Claims Adjuster

PROFESSIONAL PROFILE

 High knowledge of claims handling concepts, practices and techniques to include but not limited to coverage issues and product line knowledge

 Strong computer skills with thorough knowledge of Microsoft Word and Excel

 Superior interpersonal and communication skills (written/ verbal)

 High level of analytical, decision making and negotiation skills

 Able to multi- task and work efficiently with minimum to no supervision

PROFESSIONAL EXPERIENCE

Property Claims Adjuster, Travelers Insurance - October 2008 – Present

 Analyze, Investigate and evaluate all relevant facts of a loss to determine coverage and disposition of first-party property damage claims

 Establish appropriate reserves for both indemnity and expense within settlement authority to ensure adequacy

 Facilitate and fully inventory replacement value of damaged and/or destroyed personal property when necessary

 Analyze and process routine to moderately complex property claims

 Document and determine the potential for subrogation upon recognition of potential recovery

 Evaluate claims for potential fraud and make referrals to the Special Investigations Unit as appropriate

 Alert underwriting , marketing and/or risk management regarding questionable risks discovered during investigation process

 Compliance with same day voice to voice contact in accordance with Best Claims Practices and office goals

 Handle files in compliance with state regulations, where applicable

 Provide excellent customer service to meet the needs of insured, agent and all other internal and external customers

 Plan and execute all time schedules necessary to promptly and effectively conclude all assigned cases while adhering to high standards of professional conduct

Auto/Medical Claims Adjuster, Nationwide Insurance -April 2006 – October 2008

 Retain and manage to conclusion first and third party auto damage/medical claims

 Manage medical process through Mitchell; determine the nature and extent of injury, mechanism of injury, and type of treatment received or anticipated.

 Compliance with same day voice to voice contact in accordance with Best Claims Practices and office goals

 Obtain facts to evaluate coverage, negligence, medical necessity and causation/damages

 Document and determine the potential for subrogation upon recognition of potential recovery

 Evaluate claims for potential fraud and make referrals to the Special Investigations Unit as appropriate

 Alert underwriting , marketing and/or risk management regarding questionable risks discovered during investigation process

 Determine and engage the need for independent adjusters, cause and origin experts and independent medical examiners

 Plan and execute all time schedules necessary to promptly and effectively conclude all assigned cases while adhering to high standards of professional conduct

 Establish and maintain appropriate claim and expense reserves

Legal Assistant, Morris & Witcher Law Firm - April 2004- April 2006

 Serve as a communication liaison between disabled clients and the Social Security Administration

 Responsible for approximately 400 clients, and for the intake and preparation of their claims for the lead attorney

 Request medical records as well as interacting and corresponding with various hospitals and medical facilities

 Submit authorized information regarding client’s mental and physical capabilities to Social Security Adjudicator as well as Hearing and Appeal Judges

 Maintain confidentially in accordance with HIPPA regulations

 Assist with accounts payable invoices, contracts, and reconciliation while using Microsoft Excel, Word

Administrative Assistant, Budget Rent-A-Car -August 2002 – April 2004

 Responsible for administrative functions such as filing, data entry, and visitor relations

 Coordinated and scheduled meetings including personal and professional events for supervisors

 Processed employee time sheets, assisted with new hires

 Responsible for replenishing office supplies, checked screened and distributed mail and filed correspondence

 Served as liaison between clients and company executives

 Supervised customer service, ensuring prompt delivery of orders and highest levels of service at all times,

for multiple accounts

 Placed dealer orders, consumer phone orders, as well as follow up with any questions and inquires

sent through email

 Assisted managers to provide superior client interaction to ensure that all clients needs were met

EDUCATION

Devry University

Bachelor of Science in Technical Management

October 2005

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