master of Science - Business

Administration And

Management

Ohio State University

Columbus, OH

08/2005

Bachelor of Science in

Psychology

Kansas State University

05/1999

High School Diploma

Pine Ridge High School

Chadron, NE

CERTIFICATIONS

•2024 NFIP Certified

•

•MS Office

•Property adjusting

•Regulatory Compliance

•Litigation Management

•Attention to Detail

•Task Prioritization

•Public Speaking

•Report Writing

•Customer service and support

•Settlement Negotiation

•Evidence collection

•Problem-solving abilities

•Coaching and Mentoring

WORK EXPERIENCE

Claims Adjuster (Wind/Hail) Cross Country

Adjusting OH

03/2023 - 05/2024 •Investigated property damage claims to determine coverage and liability.

•Conducted field investigations, interviews,

inspections, and surveys.

•Evaluated policy provisions, applicable laws, and other relevant information to determine claim

payments or denials.

•Assess claims related to worker injuries, including determining the extent of injury, work-related

causality, and determining the appropriate

compensation benefits.

Analyzed claim data such as photographs,

diagrams, witness statements, and police reports.

•Examined estimates of repair costs for vehicles or buildings.

•Prepared detailed written reports outlining

investigation results.

•Negotiated settlements with claimants to resolve

disputes.

•Facilitate negotiations between injured workers,

their legal representatives, and insurance

companies to reach a fair settlement for the claim.

•Maintained accurate records of all claims files

including notes from meetings, correspondence

sent and received.

Auto Liability Adjuster/ Worker Compensation

Crawford & Company AL

01/2022 - 03/2023 •Investigated auto liability and worker compensation claims to determine eligibility for benefits and

appropriate coverage based on policy language and

applicable law.

•Identified potential responsible parties, conducted interviews, gathered evidence, and evaluated

damages.

•Negotiated settlements with claimants, attorneys

and other representatives.

•Evaluated workers' compensation claims involving

vehicle accidents to assess if injuries sustained

were work-related and whether compensation

benefits applied.

•Identified responsible parties for liability and worker compensation claims, conducting interviews with

workers, employers, and medical professionals to

gather evidence.

•Reviewed police reports, witness statements,

accident reconstruction reports and other

documents related to an incident.

•Assessed financial responsibility by reviewing driver license records and motor vehicle registrations.

•Maintained contact with clients throughout the life cycle of a claim in order to keep them informed of its progress.

•Interviewed and spoke with claimants, witnesses,

police officers, doctors and other parties to

determine claim settlement or denial.

•Delivered exceptional customer service to clients by communicating information and actively listening to concerns.

Auto Liability Adjuster/ Worker Compensation

All State Insurance Company Kansas City, MO

03/2021 - 03/2023 •Investigated auto liability and worker compensation claims to assess coverage and determine eligibility for workers’ compensation benefits for injuries

sustained during work-related accidents.

•

•Evaluated medical records and reports to

determine the severity of worker injuries and

collaborated with healthcare professionals to assess the treatment and recovery process.

•Identified potential responsible parties, conducted interviews, gathered evidence, and evaluated

damages.

•Negotiated settlements with claimants, attorneys

and other representatives.

•Researched legal precedent in order to provide

accurate interpretation of policies.

•Drafted letters of denial or explanation of coverage for auto liability claims.

•Reviewed police reports, witness statements,

accident reconstruction reports and other

documents related to an incident.

•Maintained clear communication with clients,

keeping them informed about the status of their

worker compensation claims and next steps.

•Worked with employers to ensure the return-to-

work process was smooth and that injured workers

received proper accommodations and ongoing

support during recovery.

•Assessed financial responsibility by reviewing driver license records and motor vehicle registrations.

•Prepared detailed summaries of each claim file

including all pertinent information regarding

coverage issues, liability determinations and

damages calculations.

•Provided customer service support to insureds by

answering questions about their claim status or

providing additional information as needed.

•Maintained contact with clients throughout the life cycle of a claim in order to keep them informed of its progress.

Property Field Claim Adjuster (BUSD) Alacrity

Soloutions NJ

09/2020 - 03/2021 •Investigated insurance claims to determine liability and damages.

•Negotiated settlements with claimants, attorneys

and other parties.

•Drafted correspondence related to claim

investigations and settlements.

•Assessed potential losses for insureds in accordance with applicable laws and regulations.

•Maintained detailed records of all claim activities in a timely manner.

•Established reserves for each claim based on

analysis of the facts and applicable law.

•Coordinated activities between multiple

departments within the company.

Resolved claims for insureds by providing relevant policy details and excellent customer service.

•Identified and obtained evidence to ascertain claim value.

Senior Account Manager Int'l Market Masters

Kansas City, MO

10/2014 - 09/2020 •My responsibilities with market masters consist of the review and/or upgrade to policy & procedure,

ensure associates receive and adhere to company

updates, associate evaluations, financial reports

(charts, graphs, and spreadsheets), program

implementation, communicate positioning,

generate leads, develop and cement long term

business relationships, help clients to attain their goals both personal and in business, and anything

else we can do to provide a more better service,

than that of which is expected.

•Coordinated closely with colleagues across multiple departments when launching new products or

services into an existing account base.

•De-escalated customer interactions by providing

alternative solutions to issues.

•Onboarded new team members to integrate into

organization.

•Maintained an in-depth knowledge of industry

trends, competitors, and market conditions to

provide strategic advice to clients.

•

•Prepared and presented detailed reports on account status, challenges, and growth opportunities to

executive leadership.

•Led cross-functional teams to address complex

client needs, ensuring cohesive effort and solutions. Property Field Claims Adjuster (Proximity)

Worley Catastrophe Services NJ

03/2014 - 09/2018 •Determined and applied all applicable coverage

•Investigated insurance claims to determine

coverage and liability.

•Assessed property damage by scoping and

estimating utilizing Xactimate software

applications, including sketch to write structural damage estimates for various types of loses

including wind/hail, sewer drainage, ice and snow

•Served as team lead during a catastrophic event,

responsible for file reviews, authority request, and supervision of 10 adjusters.

•

•Conducted field investigations, including on-site inspections of property damage.

•Evaluated complex documentation such as legal

documents, police reports, medical records, and

engineering reports.

•Processed paperwork for payment of claims in

accordance with state regulations.

•Reviewed policy language to ensure accuracy when

processing a claim.

•Traveled to customer sites to evaluate fallen trees, leaking roofs and other issues to create accurate

cost estimations.

Financial Analyst

Randstad USA Lenexa, KS

04/2011 - 10/2014 •Created Budgets and ensured that labor and material cost were in line with company goals, financial

reports on completed projects, Generated Financial Statements including cash flow charts and balance

sheets, implemented new procedures resulting in a

43% overhead reduction.

Driver UPS Parcel Service

11/2009 - 01/2011 •My current duties with Ups Include the safe and fast delivery of packages while being efficient to its

residential and business customers on time and

undamaged.

Customer Service Representative American

Family Insurance Lenexa, KS

11/2006 - 10/2009 •To handle all customer queries and complaints Provide customer with accurate up to date info.

Account Manager / Customer Service / Sales

Sprint Lenexa, KS

01/2004 - 11/2006 •To over exceed customer expectation by ensuring customer satisfaction, while effectively enhancing the quality of overall sprint service, also up sell and promote additional products and services to fit

each customer's individual needs.

Manager

TJ's Mini-Mart Kansas City, MO

10/2001 - 03/2004 •My duties with Tj's Mini Mart Included bookkeeping, Order/stock, Employee scheduling and recruiting,

Deposits, Open/close, Cook, Cashier, Delivery

Driver.

Customer Service Representative

P&M Consulting Grandview, MO

12/2002 - 06/2003 •At P&M consulting I placed calls to customers regarding questions they had pertaining to their

vacation packages, I also made outbound calls to

interested applicants to determine program

eligibility.

•

Junior Project Manager All Star Community

Outreach Kansas City, MO

06/2000 - 10/2001 •My duties were to design and fulfill children's programs, Develop and oversee fundraising

projects, deliver food to the needy, and publicly

speak for the organization.

Contact this candidate