Adjuster Resume Samples

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RB
R Bruen
Retta
Bruen
65440 Heathcote Spring
San Francisco
CA
+1 (555) 316 9619
65440 Heathcote Spring
San Francisco
CA
Phone
p +1 (555) 316 9619
Experience Experience
Detroit, MI
Claims Adjuster Trainee
Detroit, MI
Ryan-Graham
Detroit, MI
Claims Adjuster Trainee
  • Identifying and directing the assignment and coordination of expertise resources to assist in case resolution
  • Partner with appraisers/estimators to manage vehicle repairs
  • Processing mail and prioritizing workload
  • Having an appreciation and passion for strong claim management
  • Properly setting claim reserves
  • Interview customers, claimants, and witnesses
  • Negotiate with customers and other insurance carriers
Los Angeles, CA
Adjuster, Complex Claims PC
Los Angeles, CA
Kunde-Sanford
Los Angeles, CA
Adjuster, Complex Claims PC
  • Assist in continuous improvement across the region through support for the Quality Assurance / Regional Audit processes
  • Reporting key claims messages to their Team Manager and to internal stakeholders
  • Ensuring effective vendor and litigation management on Complex claims within a personal allocation
  • Ensuring effective vendor and litigation management on Complex Claims within a personal allocation
  • Strive for continuous improvement on claim file handling with feedback and support through the Quality Assurance Review processes
  • Timely, accurate and customer focused claim resolution, minimizing indemnity exposure and mitigating vendor and legal expense
  • Financial control through consistent reserve and other financial transaction discipline
present
New York, NY
Senior Adjuster
New York, NY
Stokes Inc
present
New York, NY
Senior Adjuster
present
  • Develop and assist with focus audits
  • May perform the following tasks for the Re-Inspection Function
  • May use a company claims office location as their base operations, or they may work out of their homes
  • May be responsible for all aspects of each claim, including informal hearings, arbitrations and small claims litigation and maintaining a high level of productivity, confidentiality and customer service
  • Performs other duties as assigned
  • May provide training and mentoring to adjusters
  • Assist with implementation of countrywide quality assurance program
Education Education
Bachelor’s Degree in Physical Inspection
Bachelor’s Degree in Physical Inspection
Northern Illinois University
Bachelor’s Degree in Physical Inspection
Skills Skills
  • Ability to meet or exceed Performance Competencies
  • Ability to work independently or in a team environment
  • Good time management and organizational skills
  • Strong organizational and time management skills
  • Ability to negotiate skillfully in difficult situations with both internal and external groups. Demonstrates ability to win concessions without damaging relationships
  • Demonstrates strong written and verbal communication skills. Promotes and facilitates free and open communication
  • Understanding of applicable statutes, regulations and case law
  • Attention to detail and accuracy
  • Strong interpersonal skills
  • Strong customer service skills
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15 Adjuster resume templates

1

Intermediate Maritime Section B Adjuster Resume Examples & Samples

  • Accountable for communicating in a collaborative team environment and interacting with clients, claimants, vendors. The candidate may also be required to deal with medical professionals, lawyers and accountants as applicable
  • Ensures complete claim file documentation, make claims decisions within their authority
  • Demonstrated commitment to taking ownership & accountability of client escalations as first point of contact
  • Responsible to identify service issues/gaps and recommend workflow changes to address the issues/gaps
  • Assure claims are fairly and accurately evaluated in accordance with established standards of quality, productivity and timeliness
  • Determine and address the initial customer service expectations
  • Review policy(s) and determine coverage applicable in each loss situation
  • Identify claims that require additional investigation
  • Determine loss transfer potential
  • Responsible for maintaining a case load
  • Communicate effectively with all parties involved in the claims process
  • Key to this role is compliance with all relevant legislation timeframes and guidelines, as well as adherence to the standards and procedures outlined in the RBC Insurance Accident Benefits claims unit
  • Complete additional training as required
  • Bi-Annual home-site visits as well as semiannual visits to head office in Ontario required
  • Possible requirement to visit clients, with no more than 10-20% travel
  • Superior communication skills
  • Strong time management skills and multi-tasking skills
  • Ability to adapt to fluctuating call volumes and seasonal case load volumes and ability prioritize work to optimize efficiencies
  • Fluent in workflows of VL Claims and AS400 applications
  • Minimum College diploma or University degree
  • Bilingual in both English and French
  • Residency in New Brunswick
  • LI-DC1
2

Experienced Inside Commercial Casualty Adjuster Resume Examples & Samples

  • Makes and maintains a connection with the customer by understanding and meeting their needs; serves the customer with empathy; and follows up to ensure that customer needs have been met
  • Determines and explains minimum coverage limits in complex claims involving single or multiple claimants
  • Takes recorded statements from insureds, witnesses, medical providers, etc., conducts investigations into complex auto accidents, determines liability and prepares summaries
  • Achieving targeted performance goals to manage costs and support Allstate’s industry-leading operational standards
  • 7+ years of casualty experience and 3+ years oflitigation experience required and commercial experience preferred
  • Strong computer skills with proficiency in Microsoft Office
  • Strong organization skills and the ability to work independently
  • Bilingual candidates are encouraged to apply
  • Excellent written and verbal communication skills with a passion for helping others
  • Ability to interact effectively, and coach other on interacting effectively, with internal or external customers and act with empathy
3

Commercial Casualty Adjuster Resume Examples & Samples

  • Documents a claim file with notes, evaluations and decision making process
  • Sets initial reserve, updates reserve, documents rationale and claim summary notes
  • Negotiates and settles claims in accordance with business unit best practices
  • Bachelors Degree preferred
  • Prior Casualty and Commercial Claim handling experience is required (5-7 years) and experience working with attorneys is a plus
  • Persistence and the ability to work through and solve problems
4

Inside Commercial Unrepresented Casualty Adjuster Resume Examples & Samples

  • Determines and explains minimum coverage limits in moderately complex and occasionally complex commercial claims involving single or multiple claimants
  • Takes recorded statements from claimants, insured’s, witnesses, medical providers, etc., conducts investigations into moderately complex and occasionally complex accidents involving commercial policy holders, determines liability, and prepares summaries
  • May participate in one or more moderately complex or occasionally complex special assignments
  • May serve as a committee team lead for medium-sized projects or as a committee team member on medium to large projects
  • May serve as a subrogation or arbitration panelist
  • May serve as an agent advocate
  • May participate in oversight activities
  • High School Diploma/General Education Diploma (GED),Bachelors Degree preferred, plus 3-4 years of prior related work experience year
  • Must be availabe to work between the hours of 7am-7pm Monday- Friday
  • Strong organizational and computer skills
  • Previous experience using a computer estimating system such as ADP, CCC or Mitchell is a definite plus
  • ICAR platinum certification, ASE certification and/or an Adjuster’s license are especially desirable
5

Commercial Unrepresented Casualty Adjuster Resume Examples & Samples

  • Researches and responds to moderately complex customer communications, concerns, conflicts or issues
  • Summarizes documents and enters into claim system notes
  • Determines and explains minimum coverage limits in moderately complex claims involving single or multiple claimants
  • Takes recorded statements from claimants, insureds, witnesses, medical providers, etc., conducts investigations into moderately complex auto accidents, determines liability, and prepares summaries
  • Reviews medical reports in preparation for claims settlement evaluation
  • One year of unrepresented or represented casualty experience AND 2 years of liability experience
6

Inside Commercial Liability Adjuster Resume Examples & Samples

  • Investigating, evaluating, and negotiating commercial liability claims, in order to reach a fair and equitable settlement
  • Using compassionate communication and persuasive negotiation to ensure a positive customer experience
  • Working well with others in a fast-paced, collaborative environment
  • Achieving targeted performance goals to manage costs and support Allstate's industry-leading operational standards
  • Four-year college degree preferred, plus two years’ experience in insurance adjusting
  • Bilingual candidates are strongly encouraged to apply
7

Inside Represented Commercial Casualty Adjuster Resume Examples & Samples

  • Takes recorded statements from claimants, insured’s, witnesses, medical providers, etc., conducts investigations into complex auto and property accidents involving commercial policy holders, determines liability, and prepares summaries
  • May participate in one or more complex special assignments
  • Researches, responds to, or participates in Department of Insurance complaints or investigations
  • Assists in reviewing files and making recommendations to refer files to Home Office for escalation
  • Assists in researching or responding to or resolving complex compliance issues
  • High School/GED, Bachelors degree in related field preferred or equivalent experience
  • Must be available to work Monday-Friday between the hours of 8:00am- 5:30pm with some late nights and weekend
  • Applies broad ability to leverage learned technical skills in support of team objectives
8

Represented Casualty Claims Service Adjuster Resume Examples & Samples

  • Determines and explains minimum coverage limits in complex claims involving single or multiple claimants
  • Takes recorded statements from insureds, witnesses, medical providers, etc., conducts investigations into complex auto accidents, determines liability and prepares summaries
  • Reviews file to identify complex potential legal issues
  • May serve as a committee team lead for medium-sized projects o ras a committee team member on large projects
  • May serve as a subrogation or arbitration panelist
  • May assist or participate in Telephone Alert Conferences regarding complex claims referred to Home Office
9

Commercial Casualty Represented Adjuster Resume Examples & Samples

  • Reviews file to identify complex potential legal issues
  • May serve as a committee team lead for medium-sized projects or as a committee team member on large projects
  • Must have at least 3-5 years of auto adjuster experience
  • Applies broad knowledge of insurance policy, coverage, and regulation
  • Applies broad knowledge of claim processes, policies, procedures, claim systems, coverage, liability, damage estimating, and/or settlement, and adherence to applicable legal compliance standards
  • Applies broad industry knowledge to discipline practices, including best practices, to support the business unit
  • Applies broad conflict management and problem resolution skills in managing internal and external customer relationships
10

Medical Payment Adjuster Resume Examples & Samples

  • Secure needed items of investigation
  • Determine coverage
  • Prior RHIT and/or CPC Certification preferred
  • Works independently on day to day responsibilities
11

Field Adjuster Resume Examples & Samples

  • Handling complex 1st party losses for Homeowner claims
  • Denies, settles, or authorizes payments to routine property/casualty claims based on coverage, appraisal, and verifiable damage
  • Corresponds with policyholders, claimants, witnesses, attorneys, etc. to gather important information to support contested claims in court
  • Prepares report of findings of an investigation
  • May provide field adjuster support at claimant’s site with visual inspections
  • Able to review complex coverage analysis and provide work up for approval
  • Able to handle complex claims- such as FIRE
  • Able to act as lead when needed for back up or absent Lead
  • Must have 5+ years of experience handling homeowner’s claims
  • Require someone who is a self-starter with excellent time management and sound organizational skills, effective communications ability, both verbally and in writing to interact effectively with claimants, customers and company personnel
  • Excellent technical claims handling practices and analytical skills
12

Experienced Represented Commercial Casualty Adjuster Resume Examples & Samples

  • Determines claim value
  • Reviews file to identify complex and occasionally highly complex potential legal issues
  • May participate in one or more complex or occasionally highly complex special assignments
  • Completes complex and occasionally highly complex attorney bill reviews
  • *Employee Referral Bonus (external referrals only)
  • Minimum of 7 years of litigated and/or represented casualty experience is required
  • Commercial adjusting experience is a highly preferred
  • High School Diploma/General Education Diploma (GED), Bachelors degree preferred
  • Ability to interact effectively, and coach others on interacting effectively, with internal or external customers and act with empathy
  • Advanced negotiation and/or arbitration skills and experience handling represented claims
  • Applies advanced problem solving skills to continuously improve business outcomes
  • Provides advanced individual decision making within authority limits
  • May work within complex and occasionally highly complex assignments requiring specialized knowledge in breadth and/or depth in area of expertise
  • Has and maintains all appropriate licenses and registrations for the role per state requirements
13

Commercial Represented Casualty Adjuster Resume Examples & Samples

  • Determines and explains minimum coverage limits in moderately complex and occasionally complex commercial policy claims involving single or multiple claimants
  • May assist or participate in Telephone Alert Conferences regarding complex claims referred to Home Office
  • Completes complex attorney bill review
  • Must be available to work Monday-Friday between the hours of 8:00am- 5:30pm with some late nights and weekends
  • Must have at least 3-5 years of auto adjuster experience, commercial experience highly preferred
  • Licenses and registration must be acquired within six months of joining the department
  • Interact effectively, and coach others on interacting effectively, with internal or external customers and act with empathy
  • Knowledgeable of claim processes, policies, procedures, claim systems, coverage, liability, damage estimating, and/or settlement, and adherence to applicable legal compliance standards
  • Industry knowledge to discipline practices, including best practices, to support the business unit
  • Handles conflict management and problem resolution skills in managing internal and external customer relationships
14

Consultant / Loss Adjuster Resume Examples & Samples

  • Work with clients to understand and quantify the loss incurred
  • Prepare the claims file for large loss submission to ensure all loss considerations are included
  • Work with the client, Insurers and Loss Adjusters to reach an agreeable settlement
  • Proven experience of working with clients and Insurers on major, complex, disputed or catastrophic losses
  • Experience of Property, Liability and/or Business Interruption claims will be highly beneficial, although other insurance lines will be considered
  • Ideally you will be from a claims, accounting or loss adjusting background, however, other backgrounds will be considered
15

Catastrophe Inside Associate Claims Service Adjuster Resume Examples & Samples

  • Investigates, reviews, determines and verifies coverage/policy information
  • Provides coverage explanation to customer
  • Reviews, evaluates and submits potential underwriting referral actions
  • Interprets and applies all state and storm issues across all states
  • Basic knowledge of all regional construction types and related repair methodologies
  • Bachelors degree in related field preferred or equivalent experience
  • Ability to interact effectively with internal or external customers and act with empathy
  • Gaining knowledge of insurance policy, coverage, and regulation
  • Gaining knowledge of claim processes, policies, procedures, claim systems, coverage, liability, damage estimating, and/or settlement, and adherence to applicable legal compliance standards
  • Gaining ability to apply industry knowledge to discipline practices, including best practices, to support the business unit
  • Gaining knowledge of basic analytical procedures to reconcile, manipulate, and recognize patterns of data
  • Gaining knowledge of standardized problem solving and preparation of basic reports for analysis
  • Gaining ability to leverage learned technical skills in support of team objectives
  • Gaining negotiation and/or arbitration skills
  • Gaining ability to apply conflict management and problem resolution skills in managing internal and external customer relationships
  • Ability to investigate, evaluate, negotiate and settle basic claims
  • Provides individual decision making within authority limits
  • Has and maintains all appropriate licenses and registrations for the role per state requirements
16

Claims Extended Handling Adjuster Resume Examples & Samples

  • Evaluate and investigate policy coverage, liability and damages in a timely manner following a set of general claim and statutory guidelines
  • Conduct thorough investigations which can include obtaining necessary documents and forms from claimants and insureds and conducting recorded statements
  • Evaluate and settle bodily injury claims within designated authority
17

Regional General Adjuster Resume Examples & Samples

  • Examines claims forms, policies and endorsements, client instructions and other records to determine coverage
  • Investigates claims by interviewing claimants, witnesses and other interested parties
  • Sets estimated loss values for clients
  • Prepares reports by collecting and summarizing information required by client, local, state and federal government and by Crawford & Company
  • Communicates adjustment recommendations to appropriate parties after determining liability
18

Multi Line Adjuster Resume Examples & Samples

  • Examine claim forms, policies/endorsements, and client instructions to determine coverage
  • Set loss reserves and control claims costs
  • Maintain company reputation by complying with federal and state regulations
  • Maintain high service standards
19

Senior Multi Line Adjuster Resume Examples & Samples

  • Investigate coverage, liability, compensability and damages with all parties involved in a claim as requested by our customers or Crawford and Company or a subsidiary thereof
  • Investigate claims by interviewing claimants, witnesses, establish claim reserves, handle evidence, obtain and interpret medical reports, official reports and claim forms, manages litigation, and attend/participate at mediation, trials or hearings
  • Negotiates and settles claims within client service parameters and authority levels by obtaining demands and making offers to claimants
  • Presents evidence at legal proceedings, producing reports and other documents as evidence
  • Provide filings with regulatory agencies, disposing of salvage and pursuing subrogation when appropriate
  • Prepare reports by collecting and summarizing information required by the client and obtained through investigation
  • Self starter capable of working alone or with others
  • May be required to work on-call during off work hours to respond to emergency on-site investigations
  • Maintain professional and technical knowledge through continuing education in multiple lines of business
  • Maintain acceptable product quality through compliance with service standards and compliance with internal quality control initiatives
20

Production Adjuster Resume Examples & Samples

  • Complies with established job safety practices, policies and procedures as specified in plant and corporate directives for the safe performance of the work assignment
  • Supports and follows the guidelines of the food safety system
  • Performs various manual or mechanical production functions by operating and making minor adjustments to the production equipment to meet customer specifications
  • Assists in making major adjustments or mechanical repairs to the production equipment
  • Conducts inspection of in-process or finished product
  • Responsible for replenishing supplies required for assigned area
  • Performs troubleshooting on production equipment as required
  • Performs preventative maintenance on production equipment as required
  • Performs record keeping duties as required under the direction of management
  • Accesses, inputs, and retrieves information from the computer
  • Relieves operators for breaks. Required to perform all operator duties
  • Supplies and maintains required hand tools
  • Performs clean-up, painting, and housekeeping duties
  • Communicates pertinent information to next shift
  • Initiates, reviews, and follows all standard operating procedures (SOPs) for area of responsibility
  • Rotates through workstations as directed by management
  • Establishes and maintains effective work relationships within the department, the division, the group, and the company. Includes ability to handle stress and to interact with others so as to establish and maintain a positive and productive work environment and minimize personal conflicts
  • Required to work assigned schedule or 12-hour shifts, rotating days and nights, Monday through Sunday, working hours may vary as specified by management. Incumbent must be able to work overtime on a regular basis and/or be on call as directed by management
  • Regular and predictable attendance is required between the assigned start and end times of work
  • Performs duties without posing a direct threat to anyone or to property. Direct threat is defined as a significant risk of substantial harm that cannot be eliminated or reduced to an acceptable level by reasonable accommodation
  • Assures and maintains safe and healthful working conditions while enforcing safety rules and regulations
  • Works under general supervision
  • Communication. Ability to communicate effectively, write effectively, read, comprehend, and follow complicated verbal and written instructions
  • Ability to meet the knowledge, skills, abilities, physical requirements, and working conditions set forth in this position description and on the attached Physical Demands Assessment
  • Communicates with the emergency coordinator (EC) or Environmental Focal Point/Environmental Manager (EFP/EM) regarding environmental management activities
  • Understands and responds effectively to EC directions during emergencies by being familiar with emergency procedures, equipment, and systems, as necessary. Implements contingency plan to the level required by the position
  • Understands, completes, and maintains environmental documentation for which the individual is trained, or as directed by the EC, EFP, or EM (i.e., inspections, labeling, record keeping, maintenance of equipment, etc.). Reports to the EC, EFP, or EM on the status of assigned responsibilities
  • Recognizes waste streams and minimizes waste generation, through prudent use of materials, proper disposal and segregation as directed during training or by the EC, EFP/EM. Understands and practices proper accumulation and storage requirements for wastes
  • Complies with environmental regulations when using, dispensing, or handling hazardous and non-hazardous materials and wastes
21

Associate Subrogation Adjuster Resume Examples & Samples

  • Under immediate supervision of a supervisor or senior staff, evaluates legal liability and aggressively pursues, negotiates, and resolves subrogation collection
  • Secures additional information/investigation from referring office when on-site investigation is necessary
  • Communicates with policyholders, witnesses, attorneys, and underwriters to obtain/provide the necessary information
  • Documents claim file to meet all company and state regulations. Manages pending claim cases to meet company quality and production standards
  • Stays abreast of industry trends and recent applicable litigation
  • Reports the presence of fraud indicators. Performs other duties as assigned or required
  • General knowledge of the Property and Casualty industry, products and coverages
  • Functional understanding of Subrogation concepts and procedures
  • Bachelor’s degree in related field or equivalent experience
  • 0-1 year of related experience
  • Licensed to adjust and appraise in assigned territory, as required by law
22

Claims Adjuster Trainee Resume Examples & Samples

  • Determine liability (who’s at fault for the damages)
  • Making decisions
  • Solving problems
  • Planning, prioritizing and organizing
  • Effectively communicating verbally and in writing
23

Commercial Lines Field Adjuster Resume Examples & Samples

  • Diverse, welcoming culture with Employee Resource Groups
  • Wellness program with discounts & rewards
  • Excellent negotiation and conflict resolution skills
  • Excellent organization, problem-solving and creative resolution skills
  • Proficient in basic computer skills
  • Mechanical aptitude including knowledge and hands-on experience related to commercial vehicle repairs
  • Effective communication skills both verbal & written
24

General Adjuster Resume Examples & Samples

  • College degree or equivalent experience
  • Consistent high level of performance and achievement over career span
  • 5+ years experience as adjuster handling complex property losses, required (must be evident on resume)preferably with a carrier
  • Cost estimation preferably using Xactimate and computer competencies required
  • Ability to handle business income losses
  • Knowledge of Property Claim Law and jurisdictional issues
  • Disciplined time management and organizational skills and ability to function in a self-reliant manner
  • Availability for nationwide catastrophe operations as necessary
  • Must have MS Office knowledge (ie Excel)
  • Must live close to a major airport in: Dallas, Denver, Salt Lake City, Seattle, Portland, or Phoenix
25

Rcis-travel Adjuster Resume Examples & Samples

  • High School Diploma or Equivalent and 6 or more months of experience in the agricultural area
  • Crop Adjuster Proficiency Program Certification (CAPP) must be obtained with 180 days of hire date
  • Reliable personal transportation and travel within territory
  • Travel - Ability to travel 2+ weeks at a time as needed on a monthly basis
  • RCIS Crop Adjuster Physical Requirements: walk in agricultural fields up to 3 miles, climb agricultural storage bins up to 25 feet, lift 25 lbs to 50 lbs, work outdoors in varying temperatures/weather conditions
  • Intermediate Microsoft Office skills
  • 1 year or more of experience in the agriculutral area
  • Strong organization and prioritization skills
  • Excellent verbal, written and interpersonal communication skills
26

Entry Level Medical Payment Adjuster Resume Examples & Samples

  • Make contact with customers and inquire about injuries incurred as a result of an auto accident
  • Document claim file with notes, follow-ups, and decision making process
  • Schedule availability to work a scheduled shift within the business hours of 7:00AM-7:30PM and a rotational full day Saturday shift from 8:00AM-4:45PM
  • Ability to type a minimum of 40 wpm
  • Ability to work as a team player in a fast paced office environment
  • Ability to prioritize and handle multiple tasks at a fast pace
27

Office Adjuster Resume Examples & Samples

  • Establish contact with our policyholder or their representative as soon as practical, preferably within 24 hours of being assigned a claim or 72 hours during a catastrophic event
  • Review the coverage and damage on each claim utilizing Best Practices and Best Estimating Practices as a guide
  • Work up estimates that will be used as a basis of the claim settlement
  • Communicate the claim settlement and/or the claim denial according to the requirements of each state in which the claim was reported
  • Communicate as needed during the life of each claim with our policyholder, policyholder representatives, agents, contractors, experts and independent adjusters
  • Investigate all available coverage on an “as needed” basis, based on the damage presented to the Company
  • Input payment if the claim settlement is within your authority or request authority as needed through your Claims Manager, based on each individual claim
  • Request additional information from parties to the claim as needed during the life of the claim
  • Review all pending work owned by you utilizing all available reports to manage your pending claims
  • Review all recovery possibilities that may be available, including salvage and subrogation, placing all parties on notice of the potential recovery
  • Work overtime during high volume periods or after catastrophic events, as needed
  • Must have current and valid adjusters license in all states that claims are assigned
  • Must have basic knowledge of property insurance policies
  • Ability to empathize with customers and agents
  • Must be familiar with computer systems and Microsoft office programs
28

Senior Adjuster, Claims Resume Examples & Samples

  • Leads overall performance accountability (attendance, communication, flexibility, adaptability, interpersonal skills, teamwork and cooperation)
  • Researches tracers, adjustments, and re-submissions of more complex claims
  • Adjudicates or re-adjudicates high volume of claims in a timely manner to ensure compliance to departmental turn-around time and quality standards
  • Manages defect reduction by identifying and communicating error issues and potential solutions to management
  • Handles special projects as assigned and required by changes in claims payment policies or contracting methodologies
  • Meets department quality and production standards
  • 5-7 years
29

Senior Adjuster, Commercial General Liability Resume Examples & Samples

  • Must have or secure and maintain appropriate state adjuster license(s) and continuing education credits
  • Works within significant limits and authority on assignments of higher technical complexity and coordination
  • Authority levels are higher in recognition of the higher proficiency associated with this level
  • May be responsible for all aspects of each claim, including informal hearings, arbitrations and small claims litigation and maintaining a high level of productivity, confidentiality and customer service
  • They may be used as a technical resource by adjusters. May represent the company at mediation, arbitration and trials
  • May provide training and mentoring to adjusters
  • Bachelors Degree or equivalent experience, industry designation preferred
  • Makes decisions in an informed, confident and timely manner
  • Maintains constructive working relationships despite differing perspectives
  • Considers the perspectives of others and gives them credibility
  • Ability to negotiate skillfully in difficult situations with both internal and external groups. Demonstrates ability to win concessions without damaging relationships
  • Demonstrates strong written and verbal communication skills. Promotes and facilitates free and open communication. Understanding of applicable statutes, regulations and case law
  • Operates with latitude for un-reviewed action or decision
30

Senior Adjuster Resume Examples & Samples

  • Must have or secure and maintain appropriate states adjuster license(s) and continuing education credits
  • Handle complex personal and commercial property claims requiring outside field investigations and/or inspections
  • May use a company claims office location as their base operations, or they may work out of their homes
  • Uses discretion and independent judgment in claim handling
  • Possesses demonstrated technical knowledge and skills, including product and industry, reflective of successful progression through various job family levels
  • Claims handled will be of greater complexity and will require a higher level of investigation, analysis, evaluation and negotiation including interpretation of commercial coverages
  • Claims handled will involve moderate complexity, severity and exposures including litigation
  • May be responsible for all aspects of each claim, including informal hearings, arbitrations and small claims litigation and maintaining a high level of productivity, confidentiality and customer service
  • Authority levels are higher in recognition of the higher proficiency associated with this level
  • May be used as a technical resource by adjusters. May represent the company at mediation, arbitration and trials
  • May provide training and mentoring to adjusters
  • Assignments are broad in nature, usually requiring originality and ingenuity
  • May perform the following tasks for the Re-Inspection Function
  • Assist with implementation of countrywide quality assurance program
  • Develop and assist with focus audits
  • Bachelor’s Degree or equivalent experience
  • Typically has 3 - 10 years of experience
  • Dedicated to meeting the expectations and requirements of internal and external customers
  • Makes decisions in an informed, confident and timely manner
  • Maintains constructive working relationships despite differing perspectives
  • Strong organizational and time management skills
  • Ability to negotiate skillfully in difficult situations with both internal and external groups. Demonstrates ability to win concessions without damaging relationships
  • Demonstrates strong written and verbal communication skills. Promotes and facilitates free and open communication
  • Understanding of applicable statutes, regulations and case law
  • Thinks critically and anticipates, recognizes, identifies and develops solutions to problems in a timely manner
  • Easily adapts to new or different changing situations, requirements or priorities
  • Cultivates an environment of teamwork and collaboration
  • Operates with latitude for un-reviewed action or decision
  • Computer experience (MS Office, excel, word, etc)
  • Proficient using Claims systems (i.e. CSS, PMS, etc.)
31

Senior Commercial General Liability Adjuster Resume Examples & Samples

  • Handle complex commercial liability claims
  • Uses discretion and independent judgment in claim handling
  • Identifies possibly suspicious claims. Possesses demonstrated technical knowledge and skills, including product and industry. Claims handled will be of greater complexity and will require a higher level of investigation, analysis, evaluation and negotiation including interpretation of commercial coverages
  • Claims handled will involve moderate complexity, severity and exposures
  • Assignments are broad in nature, usually requiring originality and ingenuity
  • Review and analyze contracts, leases, and identify risk transfer opportunities
  • Demonstrate ability to write positional coverage letters
  • Typically has 4 to 10 years Commercial General Liability experience
  • Dedicated to meeting the expectations and requirements of internal and external customers
  • Thinks critically and anticipates, recognizes, identifies and develops solutions to problems in a timely manner
  • Easily adapts to new or different changing situations, requirements or priorities.? Cultivates an environment of teamwork and collaboration
32

Executive General Adjuster Resume Examples & Samples

  • Examine claims forms, policies and endorsements, client instructions and other records to determine coverage
  • Investigate claims or directs personnel in local branch in doing so by interviewing claimants, witnesses and other interested parties; by obtaining official reports, by inspecting physical damage, by comparing claim information with evidence and/or by consulting with experts
  • Set loss reserves and control claim costs
  • Communicate adjustment recommendations to appropriate parties after determining liability
  • Recommend litigation when appropriate
  • Participate in special projects or performs duties in other areas as requested
  • Licensed as required by state and local jurisdictions
  • A valid driver’s license
  • Strong analytical and mathematical ability
  • Strong organizational and interpersonal skills
33

Adjuster, Claims Resume Examples & Samples

  • Researches tracers, adjustments and re-submissions
  • Handles basic projects as assigned
  • Assists with defect reduction by identifying and communicating error issues and potential solutions to management
  • Helps to improve overall performance accountability (attendance, communication, flexibility, adaptability, interpersonal skills, teamwork and cooperation)
  • Adjudicates or re-adjudicate claims in a timely manner to ensure compliance to departmental turn-around time and quality standards
34

Lead Mill Adjuster Resume Examples & Samples

  • Previous SBQ rolling experience
  • Self-motivated, goal oriented, cost driven and organized
  • Absolute dedication to continuous improvement within his/her department
  • Consistent energy/work ethic; determination to be as helpful and resourceful as possible
  • Supervisor and/or Manager recommendation
  • Understanding of the rolling process and all associated processes
  • Understanding of reheat furnace and rolling induced defects
35

Commercial Tech Adjuster Resume Examples & Samples

  • Oversees/Adjust claims and demonstrates proficient understanding of all facets of claims adjustment
  • Review/oversee Examiners, IA’s, AMIG Staff, AGA’s on applicable files
  • Extensive experience handling Residential and/or Recreational Property /Casualty and liability claims of high complexity including suspicious losses and BI claims
  • High Settlement authority on Property claims (up to $125,000)
  • Proficient/knowledgeable regarding CAT Operations and participate in same as assigned/ take leadership role in such as assigned
  • Ability to negotiate claims with policy holders, claimants, contractors, repair facilities, public adjusters and attys
  • Monitor and Direct activities of Adjusters and/or Examiners I
  • Minimal direct supervision required
  • Proficient at conducting Field training and/or reviews/audits including desk reviews
  • Lead and /or participate in key Department/Division/Unit initiatives as required
  • Mentor adjusters and/or Examiners as required
  • Contact with agents
  • Actively participates in key initiatives and projects
  • Participate in Staff Adjuster recruiting as assigned
  • Assist with review of large/complex losses
  • Respond to Dept of Insurance inquiries-as assigned
  • 4 year college degree or equivalent work experience (required)
  • CCEP completion of Examiner level or method or professional industry experience /education equivalent (i.e. Industry designation-AIC, SCLA)
  • Mobile Home and Dwelling claims handling experience. Policy interpretation and application. Residential construction, motorcycle and RV repair methods
36

Material Damage Adjuster Resume Examples & Samples

  • Reviews assigned loss reports to determine extent of investigation and additional information needed. Reads, analyzes and interprets insurance policies and endorsements and bulletins and applies to claims situations. Applies read-in/read-out approach to determine policy coverage. Verifies coverage limits, effective dates and possible restriction or exclusions
  • Investigates to establish facts of the claim. Reviews police reports, weather reports, records from ISO database, fire reports and other pertinent information to verify losses
  • Reviews details and evaluates claim based on evidence obtained in the investigation. Sets and adjusts reserves
  • Inspects damaged vehicles, prepares estimates utilizing computerized estimating tools, handles auto valuations and performs reinspections as needed. Inspects damaged property and prepares estimates utilizing computerized estimating tools. Reviews and negotiates estimates and appraisals presented by customers. Coordinates rental vehicles. Works with salvages facilities, handling salvage issues including documentation in accordance with state statues
  • Examines and reviews potential subrogation claims and pursues subrogation according to Company guidelines. Ensures recovery process is initiated and progressing, using techniques necessary to prevent damage to evidence. Obtains other party information to determine Shelter's subrogation rights and places responsible parties on notice of a possible subrogation claim
  • May support other units in investigation of losses, including obtaining photos, performing scene analysis and diagrams, field inspections, statement taking and courthouse searches
  • Prepares and maintains file documentation. Takes recorded statements as needed
  • Communicates with outside vendors, expert consultants, and attorneys
  • Reviews open files on a regular basis and makes contact with insureds, claimants or representatives to determine progress of claim. Documents pending files in writing and reviews with supervisor on a regular basis. Handles proofs of loss according to state statutes, policy and appropriate adjusting guidelines. Negotiates settlement of claims with insureds, claimants and others up to authority limits. Gives written notice to claimants, insureds and legal counsel of denied claims
  • Visits agents' offices and performs duties on catastrophe storm teams as assigned. Provides support to agency force, including policy interpretation, training and general understanding of Claims operations. Assists Underwriting by utilizing Risk Alerts and investigating material misrepresentations on insurance applications
  • Must be able to safely operate an automobile, telephone, fax machine, copy machine, digital camera, personal computer, and miscellaneous office equipment. Resident adjusters must have high-speed Internet access (via DSL or cable modem) from their residence
  • Performs other duties as requested by Branch Claims Supervisor or Branch Claims Manager
  • Essential Duties as described in this document are general in nature and should not be construed as encompassing all duties and/or functions of this job
  • Requires excellent analytical, organizational, and decision-making skills
  • Superior skills in investigation, negotiation, communication and customer service are required
  • Requires good basic but advancing knowledge of automobile repair and property construction
  • Ability to learn through on-the-job training and claims training courses related to the study of insurance policy coverage analysis and interpretation, investigative procedures, construction estimating, and motor vehicle estimating
  • Must possess a valid driver's license supported by a good driving history
  • Must be physically able to travel long distances and lift/move/climb ladders
  • Must be able to work outside in all temperatures and inspect property physically and visually
  • Must be able to travel overnight as job requires
  • Must exhibit strong skills in technology to include keyboarding and familiarity with word processing software, electronic communications, construction estimating software, personal property replacement software, automobile estimating software and Internet research capabilities
  • Ability to maintain schedules and deadlines and work well with others. This is the skill set for an individual at mid point of position. Based upon banding of grades, the skills needed may vary
  • A minimum of two years general business experience is preferred in an insurance setting, demonstrating experience in organization, communication, negotiation and decision-making
  • Responsible for handling claims with accuracy and consistency, following established procedures and authority limits, policy language and provisions, and applicable state and local statutes
  • Responsible for promptly and accurately examining details of each claim assigned and making sound decisions with regard to investigation, gathering of information, and payment or denial in accordance with policy, procedural, and statutory requirements
  • Responsible for properly recording data to claims system to ensure claims are appropriately paid and recorded for statistical data, and completing required reports in a timely manner
  • Responsible for reviewing assigned claims on a regular basis and is accountable for accurate reserves
  • Responsible for maintaining a high level of technical knowledge required for accurate, timely, and efficient claims handling. May be required to acquire and maintain state licenses as applicable
  • Assists with training of Adjusters and other office staff
37

Catastrophe Response Team Adjuster Resume Examples & Samples

  • Reviews assigned loss reports to determine extent of investigation and additional information needed. Reads, analyzes and interprets insurance policies and endorsements, applicable state and local statutes, case law, bulletins/decisions and applies to claims situations. Applies read-in/read-out approach to determine policy coverage. Verifies coverage limits, effective dates and possible restrictions or exclusions
  • Investigates to establish facts of claim. Reviews police reports, weather reports, fire department reports, records from ISO database or other pertinent information to verify losses. Identifies potential fraud issues and consults with Claims management. May perform extensive background, courthouse and tax record investigations
  • Reviews details and evaluates claim based on evidence obtained in investigation. Sets and adjusts reserve
  • Inspects damaged property, prepares estimates utilizing computerized estimating tools, and performs reinspections as needed. Researches replacement and repair options. Reviews and negotiates estimates and appraisals presented by customers
  • Examines and reviews potential subrogation claims and pursues subrogation. Ensures recovery process is initiated and progressing using techniques necessary to prevent damage to evidence. Obtains other party information to determine Shelter's subrogation rights and places responsible parties on notice of a possible subrogation claim. Handles salvage issues including establishing systems for disbursement of salvage items and documentation
  • May support other adjuster units in investigation of losses, including obtaining photos, performing field inspections, taking statements, and courthouse searches
  • Prepares and maintains file documentation. Takes recorded statements as needed
  • Communicates with outside vendors, expert consultants, and attorneys. Coordinates efforts of origin and cause experts and reviews/analyzes reports submitted
  • Reviews open files and makes contact with insureds, claimants or representatives to determine progress of claim. Documents pending files in writing concerning activities and reviews with supervisor on a regular basis. Handles proofs of loss according to state statutes, the policy and appropriate adjusting guidelines
  • Negotiates settlement of claims with insureds, claimants and others up to authority limits. Gives written notice to claimants, insureds and legal counsel of denied claims
  • Participates in Examinations Under Oath, depositions, mediations and testimony during litigation process. Visits agents' offices and performs duties on catastrophe storm teams as assigned. Provides support to agency force, including policy interpretation, training and general understanding of Claims operations. Assists Underwriting by utilizing Risk Alerts and investigating material misrepresentations on insurance applications
  • Must be able to safely operate an automobile, telephone, fax machine, copy machine, digital camera, personal computer, and miscellaneous office equipment. Resident adjusters must have high-speed Internet access (via DSL or cable modem) from their residence
  • Assists with training of Adjusters and other office staff
  • Performs other duties as requested by Supervisor or Manager
  • Requires excellent analytical, organizational, and decision-making skills
  • Superior skills in investigation, organization, negotiation, communication, documentation and customer service are required
  • Ability to learn through on-the-job training and claims training courses related to the study of insurance policy coverage analysis and interpretation, investigative procedures, and construction estimating
  • Must possess a valid driver's license supported by a good driving history
  • Must be physically able to travel long distances and lift/move/climb ladders
  • Must be able to work outside in all temperatures and inspect property physically and visually
  • Must be able to travel overnight as job requires. Must exhibit strong skills in technology to include keyboarding and familiarity with word processing software, electronic communications, construction estimating software, personal property replacement software, and Internet research capabilities
  • Ability to maintain schedules and deadlines and work well with others
  • This is the skill set for an individual at mid point of position. Based upon banding of grades, the skills needed may vary
  • Requires an advancing knowledge of property construction
  • A minimum of two years general business experience is preferred in an insurance setting, demonstrating experience in organization, communication, negotiation and decision-making
  • Responsible for handling claims with accuracy and consistency, following established procedures and authority limits, policy language and provisions, and applicable state and local statutes
  • Responsible for promptly and accurately examining details of each claim assigned and making sound decisions with regard to investigation, gathering of information, and payment or denial in accordance with policy, procedural, and statutory requirements
  • Responsible for properly recording data to claims system to ensure claims are appropriately paid and recorded for statistical data
  • Responsible for reviewing assigned claims on a regular basis
  • Accountable for accurate reserves
  • Responsible for maintaining a high level of technical knowledge. May be required to acquire and maintain state licenses as applicable
38

Casualty Med Pay No-fault Adjuster Resume Examples & Samples

  • Basic experience handling casualty claims of moderate complexity (e.g., coverage questions, or medical payments)
  • Basic knowledge and understanding of policies and endorsements related to casualty coverage
  • Basic knowledge and understanding of medical terminology, treatment and billing
  • Basic knowledge and understanding of casualty claim handling process
39

Claims Adjuster Trainee Resume Examples & Samples

  • Under close supervision and guidance, analyzing claim forms, policies and endorsements, client instructions and other records to determine whether the loss falls within the policy coverage
  • Investigating the claim - this requires calling the claimant, insured employer, and witnesses to determine compensability issues, and subrogation potential
  • Managing a diary, completing tasks and applying creative solutions to ensure that cases are resolved timely and at the right financial outcome
  • Identifying and directing the assignment and coordination of expertise resources to assist in case resolution
  • Processing mail and prioritizing workload
  • Having an appreciation and passion for strong claim management
  • Polished and professional written and verbal communication skills
40

Homeowner Field Adjuster Resume Examples & Samples

  • Determines scope of repairs. Prepares a repair bid using Xactimate estimating system. Comes to an agreed cost of repair with the insured, and possibly Managed Network or insured's contractor. Follows the repair process to conclusion
  • Coordinates with owning adjusters to determine coverage, subrogation potential and salvage retention
  • Strong analytical, problem solving and organizational skills
  • BA/BS or equivalent combination of education and experience
41

Homeowner Field Adjuster Newark / Fremont Resume Examples & Samples

  • LI-JA1
  • Must live within 30 miles of the territory
  • Proven customer service experience
42

Homeowners Field Adjuster Resume Examples & Samples

  • Receives task assignment and communicates and coordinates with the owning adjuster. Contacts and meets with the insured or 3rd party to photograph and inspect all damaged dwelling, other structures and personal property
  • Settles and pays dwelling or other structure damages once the coverage analysis is completed
  • Valid driver's license with insurable driving record
43

Commissioned Desk Adjuster Resume Examples & Samples

  • Examines claims forms, policies and endorsements to determine coverages
  • Investigates claims by interviewing insureds, claimants and witnesses, obtaining official reports, and by comparing claim information with evidence
  • Sets loss reserves and controls claim costs
  • Recommends litigation when appropriate
  • Strong verbal and written communication skills with good attention to detail
  • Strong analytical and mathematical ability
  • Licensed as required by the State of HI>
  • Ability to handle a variety of situations with tact and diplomacy
44

Multi Line Adjuster Resume Examples & Samples

  • Set loss reserves
  • Control claims costs
  • Recommend litigation when appropriate and present evidence at legal proceedings
  • 2 or more years experience resolving moderately complex personal and commercial property loss claims
  • 2 two or more years experience resolving auto collision and liability claims
  • And strong PC/laptop skills to include a claims or appraisal system such as Xactimate
45

Regional Adjuster Resume Examples & Samples

  • Handle assigned claims by determining coverage, identifying damages and resolving claim within a set amount of time
  • Provide training and support to others across National General on high net worth claim processes and procedures
  • Work collaboratively with leadership and team members to assist in the development of claim best practices and workflows that support a fast-paced, high growth environment
  • Represent assigned area by supporting Business Development during prospect and relationship management meetings
  • Provide excellent customer service to diverse groups of people (vendors, customers, team members, etc.) by meeting customer's needs in a timely manner and managing expectations as needed
  • Direct, control and manage the work of vendor partners to ensure their work meets our expectations in regard to quality and expense
  • Participate in committees and special projects
  • Obtain/Maintain appropriate licensing or educational requirements
  • Thorough knowledge of claims policies and procedures
  • Ability to work independently and remotely as a self-starter
  • Skills in research, investigation and problem solving
  • Ability to successfully work in a fast paced, changing environment
  • Proficient in MS Office (Word, Excel, Power point)
  • Able to enter and access damaged residential homes
  • Capable of climbing ladder or obtain ladder assistance to inspect roof and other high area damage
  • Travel estimated to be 25+%
  • 5 + years of experience in claim adjusting
  • Experience in personal claim lines (i.e. high net worth) residential dwelling personal property and collection claim handling
  • Experience in Multi-line adjusting
  • Successful completion of one or more professional designations: (i.e. SCLA, CPCU, AIC, PCLA)
  • Proficient in Insurance Software Programs (i.e. Estimating Software/Xactimate, Homeowner Line Insurance programs, Claims system software etc.)
  • Ability to be a mentor and/or trainer for others or serve as a technical resource
  • Knowledge of one or more of the following areas: Mortgage industry, Residential Construction
46

Loan Adjuster Resume Examples & Samples

  • Solid verbal communication skills, effective telephone techniques and the ability to be firm, direct, and concise, while maintaining a professional manner at all times
  • Ability and skills to effectively deal with borrowers, attorneys, and third parties while remaining professional at all times to cure a past due account
  • Solid follow-up and negotiation skills
47

Adjuster, Complex Claims PC Resume Examples & Samples

  • Broader internal / external stakeholder communication where required as Auto technical claims expert
  • Assist in continuous improvement across the region through support for the Quality Assurance / Regional Audit processes
  • Ensure adherence to best practice procedures for Auto Complex claims, consistent with global best practice
  • Delivery of technical training to colleagues and external contacts as appropriate
  • Handle higher level of complexity claims Complex losses within authority limits
  • Any other projects/tasks which may be assigned to you from time to time
  • Accountabilities
  • Effective communication of key advanced Complex claims and Auto Claims portfolio messages to internal stakeholders
48

General Adjuster Casualty Claims Resume Examples & Samples

  • Conducts on-site investigations, interviews claimants and witnesses and obtains official reports
  • Sets loss reserves and controls claim costs
  • Pursues subrogation when appropriate
  • Performs duties in other areas as requested.*
49

WC Lost Time Adjuster Qual-lynx Resume Examples & Samples

  • Review, investigate and analyze Workers’ Compensation claims
  • Interact with injured employees to ensure awareness and understanding of the Workers’ Compensation process, requirements and entitlements
  • Manage potentially high exposure and complex claims
  • Establish claim reserve levels by estimating the cost of each assigned claim; monitor reserves and update amounts as necessary
  • Manage diary and complete tasks to ensure that cases move to the best financial outcome and timely resolution
  • Close all files as appropriate in a timely and complete manner
  • Oversee and coordinate medical treatment for injured employees and provide information to treating physicians regarding employees’ medical history, health issues, and job requirements; provide direction to assigned nurse case manager where applicable
  • Identify subrogation potential and pursue the process of reimbursement
  • Communicate with defense attorneys regarding litigated cases; make recommendations regarding proposed strategies for claim resolution. Extend bona fide offers, where warranted
  • Analyze, compute and process indemnity payments for all appropriate benefits due, including TTD (temporary total disability) PPD (permanent partial disability) and PTD (permanent total disability)
  • Identify all potential liens and credits available and apply them as appropriate
  • Attend and participate in staff meetings and keep supervisor informed of status on all assigned cases and plan of action. Stay abreast of new trends, pending legislation and case law related to workers’ compensation
  • Process PARs (payment authority request) when applicable
  • Assign to the field investigator for GOTCHA visitation within the account specific timeframe
  • Manage self-insured retention excess reporting
  • Routinely interact with clients, claimants, attorneys, investigators, experts and other vendors
50

Field Crop Adjuster, Rcis Resume Examples & Samples

  • Follow regulatory and company rules, policies and procedures
  • Walk in agricultural fields up to 3 miles
  • Lift 25 lbs. to 50 lbs
  • Work outdoors in varying temperatures/weather conditions
51

Claims Adjuster Trainee Resume Examples & Samples

  • Responsible for handling insurance claims filed by policyholders
  • This is an entry-level Claims Adjuster role. Safelite will support licensing & training requirements for those hired
  • This is the first tier of a career path as a licensed claims adjuster
  • Plans and schedules work needed to process and investigate claims
  • Review settled insurance claims to determine that payments and settlements have been made in accordance with company practices and procedures
  • Report overpayments, underpayments, and other irregularities
  • Verify and analyze data used in settling claims to ensure that claims are valid and that settlements are made according to company practices and procedures
  • Analyze information gathered by investigation and report findings and recommendations
  • Maintain claim files, such as records of settled claims and an inventory of claims requiring detailed analysis
52

General Adjuster Resume Examples & Samples

  • Examines claim forms and other records to determine insurance coverage
  • Interviews, telephones, or corresponds with claimant and witnesses regarding claim
  • Consults police and hospital records; and inspects property damage to determine extent of company's liability and varying methods of investigation according to type of insurance
  • Estimates cost of repair, replacement, or compensation
  • Prepares report of findings and negotiates settlement with claimant
  • Recommends litigation by legal department when settlement cannot be negotiated
  • Attends litigation hearings
  • Revises case reserves in assigned claims files to cover probably costs
  • Prepares loss experience reports to help determine profitability and calculates adequate future rates
  • Performs other duties as assigned
  • Supports the organization's quality program(s)
  • Travels as required
  • Strong oral and written communication, including presentation skills
  • PC literate, including Microsoft Office products
  • Strong customer service skills
  • Attention to detail and accuracy
  • Good time management and organizational skills
  • Ability to work independently or in a team environment
  • Ability to meet or exceed Performance Competencies
53

Senior Adjuster Resume Examples & Samples

  • Inspects claims and contacts involved parties in a timely manner
  • Investigates circumstances of claim(s) as required for coverage determination, cause, and compensable damages/reserves
  • Examines insurance policies and other records to determine insurance coverage
  • Prepares estimates for cost of repair and/or replacement
  • Conducts interviews with claimant and witnesses regarding submitted claim(s)
  • Negotiates and settles both 1st and 3rd party claims
  • Addresses salvage and subrogation as required by the client
  • Maintains client relationships to assure repeated business referrals
  • Performs other duties as assigned
  • Supports the organization's quality program(s)
  • Travels as required
  • Strong oral and written communication, including presentation skills
  • PC literate, including Microsoft Office products
  • Demonstrated commitment to timely reporting
  • Strong customer service skills
  • Strong interpersonal skills
  • Attention to detail and accuracy
  • Good time management and organizational skills
  • Ability to work independently or in a team environment
  • Ability to meet or exceed Performance Competencies
54

Adjuster General Regional Resume Examples & Samples

  • Examines claim forms and other records to determine insurance coverage
  • Interviews, telephones, or corresponds with claimant and witnesses regarding claim
  • Consults police and hospital records; and inspects property damage to determine extent of company's liability and varying methods of investigation according to type of insurance
  • Estimates cost of repair, replacement, or compensation
  • Prepares report of findings and negotiates settlement with claimant
  • Recommends litigation by legal department when settlement cannot be negotiated
  • Attends litigation hearings
  • Revises case reserves in assigned claims files to cover probably costs
  • Prepares loss experience reports to help determine profitability and calculates adequate future rates
  • Strong oral and written communication, including presentation skills
55

Adjuster General Executive Resume Examples & Samples

  • Handles complex losses locally unassisted up to designated authority; assists on larger losses, including handling accounting-based losses (business interruption and stock)
  • Examines claim form and other records to determine insurance coverage
  • Interviews, telephones, or corresponds with claimant and witnesses regarding claim
  • Consults police and hospital records; and inspects property damage to determine extent of company's liability and varying methods of investigation according to type of insurance
  • Estimates cost of repair, replacement, or compensation
  • Prepares report of findings and negotiates settlement with claimant
  • Recommends litigation by legal department when settlement cannot be negotiated
  • Attends litigation hearings
  • Revises case reserves in assigned claims files to cover probably costs
  • Prepares loss experience reports to help determine profitability and calculates adequate future rates
  • Supports the organization's quality program(s)
  • Travels as required
  • Strong oral and written communication, including presentation skills
  • PC literate, including Microsoft Office products
  • Good time management and organizational skills
56

Maintenance Adjuster Resume Examples & Samples

  • 4 years verifiable industrial mechanical experience, and must be able to pass a job-related maintenance mechanics test
  • Work positions include squatting (20%), with extended reach above head (20%) and in front of body (60%), above 18 inches and in front 30 inches
  • Lifts materials and equipment weighing 50 pounds and places on pallet, and carries while walking up to 10 times per hour for distances up to 10 feet
  • Requires handling materials weighing 50 pounds while pushing, pulling, lifting and twisting, lifting while twisting, lifting and walking, bending and lifting, reaching and lifting, and reaching while lifting
  • Works in non-air conditioned environment with high noise levels, and is subject to both heat and cold
  • Operates mechanical lifting devices (i.e., pallet jacks and forklifts) to move materials, and must get on and off 5 to 10 times per hour. Requires squatting and pushing to position forks and stock materials on shelves weighing up to 100 pounds, at heights of 30 feet
  • Drives forklifts in reverse, which requires twisting the upper body and neck up to 10% of the time
  • Requires valid forklift certification
57

Regional General Adjuster Resume Examples & Samples

  • Analyze large quantities of medical records and discern key issues
  • Work with high authority limits on assignments reflecting a very high degree of technical complexity and coordination
  • Possesses a high and extensive level of technical knowledge and skills including product and industry for Healthcare Liability
  • Responsible to provide consultation and participation in the development of large claim strategies
58

Claims Representative Casualty Adjuster Resume Examples & Samples

  • College degree is preferred
  • 3+ year’s casualty claims handling experience is preferred
  • A minimum of 3 year’s BI experience handling large exposure claims is preferred
  • States handled TX, OK, LA, MS, KS and MO
  • Licensed in Texas
  • Must have claims related computer systems experience; Guide Wire claims system experience a plus
  • Ability to work Monday - Friday, 8:00 am - 5:00 pm – There is also the possibility of limited Saturday work on a rotational basis from 9:00 am – 2:00 pm
  • Fluent in Spanish a plus, but not required
59

Subrogation Adjuster Resume Examples & Samples

  • Bachelor’s degree preferred
  • 3+ years adjusting experience in an insurance related claims field
  • Valid adjusters’ license(s) in appropriate states or ability to obtain such
  • Insurance coursework (I.e. IIA, CPCU,SCLA,AEI), is beneficial
  • Good analytical abilities to review, exercise judgment and evaluate claims in order to make sound decisions
  • Understanding of liability and negligence, multijurisdictional exposure preferred
  • Excellent negotiation skills
  • Excellent computer skills are needed due to multiple claim systems and automated recovery tools such as ISO, Arbitration Forums, etc.; ability to learn new software programs
  • Sound command of the English language--its grammar, syntax and style, including an understanding of the conventions of punctuation and capitalization
60

Senior Liability Adjuster Qual-lynx Resume Examples & Samples

  • Understand concepts of coverage, policy interpretation, exposure recognition and liability determination to analyze and move claims toward resolution using Best Practices
  • Promptly investigate all assigned claims for coverage, liability assessment and damages
  • Investigate claims by interviewing claimants and witnesses, establish claim reserves, handle evidence, obtain evidence, obtain and interpret official reports and claim forms
  • Negotiate and settle claims, set reserves and manage litigation within client service parameters and authority levels by obtaining demands and making offers to claimants
  • May present evidence at legal proceedings
  • Direct appraisal and/or inspection of damaged property
  • Dispose of salvage and pursue subrogation when appropriate
  • Report all serious injuries/liability issues and potential large loss claims to the client and/or reinsurer based upon the criteria provided by the client
  • Document plan of action in the claim system and set appropriate diaries
  • Manage diary and complete tasks to ensure that cases move to the best financial outcome and timely resolution
  • Close all files as appropriate in a timely and complete manner
  • Maintain closing ratio as directed by management team
  • Attend/participate at mediation, trials or hearings
  • Routinely interact with clients, claimants, attorneys, investigators, experts and other vendors
  • Perform other duties as required
61

Adjuster, Complex Claims PC Resume Examples & Samples

  • Ensuring effective vendor and litigation management on Complex Claims within a personal allocation
  • Broader internal / external stakeholder communication where required as Auto Technical Claims Expert
  • Handle higher level of complexity claims, complex losses within authority limits
  • Timely, accurate and customer focused claim resolution, minimizing indemnity exposure and mitigating vendor and legal expense
  • Effective communication of key advanced Complex Claims and Auto Claims portfolio messages to internal stakeholders
  • Attain objectives for assigned projects
  • Benchmarks for claims processing and file closure
62

Cargo Adjuster Resume Examples & Samples

  • Investigate and adjust Motor Truck Cargo, Inland Marine, Military Cargo Claims, GL, and/or Commercial Auto claims
  • Manage and maintain successful Broker/Client relationships
  • Handle extensive coverage issues
  • Excellent verbal and written communication skills required
  • Possess strong technical skills, including extensive coverage experience
  • Must have the ability to manage and maintain successful Broker/Client relationships
  • 5+ years Commercial Lines Casualty including Motor Truck Cargo, Inland Marine, Military Cargo Claims, GL, and/or Commercial Auto in the Transportation/Moving and Storage Industry
  • Multi-state licensing a plus
63

Material Damage Adjuster Resume Examples & Samples

  • Arranges to inspect vehicles, driving to site of accident/damage within assigned territory or others if required. Photographs damaged areas, writes estimates, determines rental need and controls those costs according to company guidelines
  • Negotiates repair costs, establishes value, settles total losses and handles disposal of salvage
  • Distinguishes cause of damage for appropriate policy coverage
  • Issues settlement checks and keeps appropriate records
  • Responds to Policyholders and claimants complaints stemming from original adjustment
  • Establishes rapport with Agents and claims adjusters
  • At the request of Underwriting, evaluates antique and classic cars for coverage value
  • Attends appropriate training sessions
  • The first five duties listed are the functions identified as essential to the job. Essential functions are those job duties that must be performed in order for the job to be accomplished
64

Senior Multi Line Adjuster Resume Examples & Samples

  • Investigate and settle claims promptly and fairly
  • Recommend litigation when appropriate
  • Maintain company reputation by complying with federal and state regulation
  • And maintain professional and technical knowledge through continuing company provided industry best education
65

Field Adjuster Resume Examples & Samples

  • May use a company claims office location as their base operations, or they may work out of their homes
  • Handle business interruption (BI) features in conjunction with BI specialists
  • Works within specific limits and authority on assignments of moderate technical complexity
66

Adjuster, Claims Resume Examples & Samples

  • Processes motor vehicle, liability and casualty claims, research and gather relevant information; evaluates claim validity; negotiates claims within a prescribed authority limit to ensure equitable and timely settlements; and communicates with involved parties
  • Prepares and submits initial reports and tracks actions taken, claim developments and status of assigned claims
  • Submits administrative reports as required
  • Pursues third parties to recover damage to company vehicles
  • Associate degree
  • Adjuster License
  • 3 years of experience investigating, evaluating, and resolving General Liability and automobile claims
  • Interpersonal skills including negotiating, influencing, and persuasion
  • Demonstrated ability in decision making skills
  • Computer literacy - intermediate proficiency
67

Adjuster, Senior Casualty Resume Examples & Samples

  • Evaluate insurance coverage based on claim report, the insurance policy, applicable statutes and case law to determine if a claim can be accepted as within coverage
  • Comply with all statutory and regulatory requirements in all applicable jurisdictions
  • Obtain and review medical records
  • Interview, telephone, and/or correspond with claimant and witnesses; obtains and reviews police hospital records, appraisals and repair estimates to evaluate injuries property damage; Reports to client as required by contractual account instructions; varying method of investigation according to type of coverage
  • Identify key issues and investigation required
  • Meet detailed quality assurance standards of performance
  • Obtain and maintain all required licenses and certifications and meet all continuous training and certification requirements
  • Determine extent of the client’s financial exposure with respect to claims; set case reserves for use by clients and regulatory authorities
  • Revise case reserves based on developments in the course of adjusting the claim
  • Settle claims within assigned levels of authority as set forth in complex, detailed client account instructions
  • Handle complex litigated claims with limited input from the Unit Manager and/or AVP
  • Effectuate prompt payment (with client’s funds) to claimants and service providers
  • Select and manage defense and coverage counsel
  • Select and manage experts
  • Work with and provide claim-specific guidance to Field Adjusters
  • Be alert to insurance fraud and implement special procedures if fraud is suspected
  • Involve client in decision-making as appropriate and/or follow client-specific requirements for escalation when client decision-making and/or notification is required
  • Interact successfully with co-workers
  • Other duties as assigned
  • Excellent negotiation skills
  • Engage and manage coverage counsel and defense counsel
  • Review and analyze medical records
  • Review and analyze expert’s reports
  • Excellent oral and written communication and presentation skills
  • Analytical and interpretive skills
  • Strong organizational skills
  • Solid interpersonal skills
  • Strong customer service skills
  • Able to multitask
  • Capable of setting priorities
  • Works well under pressure
  • Spanish fluency is a plus
  • In-depth knowledge of multi-jurisdictional claims handling issues
  • PC literate, including Microsoft Office products
  • Extensive knowledge of investigation management including, but not limited to, taking and using recorded statements, determining coverage and application of coverage to claims, delivering case value and negotiation and resolution of claims
  • Minimum of 5 + years of industry experience in Property and Casualty Claims
68

Rcis Field Crop Adjuster Resume Examples & Samples

  • Crop Adjuster Proficiency Program Certification (CAPP) must be obtained within 180 days of hire date
  • RCIS Crop Adjuster Physical Requirements
  • Climb agricultural storage bins up to 25 feet
69

Regional Liability Adjuster Resume Examples & Samples

  • Works with high authority limits on assignments reflecting a very high degree of technical complexity and coordination
  • Possesses a high and extensive level of technical knowledge and skills including product and industry
  • Negotiate settlements, mitigate losses, and control expenses on our company’s largest losses
  • Recognized as the company consultant in a field providing technical guidance, assistance, and training to lower level associates. May have regional, zone or company wide scope
70

Certified Repair Program Adjuster Resume Examples & Samples

  • Basic knowledge and understanding of office, field and Customer Repair Program claim handling processes related to Physical Damage claims
  • Basic knowledge and understanding of policies and endorsements related to physical damage coverages
  • Demonstrated experience handling simple to moderately complex physical damage claims
  • Valid driver's license required plus an acceptable driving record (field position only)
71

Homeowner Large Loss Field Adjuster Resume Examples & Samples

  • Responsible for the investigation and evaluation of extremely complex, high-value property claims requiring expert knowledge of construction techniques and processes
  • Handles multiple states and must understand the laws and regulations of each
  • 2-3 years experience with Xactimate or similar estimating system
72

Unrepresented Commercial Adjuster Resume Examples & Samples

  • Bachelors degree in related field preferred or equivalent experience
  • Commercial experience preferred
  • Ability to interact effectively with internal or external customers and act with empathy
  • Applies general and occasionally broad knowledge of insurance policy, coverage, and regulations
  • Applies general and occasionally broad knowledge of claim processes, policies, procedures, claim systems, coverage, liability, damage estimating, and/or settlement, and adherence to applicable legal compliance standards
  • Applies general and occasionally broad industry knowledge to discipline practices, including best practices, to support the business unit
  • Applies general and occasionally broad knowledge of analytical procedures to reconcile, manipulate, and recognize patterns of data
73

Represented Commercial Adjuster Resume Examples & Samples

  • Obtains photos and/or conducts scene investigation
  • Takes recorded statements from claimants, insured’s, witnesses, medical providers, etc., conducts investigations into complex and occasionally highly complex auto accidents involving commercial policy holders, determines liability, and prepares summaries
  • Evaluates and determines potential use of experts; reviews reports and selects the expert
  • May serve as a committee team lead for large projects or as a committee team member on very large projects
  • Participates in or leads Telephone Alert Conferences regarding complex claims referred to Home Office
  • Commercial experience a plus
  • Applies advanced knowledge of insurance policy, coverage, and regulation
  • Applies advanced knowledge of claim processes, policies, procedures, claim systems, coverage, liability, damage estimating, and/or settlement, and adherence to applicable legal compliance standards
  • Applies advanced knowledge of analytical procedures to reconcile, manipulate, and recognize patterns of data
  • Applies advanced knowledge of problem solving and preparation of complex reports for analysis
  • Applies advanced ability to leverage learned technical skills in support of team objectives
  • Applies advanced negotiation and/or arbitration skills
  • Applies advanced conflict management and problem resolution skills in managing internal and external customer relationships
  • Ability to investigate, evaluate, negotiate and settle complex and occasionally highly complex claims
  • This position requires travel
  • Have and maintain the licenses and registrations for the role per state requirement
74

Experienced Commercial Represented Casualty Adjuster Resume Examples & Samples

  • Bachelors degree in related field preferred
  • At least 7 years of progressive represented casualty experience is a MUST
  • Commerical experience is preferred, but is not required
  • Advanced knowledge of insurance policy, coverage, and regulation
  • Advanced knowledge of claim processes, policies, procedures, claim systems, coverage, liability, damage estimating, and/or settlement, and adherence to applicable legal compliance standards
  • Advanced industry knowledge to discipline practices, including best practices, to support the business unit
  • Knowledge of analytical procedures to reconcile, manipulate, and recognize patterns of data
  • Problem solving and preparation of complex reports for analysis
  • Ability to leverage learned technical skills in support of team objectives
  • Advanced negotiation and/or arbitration skills
  • Conflict management and problem resolution skills in managing internal and external customer relationships
  • Ability to assist leadership in achieving business unit objectives
  • Applies advanced knowledge of training facilitation and coaching skills
75

Rcis Crop Adjuster Resume Examples & Samples

  • Complete field inspections and related responsibilities such as reading maps and aerial photos, measuring field and storage bins, and discussing findings of crop loss with farmers
  • Perform fact finding regarding crop damage; record information and transmit loss information to accurately determine potential damages
  • Provide excellent service to our customers – both agents and policyholders (farmers)
  • Utilize company software to electronically transmit claims information directly from the field to RCIS to ensure claims are processed timely and accurately
  • Follow regulatory and company rules, policies and procedures
  • High School Diploma or Equivalent and 6 or more months of experience in the agricultural area
  • Crop Adjuster Proficiency Program Certification (CAPP) must be obtained with 180 days of hire date
  • Reliable personal transportation and travel within territory
  • RCIS Crop Adjuster Physical Requirements: walk in agricultural fields up to 3 miles, climb agricultural storage bins up to 25 feet, lift 25 lbs to 50 lbs, work outdoors in varying temperatures/weather conditions
  • Excellent verbal, written and interpersonal communication skills
  • Strong organization and prioritization skills
  • Intermediate Microsoft Office skills
76

Claims Representative Casualty Adjuster Resume Examples & Samples

  • 3+ years of casualty claims handling experience
  • College degree or equivalent work experience
  • 2+ years of BI experience preferred
  • Bilingual is a plus
77

Field Large Loss Contents Adjuster Resume Examples & Samples

  • Delivering exceptional and courteous customer service
  • Traveling to the location of damaged property and/or conducting assessments on site
  • Achieving targeted performance goals to support Allstate's industry-leading operational standards
  • High School Diploma/General Education Diploma (GED), plus three years’ experience writing estimates for an insurance carrier
78

WC Adjuster Qual-lynx Resume Examples & Samples

  • Review, investigate and analyze Workers’ Compensation claims
  • Interact with injured employees to ensure awareness and understanding of the Workers’ Compensation process, requirements and entitlements
  • Manage potentially high exposure and complex claims
  • Establish claim reserve levels by estimating the cost of each assigned claim; monitor reserves and update amounts as necessary
  • Manage diary and complete tasks to ensure that cases move to the best financial outcome and timely resolution
  • Close all files as appropriate in a timely and complete manner
  • Oversee and coordinate medical treatment for injured employees and provide information to treating physicians regarding employees’ medical history, health issues, and job requirements; provide direction to assigned nurse case manager where applicable
  • Identify subrogation potential and pursue the process of reimbursement
  • Communicate with defense attorneys regarding litigated cases; make recommendations regarding proposed strategies for claim resolution. Extend bona fide offers, where warranted
  • Analyze, compute and process indemnity payments for all appropriate benefits due, including TTD (temporary total disability) PPD (permanent partial disability) and PTD (permanent total disability)
  • Identify all potential liens and credits available and apply them as appropriate
  • Attend and participate in staff meetings and keep supervisor informed of status on all assigned cases and plan of action. Stay abreast of new trends, pending legislation and case law related to workers’ compensation
  • Process PARs (payment authority request) when applicable
  • Assign to the field investigator for GOTCHA visitation within the account specific timeframe
  • Manage self-insured retention excess reporting
  • Routinely interact with clients, claimants, attorneys, investigators, experts and other vendors. Attent client meetings and present PARS
79

Medical Adjuster Resume Examples & Samples

  • Minimum of 1 year related experience required
  • Appropriately licensed and/or certified in all states in which claims are being handled
  • Able to operate a computer; knowledge of MS Office applications, and related claims and business software
  • Knowledge of claims investigation and settlement procedures and applicable state laws and industry standards required
  • Solid analytical skills necessary to make decisions and resolve issues inherent in handling claims
  • Able to plan and organize activities and workload and respond to multiple demands
  • Good verbal and written communications skills
  • Work Traits
80

Homeowners Senior Field Adjuster Resume Examples & Samples

  • Adheres to high standards of professional conduct consistent with the delivery of superior service
  • Timely identification, analysis and resolution of coverage issues arising in claims investigation
  • Negotiate and settle claims within delegated authority as outlined in company policies and procedures
  • Maintains current knowledge of insurance and applicable product/services
  • Relevant experience includes Claims or Customer Service experience that required the ability to think critically, problem solve, and effectively communicate verbally and in writing
81

Adjuster General Resume Examples & Samples

  • Examines claim forms and other records to determine insurance coverage
  • Interviews, telephones, or corresponds with claimant and witnesses regarding claim
  • Consults police and hospital records; and inspects property damage to determine extent of company's liability and varying methods of investigation according to type of insurance
  • Estimates cost of repair, replacement, or compensation
  • Prepares report of findings and negotiates settlement with claimant
  • Recommends litigation by legal department when settlement cannot be negotiated
  • Attends litigation hearings
  • Revises case reserves in assigned claims files to cover probably costs
  • Prepares loss experience reports to help determine profitability and calculates adequate future rates
  • Performs other duties as assigned
  • Supports the organization's quality program(s)
  • Travels as required
  • Strong oral and written communication, including presentation skills
  • PC literate, including Microsoft Office products
  • Strong customer service skills
  • Attention to detail and accuracy
  • Good time management and organizational skills
  • Ability to work independently or in a team environment
  • Ability to meet or exceed Performance Competencies
82

Crop Field Adjuster, Rcis Resume Examples & Samples

  • Complete field inspections and related responsibilities such as reading maps and aerial photos, measuring field and storage bins, and discussing findings of crop loss with farmers
  • Perform fact finding regarding crop damage; record information and transmit loss information to accurately determine potential damages
  • Provide excellent service to our customers – both agents and policyholders (farmers)
  • Utilize company software to electronically transmit claims information directly from the field to RCIS to ensure claims are processed timely and accurately
  • Provide your own reliable personal transportation and travel within territory
83

Loan Adjuster Resume Examples & Samples

  • Maintain an automated history of delinquent installment loans and lines of credit. Contact delinquent customers by telephone, letter, and field calls visiting customers at their residence to make arrangements to bring their accounts to a current status. Make recommendations to Collection Supervisor for legal action and charge offs
  • Assist in the repossession of property under lien. Coordinates collection efforts with branch and other departments
  • Assist in the writing and coordination of new loan documents for delinquent loans with the approval of the Vice President Collection Manager or the Recovery Officer
  • Represent the Bank at sheriff sale or bankruptcy proceeding. File and present Bank’s case at civil complaint hearings
  • Complete various floor plan audits each month, for both true floor plans and lines of credit. In addition they will review their findings with the Vice President Collection Manager and report on any potential problems
  • Assist in the enforcement of insurance requirements for property under lien
  • Assist Bank customers in structuring budgets, as well as making recommendations for reaging and extensions to Collection Supervisor
  • 3 or more years of collections experience. (Required)
84

Field Adjuster Resume Examples & Samples

  • Investigates, analyzes, evaluates and negotiates personal claims of minimal to moderate complexity. May handle low complexity commercial claims
  • May be responsible for all aspects of each claim, including informal hearings, arbitrations, and claims litigation and maintaining a high level of productivity, confidentiality and customer service
  • Implement and coordinate the most effective management techniques to mitigate loss and expense payments
85

Adjuster, Express Claims PC-sa Fnol Resume Examples & Samples

  • Entering accurate and detailed information into claim handling platform to generate a claim number to ensure the claim is segmented appropriately
  • Creating and sending customers an acknowledgement letter (FAQ) which includes claim number and adjuster contact information
  • Assessor and adjuster assignment both internal and external if necessary and assessing whether a third party exposure exists or not
  • Ensuring that all allocated work is handled within the Key Performance Targets of the XXX Department following agreed internal and external processes, policies and procedures to ensure quality and service standards are met and leakage minimized
  • Identifies and recommends referral of potentially recovery exposure to Subrogation
  • Ability to take a pro-active and results orientated approach to FNOL handling, whilst making claimants feel valued
  • Takes ownership and follows through on agreed commitments and will take the initiative to suggests improvements to the process in order to service our customers more efficiently
  • Call handling in line with SLA targets related to both accuracy and service as measured via monthly audits
  • Ability to identify the appropriate solution from a range of options whilst holding conversations with customers and claimant
  • Demonstrate good understanding of claims procedures, products and services following on boarding
  • Time management - Ability to handle multiple priorities, organize work and meet deadlines
  • Microsoft Packages – Excel, Word, Outlook etc and ability to use applications in a Windows environment
  • Team Player, non calculative, hardworking
86

Adjuster General Resume Examples & Samples

  • Handles complex losses locally unassisted up to designated authority; assists on larger losses, including handling accounting-based losses (business interruption and stock)
  • Examines claim form and other records to determine insurance coverage
  • Assists in preparing loss experience report to help determine profitability and calculates adequate future rates
  • Demonstrated commitment to timely reporting
  • Strong interpersonal skills with varying levels (co-workers, vendors, clients, and management)
  • Strong integrity
87

General Adjuster Resume Examples & Samples

  • Handles complex losses locally unassisted up to designated authority; assists on larger losses, including handling accounting-based losses (business interruption and stock)
  • Examines claim form and other records to determine insurance coverage
  • Assists in preparing loss experience report to help determine profitability and calculates adequate future rates
  • Demonstrated commitment to timely reporting
  • Strong interpersonal skills with varying levels (co-workers, vendors, clients, and management)
  • Strong integrity
88

Commercial Represented General Liability Adjuster Resume Examples & Samples

  • Makes and maintains a connection with the customer by understanding and meeting their needs; serves the customer with empathy; and follows up to ensure that custome needs have been met
  • Researches and responds to complex customer communications, concerns, conflicts or issues
  • Reviews customer satisfaction results; participates in determining necessary personal and business unit action plans
  • Evaluates and determines potential use of experts; reviews reports and participates in selecting the expert
  • Completes complex attorney bill reviews
89

Commercial Liability Determination Adjuster Resume Examples & Samples

  • Investigating, evaluating, and negotiating claims, in order to reach a fair and equitable settlement
  • Four-year college degree preferred, plus two years’ experience delivering outstanding customer service
  • Ability to be a self-starter and work independently
  • Military candidates are encouraged to apply CLK789
90

Workers Comp Lost Time Adjuster Qual-lynx Resume Examples & Samples

  • Review, investigate and analyze Workers’ Compensation claims
  • Interact with injured employees to ensure awareness and understanding of the Workers’ Compensation process, requirements and entitlements
  • Manage potentially high exposure and complex claims
  • Establish claim reserve levels by estimating the cost of each assigned claim; monitor reserves and update amounts as necessary
  • Manage diary and complete tasks to ensure that cases move to the best financial outcome and timely resolution
  • Close all files as appropriate in a timely and complete manner
  • Oversee and coordinate medical treatment for injured employees and provide information to treating physicians regarding employees’ medical history, health issues, and job requirements; provide direction to assigned nurse case manager where applicable
  • Identify subrogation potential and pursue the process of reimbursement
  • Communicate with defense attorneys regarding litigated cases; make recommendations regarding proposed strategies for claim resolution. Extend bona fide offers, where warranted
  • Analyze, compute and process indemnity payments for all appropriate benefits due, including TTD (temporary total disability) PPD (permanent partial disability) and PTD (permanent total disability)
  • Identify all potential liens and credits available and apply them as appropriate
  • Attend and participate in staff meetings and keep supervisor informed of status on all assigned cases and plan of action. Stay abreast of new trends, pending legislation and case law related to workers’ compensation
  • Process PARs (payment authority request) when applicable
  • Assign to the field investigator for GOTCHA visitation within the account specific timeframe
  • Manage self-insured retention excess reporting
  • Routinely interact with clients, claimants, attorneys, investigators, experts and other vendors