Quality Assurance Claims Operations

PAMELA WHITMAN

LEAWOOD, KS 816-***-**** **********@*****.*** LINKEDIN

Experienced and strategic claims leader with years of success in claims operations, compliance, and litigation oversight. Proven track record of reducing loss expenses, improving quality assurance, and driving claims modernization across both national and regional insurers. Recognized for building high-performing teams and aligning operations with enterprise goals through empathetic leadership and data-driven strategies. CORE STRENGTHS

Claims Operations Claims Technical Claims Compliance Litigation Management Regulatory Reporting TPA Oversight Vendor Management Audit Readiness Budget Management Loss Trending Training & Development Claims Quality Assurance Coverage Analysis Leadership Communication Change Management SOFTWARE & P LATFORMS

Guidewire Duck Creek OneSumX Tableau Microsoft Excel SharePoint Adobe Acrobat LexisNexis ISO ClaimSearch ISO Navigator Claims Toolkit

S E L E CT CAREER HIGHLIGHTS

Led major transformation at CSE Insurance, implementing performance-based culture and strategic vendor realignment, resulting in reduced ULAE and ALAE.

Directed enterprise-wide compliance at Allianz/Fireman’s Fund, including state/federal regulatory oversight, SOX/ICOFR controls, and audit readiness.

Selected for Allianz Future Executive Program, highlighting leadership potential and strategic contributions to global claims initiatives.

P R OFESSIONAL OVERVIEW

SENIOR DIRECTOR OF CLAIMS

CSE INSURANCE OCTOBER 2020 - PRESENT

Directed multiple remote-based, multi-line team managing property and casualty claims across multiple states.

Drove major organizational change, embedding a performance-based culture and employee engagement initiatives.

Reduced ULAE and ALAE expenses through vendor consolidation and internal process optimization.

Designed and implemented strategic initiatives involving technology, vendors, and claims handling protocols.

Served as final authority on complex claims decisions, including litigation, coverage, and reserves.

Analyzed loss trends, defined KPIs, and advised executive leadership on product risks and development.

Oversight of TPA accounts; including selection coordination, oversight and assessment.

Instituted customer service metrics and surveys to elevate policyholder satisfaction.

Created QA programs and training roadmap to improve team effectiveness and compliance. CONTINUED

CLAIMS COMPLIANCE DIRECTOR, NORTH AMERICA

ALLIANZ CORPORATE & SPECIALTY/FIREMAN’S FUND INSURANCE CO. 2013 - 2020

Led claims compliance team overseeing regulatory adherence across U.S. jurisdictions.

Managed DOI inquiries, audits, and reporting, ensuring timely and accurate responses.

Oversaw adjuster licensing, continuing education, and Medicare/Privacy compliance.

Developed compliance audits, trending metrics, and corrective action plans.

Collaborated on global strategic projects, including system development and vendor oversight.

Spearheaded SOX/ICOFR testing and managed external audit relationships.

Selected for Allianz Future Executive Program in recognition of enterprise leadership. CLAIMS TECHNICAL MANAGER

FIREMAN’S FUND INSURANCE CO. 2010 - 2013

Provided oversight of complex claims exceeding field authority, ensuring adherence to strategy on Commercial General Liability and Auto, affluent Personal Lines and supported and unsupported Excess claims.

Led litigation planning, trial preparation, and counsel oversight.

Owned strategic claims tools and vendor relationships across Personal and Commercial lines.

Designed and delivered technical training programs for field staff.

Directed TPA program technical reviews and aligned actions with severity trends. P R EVIOUS ROLES HELD W I T H F I R EMAN’S FUND I N SURANCE CO. CLAIMS QUALITY ASSURANCE SPECIALIST

LITIGATION MANAGER

CLAIMS SUPERVISOR

SENIOR CLAIMS ADJUSTER

EDUCATION & CREDENTIALS

BACHELOR OF SCIENCE IN BUSINESS ADMINISTRATION – WILLIAM JEWELL COLLEGE Society of Claims Law Associates (SCLA)

Associate in Risk Management (ARM)

Associate in Claims (AIC)

CA License

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