Claims Adjuster - Property & Workers Compensation Expert
Resume:
ANNIE STEWART
**** ***** **. **** * Houston, TX *7033
************@*****.***
OBJECTIVE Seeking a position as a claims adjuster that will allow me to utilize my knowledge of insurance and customer service to investigate, negotiate, evaluate, and settle assigned claims.
SUMMARY Texas, Louisiana, FL
2years of experience in Workers Compensation Claims. 7years of experience in Insurance, State Farm Auto Certification State Farm Property Certification, Texas Windstorm Certification, Xactimate, Ability to prioritize, organize and multi-task in a fast-paced environment. Excellent computer and analytical skills
EXPERIENCE 03/2023 - 06/2023 PILOT, DESK ADJUSTER
Investigate, Analyze, and determine the extent of liability concerning first party homeowner property losses, and damages. Experience working contractors, and vendors for claims resolution, effectively communicate with policyholders’ agents and service providers via phone, email, and internal syst5ems to accurately document claim details. Ability to successfully manage a pending claim load at varying stages of the claims process. Interpret and apply the details of an insurance policy to ensure the accuracy of payments claims declinations. Ability to understand computer generated loss estimates, engineer’s reports, and construction terminology. Update and maintain comprehensive claim handling notations in our electronic claims management system and other related applications.
11/2022 - 01/2023 FKS CLAIMS, DESK ADJUSTER
Conducts thorough investigations, as outlined in the claim handling guidelines and best practices, Denies, settles, or authorizes payments to property claims based on coverage, field reports, and verifiable damage. Interviews, telephones, or corresponds with insureds, claimants, vendors, carriers, witnesses, public adjusters, attorneys, etc. to gather important information to support the claims, including proofs of loss. Sets proper reserves, takes PAGE 2
recorded statements as needed.
Reviews and evaluates property claims for coverage and further claim handling procedures to conclude within required statutory time frame. Interpret policy language and evaluate coverage issues of multiple different policies and endorsements, addresses diaries, emails and voicemails, Prepares technical claim documents and correspondence. Prepares report of findings of an investigation. Contributes to department efforts with an emphasis on team collaboration.
08/2021 - 11/2022-RYZE CLAIMS SOLUTION, CLAIMS ADJUSTER Maintain contact with field adjusters to ensure timely inspection and estimate/report submissions. Review adjuster reports and estimates to ensure estimates are technically accurate and meet appropriate industry guidelines and standards for repair. Understand and follow all Best-Practices guidelines to ensure that all client expectations are met. Knowledge of insurance policies and appropriate application of coverage. Confirm all appropriate file documentation is included for completion of the review process. Ability to work with Xactimate/Xactanalysis and collaborate on estimates. Respond timely and appropriately to follow-ups/requests for the client. Monitor and maintain individual queues to ensure that files are being completed in a timely manner. Understand and work within multiple client systems, programs, and guidelines. Assist with training adjusters on client specific requirements when necessary. All other related duties as assigned.
05/2022 - 10/2022 Claims Adjuster Cognizant
Damage Estimating in oversight activities as a liability consultant. Manages auto physical damage claims by gathering information to determine liability exposure.
Takes recorded statements from claimants, insureds, witnesses, medical providers, conducts investigations into moderately complex auto accidents, determines liability, and prepares summaries. Provides timely service throughout the life of the claim by meeting all service level agreements, initiating timely contact with all appropriate parties, and responding to incoming inquiries according to company policy and procedures. Reviews open files on a regular basis and contacts insureds, claimants, or representatives to determine progress of claims.
05/2020 - 01/2022 Claims Adjuster Crawford & Company Researching and analyzing information gathered through investigation and premising decisions/ recommendations on said information. PAGE 3
Excellent judgment and decision-making skills to ensure claims are resolved in the best interest of the Company. Ability to conduct investigations in multi- party situations. Ability to combine pieces of information to form conclusions necessary to determine coverage, evaluate liability and evaluate damage exposures to ensure that claims are paid in a fair and equitable manner. Interviewing agents and claimants to correct errors and investigating questionable claims. Deciding on how much money will be paid out to the policyholder or claimant in damages.
03/2018 - 04/2020 CLAIMS ADJUSTER PILOT CATASTROPHE Handle all aspects of claim settlement including investigation, correspondence, negotiation, and settlement. Deliver a customer-focused claims experience through proactive correspondence while maintaining a full case load in a fast- paced environment. Conduct thorough investigation to arrive at a fair settlement, including interviews with claimants and witnesses, consultation with police, review of hospital records, and inspecting vehicle damage. 02/2017 - 03/2018 Property Adjuster Worley
Confirm coverage, investigate, negotiate settlement and recovery as well as conduct reporting and documentation of claims in accordance with established guidelines. Conduct investigations of claims through contact with insurers, witnesses, other carriers, contractors, etc. Evaluate, analyze, and interpret policy wordings to determine coverage applicable to the loss. Based on established performance and guidelines, select, assign, and proactively manage service suppliers in the resolution of the claim with a view to controlling expenses while accurately assessing policyholder indemnity entitlement. Ensure all phone messages and incoming documentation are responded to promptly and within company timelines. Determine and obtain the type of required documentation necessary to support claims in accordance with company policy, as well as federal, provincial, and local regulations. Ensure the accurate and efficient payment of claims. 01/2016 - 12/2016 Bodily Injury Adjuster, E.A. Renfroe Assess policy coverage for submitted claims and notify the insured of any issues; determine and establish reserve requirements, adjust reserves as necessary during the processing of the claim. effectively use client’s claim systems and technology to successfully enter and verify pricing information. Plan and conduct investigations of claims to confirm coverage and to determine liability, compensability, and damages. Determine and document, during the investigation process, the potential for subrogation and refer claims PAGE 4
to the subrogation group as appropriate. Work in a team environment handling complex bodily injury claims and high-volume work. Assess actual damages associated with claims and conduct negotiations within assigned authority limits to settle claims. Adhere to high standards of accountability, confidentiality, and professionalism while dealing with claim information. 09/2014 - 12/2015 Claims Specialist, Wardlaw
Evaluate and investigate policy coverage, liability and damages in a timely manner following a set of general claim and statutory guidelines. Assists internal and external customers with problems or questions regarding claims by phone or through written correspondence while providing a high level of customer service. Establish initial reserves for all potential exposures and adjust as appropriate throughout the claim. Investigate and evaluate claims using a lowest ultimate cost strategy, Establish and maintain appropriate diary of open claims following company guidelines. Conduct thorough investigations which can include obtaining necessary documents and forms from claimants and insureds and conducting recorded statements. Ensure timely completion of appraisals and determine accident-related damages. Negotiate timely and appropriate settlements with claimants, insureds and attorneys and issue appropriate payments. Open and process correspondence related to assigned claims. Recognize recovery opportunities in regards subrogation and salvage. 01/2014 - 08/2014 Claims specialist Pilot
Worked on the Enterprise Claims System to handle all CTLU claims - responsibilities included but not limited to completing the total loss evaluation, pulling Autodata Report and CCC1 estimating the total loss tool for completion. Contacted all parties to negotiate and settle total loss claims. Addressed complex claims with vendors to resolve all issues that arise. Processed Team Manager Title Review requests: handle salvage titling, great communication with our insurers, agents and claimants to resolve total loss claim issues. Generate State Farm letters for insurers and claimant’s total loss claims. (2010) Worked on the ECS, took calls, established liability. 06/2014 - 07/2014 DESK Adjuster Pilot
Worked on the Enterprise Claims System to handle all Property claims - responsibilities included but not limited to completing the Xactimate Report tool for completion. Contacted all parties to negotiate and settle total claims. Receives claim assignment and confirms policy, sets reserves and recommends reserve changes to supervisor, investigates claims to determine validity and verify extent of damage, analyzes claims activity, and prepares reports for PAGE 5
clients/carriers and management. Settles claims promptly and equitably and issues company drafts in payments for claims within authority limits. Develops subrogation and third-party recovery potential and follows reclaim procedures. Generate State Farm letters for insurers and claimants. (2010) Worked on the ECS, took calls, established liability. 01/2012 - 09/2013 Claims Specialist Hallmark Insurance Group Handled bodily injury claim, read, and examined medical and police reports and negotiated settlements with claimant and/or claimant’s attorney. Assess policy coverage for submitted claims and notify the insured of any issues; determine and establish reserve requirements, adjust reserves as necessary during the processing of the claim. Effectively use client’s claim systems and technology to successfully enter and verify pricing information. Plan and conduct investigations of claims to confirm coverage and to determine liability, compensability, and damages. Determine and document, during the investigation process, the potential for subrogation and refer claims to the subrogation group as appropriate. Work in a team environment handling complex bodily injury claims and high-volume work. Assess actual damages associated with claims and conduct negotiations within assigned authority limits to settle claims.
EDUCATION REMINGTON COLLEGE-GARLAND, TEXAS ASSOCIATE BUSINESS BROOKHAVEN COLLEGE-DALLAS, TEXAS--CERTIFICATION
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