Claims Adjuster Resume Sample
Terrance Pfeffer
688 Buford Views,
Detroit,
MI
+1 (555) 901 8134
Work Experience
Senior Claims Adjuster
10/2016
-
PRESENT
San Francisco, CA
- Excellent interpersonal skills with a diverse group of contacts
- Determine extent of the client’s financial exposure with respect to claims; set case reserves for use by clients and regulatory authorities
- Effectuate prompt payment (with client’s funds) to claimants and service providers
- Determine extent of the client’s financial exposure with respect to claims; set case reserves for use by clients and applicable regulatory authorities
- Escalate concerns or issues to the Sr. Casualty Claims Manager or Sr. Director of Risk as needed
- Identify cases requiring surveillance
- Provide reporting and analysis based on productivity and results metrics
- Prepares for and participates in file reviews and claim audits as required
- Feedback’s Priceless - Sees more through other’s feedback
Claims Adjuster
01/2012
-
06/2016
Philadelphia, PA
- Accurately assess legal liability based upon knowledge obtaining via discussion with Insured’s/brokers/external/internal investigators
- Assess quantum using appropriate materials or by referral (if required)
- Identify potential saving by use of rehabilitation via AIG Medical & Rehabilitation
- Correspond with relevant parties to the claim
- Build key relationships
- Proactive control of costs relevant to claims
- Promote high standards of file maintenance by use of diary
- Identify potential fraudulent/fraudulent claims
- Gathers and assembles pertinent claim information by contacting lenders, auto dealers, borrowers, and/or agents. Ensures the completeness and accuracy of documentation for processing
Claims Adjuster Summer Intern
07/2005
-
11/2011
Phoenix, AZ
- Own it - Owns, drives, and achieves desired key results
- Win Together - Works across boundaries to achieve key results
- Trust Matters - Acts in a manner that cultivates trust in others
- Thinking Forward - Thinks and acts in a manner to deliver desired future results
- Calculate the extent of the client’s financial exposure with respect to claims, including, but not limited to, liability, estimated expenses and potential indemnification; analyze information to set case reserves for use by clients and applicable regulatory authorities
- Involve client in decision-making as set forth in client account instructions and consistent with company policies and guidelines. Determine when to involve the client in decision-making by applying client’s instructions and corporate guidelines
- Identify policy coverage & relevant deductibles, excesses and reinsurance issues
- Ensure claims system is accurate
- Handle and investigate all claims that have been allocated with the agreed Best Practice requirements
Education
The University of Kansas
2001 - 2005
Bachelor's Degree in Related Field
Professional Skills
- Excellent customer service and communication skills and sound judgment and decision making skills
- Strong negotiating, presentation skills and organizational skills are necessary
- Excellent time management skills and attention to detail. Exceptional customer service skills
- Effective communication skills, written and verbal, demonstrated by experience liaising with internal and external stakeholders
- Analytical skills and Good Decision Making Skills
- Strong interpersonal skills to professionally and effectively represent the Everest brand and claims department to both external and internal stakeholders
- Solid planning, prioritizing and organizing skills
How to write Claims Adjuster Resume
Claims Adjuster role is responsible for interpersonal, negotiation, analytical, claims, training, computer, customer, organizational, english, insurance.
To write great resume for claims adjuster job, your resume must include:
- Your contact information
- Work experience
- Education
- Skill listing
Contact Information For Claims Adjuster Resume
The section contact information is important in your claims adjuster resume. The recruiter has to be able to contact you ASAP if they like to offer you the job. This is why you need to provide your:
- First and last name
- Telephone number
Work Experience in Your Claims Adjuster Resume
The section work experience is an essential part of your claims adjuster resume. It’s the one thing the recruiter really cares about and pays the most attention to.
This section, however, is not just a list of your previous claims adjuster responsibilities. It's meant to present you as a wholesome candidate by showcasing your relevant accomplishments and should be tailored specifically to the particular claims adjuster position you're applying to.
The work experience section should be the detailed summary of your latest 3 or 4 positions.
Representative Claims Adjuster resume experience can include:
- Calculates claim proceeds in accordance with the Master Policy coverage by analyzing and reviewing borrower’s loan history, MSRP/NADA valuations, appraisals, and primary carrier’s coverage documentation
- Strong interpersonal skills and a real focus towards excellent customer experience
- Demonstrate effective communication, interpersonal, and organizational skills
- Strong interpersonal skills & effective team player and collaborator
- Well-developed interpersonal skills and customer service skills
- To effectively manage a caseload of claim files prioritising new and existing work appropriately, along with new incoming post
Education on a Claims Adjuster Resume
Make sure to make education a priority on your claims adjuster resume. If you’ve been working for a few years and have a few solid positions to show, put your education after your claims adjuster experience. For example, if you have a Ph.D in Neuroscience and a Master's in the same sphere, just list your Ph.D. Besides the doctorate, Master’s degrees go next, followed by Bachelor’s and finally, Associate’s degree.
Additional details to include:
- School you graduated from
- Major/ minor
- Year of graduation
- Location of school
These are the four additional pieces of information you should mention when listing your education on your resume.
Professional Skills in Claims Adjuster Resume
When listing skills on your claims adjuster resume, remember always to be honest about your level of ability. Include the Skills section after experience.
Present the most important skills in your resume, there's a list of typical claims adjuster skills:
- Demonstrated verbal and written communications skills, negotiation skills and influence management skills
- Solid interpersonal skills; customer service skills; negotiation skills
- Strong analytical and organizational skills along with excellent communication, negotiation and investigation skills
- Strong Analytical skills; Strong Computer skills
- Analytic Skills: Possesses strong analytical skills and sound judgment. Technical claims handling
- Good communication skills for effective internal and external communication at all levels
List of Typical Experience For a Claims Adjuster Resume
1
Experience For Senior Claims Adjuster Resume
- Superior negotiation skills, oral and written communication and presentation skills
- Understand policies and very strong reading, writing skills
- Good computer skills including Excel and in-house claims systems; knowledge of ECF2, Repository, CLASS are desirable, although some training can be provided
- Strong customer service skills, including a high level of enthusiasm and energy
- Prior Bodily Injury experience required, including litigation experience
- Excellent hungarian and english language skills
- Work on own initiative Effective workload organisation skills, with the ability to work under pressure
- 7 Good PC skills
2
Experience For Associate Claims Adjuster Resume
- To effectively manage a caseload of claim files proiristing new and existing work appropriaetly, along with incoming post
- Client facing auditing and analytical skills
- Problem-solving skills and an ability to listen
- A focus on helping Casualty underwriters develop their portfolio of risks and manage these effectively
- Contribute effectively within a team environment and with internal / external stakeholders at all levels
- Representation at internal and external meetings to feedback findings backed up with good/solid audit reports
- English language skills required – verbal and written
3
Experience For Senior Casualty Claims Adjuster Resume
- Ensure claims are managed effectively through diary, significant injury and watch-list maintenance and static and outstanding query review
- Litigation Experience Adjuster licenses , 3 + years experience
- Job Required Skills
- Liaising and building excellent working relationships with all levels of employees across the practice areas
- Starting salary range: $40,200-$44,000, salary paid commensurate with experience
- Liaising with coverholders and TPA’s to ensure the effective management of claims within XL Catlin policies and Guidelines
- Working with the Team Manager to ensure effective vendor and litigation management on Complex claims within a personal allocation
- Understanding how the Claims function operates, including the lifecycle of the claim
4
Experience For General Liability Claims Adjuster Resume
- Delivering prompt, fair, innovative and accurate claims service enhancing strong broker and client relationships
- Provide an exceptional claims experience while investigating, evaluating, negotiating and resolving first party and third party auto property claims
- Have 7+ years’ experience of working within a technical claims environment including handling large and complex claims
- Work toward developing knowledge of the AIG structure specifically A&H Business structure and promote good working relationship
- Receive mentoring and coaching from experienced Claims Specialists/Adjusters
- Provides training and mentoring to less experienced adjusters
- Deliver an exceptional Customer Experience while authorizing 20 - 28 claims per day based upon approved dollar limit while answering 40– 50 calls per day
- Three (3) to five (5) years Medical claims processing experience in a HMO/Indemnity environment including technical research and
5
Experience For Liability Claims Adjuster Resume
- Strong background in the investigation of liability, damages and the interpretation of coverage, including the authoring of ROR's and declination letters
- Prioritizes contact of various parties associated with the claim, ensuring
- Build Key Relationships with A&H customers. Interact and promote good working relationship with internalcustomers
- Proven track record in delivering customer service
- Claims handling experience
- Experience adjusting lower level complexity claims for Marine, Financial lines, Property, Floater and other lines except casualty
- At least 1 year of work experience with Medical Liens or Personal Injury/Liability Insurance claim processing
6
Experience For Complex Claims Adjuster Resume
- Significant experience working directly with insureds
- Significant experience in Energy/Engineering Claims
- Experience in bodily injury and liability claims handling
- Able to handle and investigate all claims in accordance with company standards and procedures and demonstrate accurate and timely reserving
- Energy – Oil & Petro-chemical knowledge, Oil-rig experience, Power / Utilities knowledge, CAR, Mining loss knowledge, Terrorism
- Experience handling artisan type consturction claims
- Claims handling experience
7
Experience For Casualty Claims Adjuster Resume
- Some previous auto estimating experience is needed
- One year of experience with claims handling, a property damage adjuster, or repair work within an automobile repair and/or body shop
- Experience handling artisan type construction claim
- Strong analytical & negotiating capabilities
- Experience handling artisan type construction claims
8
Experience For Commercial Liability Claims Adjuster Resume
- Commercial claims handling experience
- Claims adjusting experience (2 -3 years)
- Demonstrated high level of initiative with a curiosity for learning
- One year of claims adjusting experience
- One year claims adjusting experience
- Experience adjusting commercial property claims
- 6 months - 1 year of property claims handling experience
- Over 2 years’ working experience in an insurance company
9
Experience For Commerical Claims Adjuster Resume
- Over 1 years’ working experience in a claims environment
- Experience adjusting Workers’ Compensation Claims under MGL Chapter 152
- Commercial liability claim handling experience, and knowledge of technology, and insurance regulations
- Solid working knowledge of claims management techniques
- Analyze, define and solve problems; the use of good judgment and decision making
- Experience adjusting Workers’ Compensations Claims under MGL Chapter 152
- Develop excellent working relationship with a variety of diverse internal and external stakeholders
- Experience adjusting Workers's Compensations Claims under MGL Chapter 152
10
Experience For Claims Adjuster Specialist Resume
- Five years of bodily injury liability claims handling experience
- Good working knowledge of CLASS / ECF (Electronic Claims File) system
- Need to be experienced with handling rental car claims
- Experience working with complex coverage claims
- Maintains an effective claims management diary to ensure all claims are handled promptly
- Time management – ability to manage and prioritise workload and diary management
- Three to five years’ experience as a Workers’ Compensation Claims Adjuster is required
- Escalates cases that involve injury and/or current or prior medical history/problems
- Experience in claims adjustment or claims examiner or other insurance related claims field
List of Typical Skills For a Claims Adjuster Resume
1
Skills For Senior Claims Adjuster Resume
- Analyzes and evaluates factual information to formulate an opinion on liability claim losses that do not involve bodily injury, including loss of use and related expenses
- Strong organizational skills, including setting priorities
- Effective and strong communication skills (written & verbal)
- Experience in effectively following up on recommendations from technical claims audits and continuous file handling improvements
- Good IT Skills, including a working knowledge of Word and Excel
2
Skills For Associate Claims Adjuster Resume
- Organizational skills; ability to multi-task; Capable of setting and managing priorities
- Manage case load of multiple claim files with varying degrees of complexity. Effectively manage multiple competing priorities to ensure timely claim resolution
- Effective reasoning, analysis and decision-making skills
- Proven experience building strong relationships
- Experience completing high impact projects effectively and efficiently. Able to multitask and work independently
- Experienced negotiator, incl. mediation, arbitration and ADR skills on higher value complex claims
3
Skills For Senior Casualty Claims Adjuster Resume
- Prioritize and effectively meet deadlines
- Proven analytical and quantitative skills. Strategic thinker; able to make prompt, intelligent decisions based upon detailed analysis of complex issues
- Effective workload organisation skills, with the ability to work under pressure, whilst meeting tight deadlines
- High level of organisation, prioritisation and attention to detail skills
- Effectively prioritise and handle a case load through to settlement
- To effectively manage a caseload of claim files prioritising new and existing
- Strong negotiation skills and an ability to engage with claimants in a succinct and coherent manner
- Professional demeanor and effective people skills
- Demonstrated above average interpersonal, organizational and customer service skills, as well as written and verbal communication
4
Skills For General Liability Claims Adjuster Resume
- Demonstrated skills as a claims adjuster of non-attorney represented injury claims
- Excellent communication, interpersonal , positive work ethic and leadership skills
- Excellent customer service skills and personable demeanor
- Excellent interpersonal communication skills both verbally and written
- Strong Computer skills; Detail oriented and accurate
- The capabilities, skills and knowledge required is normally acquired through 12-18 months of directly related experience
5
Skills For Liability Claims Adjuster Resume
- Strong organizational, written, and verbal skills
- Proven specialist technical capability together with applied practical and commercial business skills
- Excellent phone and verbal skills
- Able to prioritize and multi-task effectively in a fast paced environment
- Demonstrated skills as a Claims Adjuster-Bodily Injury
- Strong basic computer skills
- To effectively manage a caseload of claim files proiristing new and existing work appropriately, along with incoming post
6
Skills For Complex Claims Adjuster Resume
- Independent decision-making, problem solving and negotiation skills
- Grow. Receive paid training and support by your supervisors while growing your skills and your career
- Have Policy language skills enabling accurate and consistent policy wording interpretation
- Prior experience handling NJ indemnity and medical for a carrier or TPA
- Computer skills/ knowledge that include Word, Excel, typing, etc
- Able to demonstrate experience in handling complex D&O and FIPI claims
- Solid working experience with Microsoft Office packages especially Excel, Word, Access, Viso, PowerPoint
- Proficient computer skills including Microsoft Office products
- Solid ability to manage multiple competing priorities
7
Skills For Casualty Claims Adjuster Resume
- Strong proven track record in handling complex Professional Indemnity and Directors & Officers claims with limited direction
- Experience of handling claims in Australia, Canada, the U.S and Europe with good relationships with local counsel and adjusters preferable
- Analytical, problem solving and organizational skills
- Great interpersonal skills, ability to work with a wide variety of individuals
- Capable and confident written English skills
- Clear and appropriate written and oral communication skills
8
Skills For Commercial Liability Claims Adjuster Resume
- Developed investigation and negotiation skills
- Fluent English skills (written & spoken)
- Evaluates agent submitted household goods/non-household goods claims
- Demonstrated experience handling casualty claims
- Foster good relationships with internal and external customers and drive excellent customer service
- Proactively partners with the Manager to further enhance skills, knowledge and performance through claims coaching routines and personal development plan
9
Skills For Commerical Claims Adjuster Resume
- Works to establish relationships and collaborate effectively across the business, and leverages those relationships in the achievement of goals and objectives
- Intermediate Word and Excel skills required
- Exceptional technical expertise and analytical skills
- Insurance Experience/Claims Experience/Medical background
- Commercial Casualty experience primarily focusing on Commercial Auto Trucking and General Liability Experience
- Recent proven experience in a market Casualty claims handling role
- No fault claims experience specific to auto injury claims or related experience
- Effectively manage legal expenses
10
Skills For Claims Adjuster Specialist Resume
- Investigation / research skills for policy interpretation and review
- Customer Service Skills - inbound/outbound calls
- Prior customer service experience
- Has the ability to contribute effectively within a team environment
- Confident numeracy skills
- Casualty Adjuster Insurance Experience and/or other Claims Experience
- Effectively negotiate settlements with claimants or their representatives
- Provides excellent customer experiences by timely contacts and immediate follow up with concerns and/or complaints
List of Typical Responsibilities For a Claims Adjuster Resume
1
Responsibilities For Senior Claims Adjuster Resume
- Good phone etiquette and customer service skills
- Maintain industry knowledge and operational skills and attend workshops, seminars, and other training sessions as appropriate
- Effectively collaborate with various departments and levels in the organization
- Intermediate negotiation and conflict resolution skills
- Effectively handle special projects and member reimbursements within established departmental guidelines
2
Responsibilities For Associate Claims Adjuster Resume
- A high level of interpersonal skills necessary to interact successfully with Bashas’ team members, legal counsel and customers
- Promoting solid business relationships through the liaison with brokers/clients/underwriters, co-insurers and others insurance and legal professionals
- Experience in investigating, evaluating, and resolving General Liability, Automobile Liability and Subrogation claims
- Phone claims processing by investigating how auto accidents occurred and ensuring that the claims experience is a smooth as possible
- Proactively demonstrate the key principles of Treating Customers Fairly in claims handling
- 6 Good command of English in both writing and speaking
- Claims handling experience and working knowledge of auto and mortgage Lender-Placed or Force-Placed/Creditor-Placed/Collateral Protection Insurance (CPI)
- Experience of handling motor claims involving liability disputes and personal injury claims
- Experience to IDX and QNXT claims processing systems
3
Responsibilities For Senior Casualty Claims Adjuster Resume
- Significant experience managing complex, multi-party litigation
- Experience in liability claims processing
- Possesses strong technical aptitude including the ability to master multiple windows simultaneously
- Experience in customer facing, financial, or service oriented position
- Investigate, handle and resolve claims in a professional manner in order to ensure excellent claims handling service with minimal leakage
- In depth experience of working in a property claims environment, within a specialised / complex claims area
4
Responsibilities For General Liability Claims Adjuster Resume
- Claims handling experience
- Strong working knowledge of crop insurance regulations, policies, procedures and best practices
- Experience handling bodily injury claims
- Experience with RMIS systems and data mining
- Develop and maintain solid working relationships with both internal and external stakeholders
5
Responsibilities For Liability Claims Adjuster Resume
- Demonstrates ability to prepare and present adjuster level claims while showing confidence and poise
- Auto Bodily Injury Claims Handling Experience (Personal/Comm)
- Experience handling claims (auto, bodily injury, GL and PL claims)
- Product liability and/or claims management experience (general liability, bodily injury or homeowner/property claims)
- Adapts to new or different situations, requirements or priorities
- Operates with latitude for un-reviewed action or decisions
- Computer experience (MS Office, Excel, Word, etc) required
6
Responsibilities For Complex Claims Adjuster Resume
- Experience in insurance administration
- Maintain valid adjusters’ license(s) in states assigned (Southeast Region) or an ability to obtain same
- Multi-taks and prioritize
- 1-3 yrs. related business experience
- Business related experience
- Build and maintain effective internal and external working relationships. Collaborate with internal support teams and management as appropriate
- Able to work in a fast-paces environment, flexibility to handle multiple priorities while maintain a high level of professionalism
- Automotive repair facility experience
7
Responsibilities For Casualty Claims Adjuster Resume
- Develop and maintain effective business relationships with internal and external clients
- Collaborate with other team members to ensure effective resolution of customer needs, follow-up and work flow
- Audit outside claims administrators for effectiveness and cost containment
- Typically has 18 months to 4 years of experience
- Prioritizes work to meet appropriate deadlines
- One year of professional work experience
- Strong medical and insurance law/policy knowledge
- Casualty claims experience specific to bodily injury claims
- Bodily injury claims experience
8
Responsibilities For Commercial Liability Claims Adjuster Resume
- Build and maintain effective relationships with internal and external customers
- Management of third party administrators, or supervisory experience
- Proven ability to investigate and negotiate fair and equitable claims settlements
- Strong awareness of and ability to maintain confidentiality
- Casualty claims experience
- Experience in a general liability insurance environment
- Prior General Liability Claims Administration
- Automotive technician or service advisor experience
9
Responsibilities For Commerical Claims Adjuster Resume
- Anticipate problems/issues prior to their occurrence and escalade them
- Experience in one or more of Warranty & Indemnity, Cyber, General Liability and/or Medmal claims
- Claims experience in General Liability, Construction or property claims
- General insurance experience or Customer Service support roles
- Exhibits water remediation/construction knowledge or experience
10
Responsibilities For Claims Adjuster Specialist Resume
- Collaborate. Be an excellent partner dedicated to superior customer service
- Litigation management and 1st party Property claims experience is preferable
- Strong background in the investigation of liability and damages, as well as the interpretation of coverage
- 1-3 yrs. related claims experience
- 5+ yrs. Casualty claims experience
- Good communicator both externally within the Market and internally within the business
- Client relationship management – ability to show credibility with and able to build strong relationships with underwriters and senior executives
- Organised, strong attention to detail, timeliness and accuracy
- Experience in customer service, administrative, operations, or retail verticals
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