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Senior Claims Representative Resume

Maryland Heights, MO

SUMMARY Business professional with 8 years of experience in the insurance industry as both a Claim Representative and Manager. Highly skilled employee with exceptional analytical abilities as it relates to the law of contracts, tort theories and damage investigation. Recognized as a reliable employee with a strong work ethic, detail directed problem solver and a highly effective negotiator. Regarded as a positive thinker, an effective team player and a skilled communicator.

KEY ACCOMPLISHMENTS

  • Led multiple company initiatives as both a Claim Representative and Manager that reduced expenses, increased customer loyalty and improved company efficiencies.
  • Selected to resolve losses of a large value (& gt;100K) due to analytical abilities, attention to detail and strong customer service abilities.
  • Member of a team that created policy language, to enhance the customer benefit and increase customer loyalty.

BUSINESS EXPERIENCE

Confidential, Maryland Heights, MO 01/2011 - Present

Senior Claims Representative Independently investigates the facts of loss, determines and verifies coverage and liability, evaluates settlement value and settlement options and negotiates claims of a serious and complex nature.

  • Establishes coverage and liability investigative plan; initiates investigation by gathering facts and evidence with all witnesses and interested parties; analyzes extent of exposure
  • Gather, analyze and evaluate, for settlement purposes,all supportive documentation and adjusts claims within authority limit.
  • Possesses a thorough understanding of state laws and regulations applicable to claims handled, including state unfair claim practice laws and regulation.
  • Assists in training and development of other Claim Representatives

Confidential, Maryland Heights, MO 01/2006 -01/2011 Claim Manager Supervised and directed the investigation and disposition of all assigned claims with my direct reporting group. Trained, developed, and provided technical and leadership guidance to Claims Representatives, and in some cases, other Claim Managers.

  • Directed resolution of problems and general public relation issues which arose concerning claims service
  • Responsible for the communication, implementation and monitoring of procedural changes and company programs.

Confidential, Maryland Heights, MO 06/2003 - 01/2006 Claim Representative Investigated the facts of loss, determined and verified coverage and liability, evaluated settlement value and settlement options and negotiated claims of a minor nature.

  • Accurately resolved customer claim concerns while providing exceptional customer service
  • Trained and mentored new employees

Confidential, Bethalto, IL 03/2002-05/2003 Teller Responsible for processing member transactions: cash/checking deposits, cash advances, loan payments and examining transactions for accuracy.

  • Determined, met and solved member needs, problems and conflicts through the creation of financial solutions
  • Maintained accurate detail of all transactions
  • Presented a positive image of the Credit Union through each customer interaction

EDUCATION, TRAINING, AND PROFESSIONAL ORGANIZATIONS

Bachelor of Science (Business Administration, Specializations in: Finance and Economics) Associate of Science,

Professional Training: Senior Claims Law Associate (SCLA), Courses in Property, Liability, Legal Principles Focus: Law of Automobile, Homeowners, Business Auto Claims

Professional Organization: Confidential, Competent Communicator Award 2008 and Competent Leader Award 2010 Member: 01/2006- 07/2011 President: 06/2009-06/2010 Vice President of Membership: 07/2010 - 07/2011

Professional Organization: Confidential Member: 08/2001-05/2003 President: 05/2002-05/2003

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