A Licensed Claim Adjuster works for the insurance company and undertakes responsibility for ascertaining the extent of liability. The job description includes inspecting homes, offices, and automobiles, and interviewing claimants and witnesses, and determining the amount to be paid. Other core duties are listed on the Licensed Claims Adjuster Resume as – investigating property damage or personal injury, gathering information from sources, preparing reports for use by the claims examiners, investigating questionable claims, consulting with specialists such as lawyers, engineers, and architects; compiling reports on investigation findings; and assisting attorneys and other specialists.
To ensure success in the field, the following skills are needed – an analytic mindset, and good math skills, competency with spreadsheet software, experience with appraisal software, detail-oriented, and excellent verbal and written communication skills, and good interpersonal skills. A high school diploma or GED is required for entry-level jobs.
Objective : To work in an environment where I can utilize my outstanding customer service skills. I am a licensed claims adjuster with litigation experience. I have worked as a senior claims examiner for Cigna Insurance and worked as a supervisor with a small TPA co. in Clearwater, Fl. I am interested with working various providers or insurance companies where my skills can be utilized to their greatest potential.
Currently worked as a claims adjuster for Pilot claim services as a consultant or subcontractor for Encompass and Allstate Insurance Companies.
Reviewed policies issued to insured and discussed and confirmed coverage and deductibles with insurds.
Confirmed covered vehicles on the policy or Declaration page with the insured.
Reviewed for prior loss's damages and repairs.
Discussed rentals with insured, and obtained rental vehicles for the insured through the ARMS software database.
Provided enterprise reservation numbers to the insured within the areas close to the insured home or business, or made arrangements for Enterprise to pickup insured as a business decision.
Reviewed photos with the insured if uploaded in Nextgen by the outside adjuster.
Experience
2-5 Years
Level
Junior
Education
High School Diploma
Licensed Claims Adjuster Resume
Summary : Over 10 years of customer service with major corporations as well as over two years of claims experience. I am confident that I possess the right combination of skills and experience and would bring value to your office. In my previous positions I demonstrated my skills in problem solving, and negotiation and have been able to build and maintain effective working relationships with customers.
Investigated claim damages and situation using internal and external resources.
Investigated steps include speaking with the insured or other involved parties such as contractors, requesting and receiving a field investigation report, research on past claim activity, research on external websites for CAT event confirmation, and engaging vendors for services, material supply and/or pricing.
Determined policy coverage through analyzing investigation data and policy terms, including whether claim will be approved or denied.
Notified insured of coverage or any issues.
Established reserve levels at the beginning of handling a claim and adjusts as appropriate based on investigation findings.
Handled and owned claims submitted by independent adjusters, including making coverage and reserve decisions, and reviewing work for accuracy.
Maintained accurate and current communication with insured/claimant.
Experience
10+ Years
Level
Senior
Education
BS In Criminal Justice
Licensed Claims Adjuster Resume
Headline : Personable, friendly, and dedicated individual who has extensive customer service, event, and meeting planning experience. Motivated, self-starter. Able to deal with people at all levels. Seeking a position where I can develop and excel while adding value to an organization.
Skills : Collections, Management.
Description :
Maintained customer satisfaction while working within company policies.
Handled several claims simultaneously from filing through completion through use of a computer database, the Internet, and Google Maps.
Worked with customers to arrange vehicle inspections and rental vehicles.
Responsible for determining level of loss for each case and deciding on compensation for client.
Investigated insurance claims, negotiate settlements, and authorize payments.
Performed liability investigations for automobile claims as per company guidelines.
Investigated claims by interviewing the claimant, insured and witnesses and obtaining a recorded statement.
Experience
5-7 Years
Level
Executive
Education
GED
Licensed Claims Adjuster Resume
Summary : A background of over 10 years of customer service with major corporations as well as over two years of claims experience. I am confident that I possess the right combination of skills and experience and would bring value to your office. In my previous positions, I demonstrated my skills in problem-solving, and negotiation and have been able to build and maintain effective working relationships with customers.
Skills : Communication Skills, Training Skills.
Description :
Reviewed and administratively sets-up claims in tracking system and writes or revises the brief description of loss to ensure that it accurately reflects the actual circumstances.
Ability to manage a claims desk in a high volume claims environment.
Determined liability.
Established and enters claim reserve requirements and makes adjustments, as necessary, during the processing of the claims.
Communicated with policyholders, witnesses, and claimants in order to gather information regarding claims.
Responded to various written and telephone inquiries including status reports.
Explained the facts and logic behind decisions in a way that the customer understands, even if they do not agree with the decision.
Experience
10+ Years
Level
Senior
Education
BS In Criminal Justice
Licensed Claims Adjuster Resume
Headline : To obtain a challenging Licensed Claims Adjuster position within an organization that will allow me to fully utilize my education, experience, and training in a productive way.
Skills : Data entry, Multiple line phone systems, Microsoft Office, Customer Service.
Description :
Included investigating and settling claims.
Interviewed claimants and witnesses to determine liability.
Requested and reviewed associated documents.
Provided verbal and written recommendations on coverage and liability.
Evaluated damages and requested appropriate funding from underwriters.
Issued payments towards expenses as needed.
Interacted directly with clients, claimants, attorneys and medical facilities throughout the claim process.
Experience
5-7 Years
Level
Executive
Education
High School Diploma
Licensed Claims Adjuster Resume
Headline : To obtain a position within an established organization that values loyalty and hard work, and that will allow me to apply my leadership abilities, problem-solving skills and customer service experience.
Skills : Certified Nursing Assistant, Clerical/Office experience, Working knowledge of basic office equipment, Managerial experience.
Description :
Investigated, researched, analyzed, verified and recommend solutions, using independent judgment on claims.
Discussed claim with all parties and take recorded statements to preserve the facts.
Ensured accuracy of information collected and reported and guard against fraudulent claims.
Reviewed estimate photos and make liability decisions to determine fault.
Established and maintained a high level of positive working relationships with internal and external customers, ensuring satisfaction with company services.
Analyzed first and third party claims to determine extent of the company's liability.
Quickly and effectively solved customer challenges.
Experience
5-7 Years
Level
Executive
Education
BA In Human Development
Licensed Claims Adjuster Resume
Objective : Responsible for Managing, investigating, and resolving claims. Investigates and evaluates coverage, liability, damages, and settles claims within prescribed authority levels. Identifing potential suspicious claims and refers to SIU and identifies opportunities for third party subrogation. Communicating with policyholders, witnesses, and claimants in order to gather information regarding claims, refers tasks to auxiliary resources as necessary, and advise as to proper course of action.
Skills : Diagnostic Medical Sonography, MS Office.
Description :
Managed, investigated, and resolved claims.
Investigated and evaluated coverage, liability, damages, and settles claims within prescribed authority levels.
Identified potential suspicious claims and refers to SIU and identifies opportunities for third party subrogation.
Communicated with policyholders, witnesses, and claimants in order to gather information regarding claims, refers tasks to auxiliary resources as necessary, and advise as to proper course of action.
Responded to various written and telephone inquiries including status reports.
Ensured adequacy of reserves.
Made effective use of loss management techniques.
Experience
2-5 Years
Level
Junior
Education
MS
Licensed Claims Adjuster Resume
Objective : Driven,ambitious, goal seeker determined to achieve the pleasure of working within medical or customer service rep related opportunities, experience is above average in both services.
Skills : Microsoft Office, Customer Service, Investigation And Report Generation.
Description :
Investigated and processed personal automobile auto insurance claims filed for the states of Texas, California, New Mexico, and Colorado.
Interviewed claimant to gather pertinent information.
Handled and processed variety of claims, including bodily injury and property damage.
Inspected property damage to determine extent of damages, request estimate/photo assignments.
Verified that coverage applies and evaluate damages.
Ensured all pertinent data and statements are recorded accurately in a report.
Managed and paid rental bills, pay estimates.
Experience
2-5 Years
Level
Executive
Education
MS
Licensed Claims Adjuster Resume
Objective : Seeking a Licensed Claims Adjuster position with an outstanding career opportunity that will offer a rewarding work environment along with a winning team that will fully utilize management skills.
Skills : Microsoft Office, Data Entry, Customer Service, Filing, Records Management, Phone Etiquette, Copiers, Scanning, Fax Machines.
Description :
Gathered facts by interviewing all involved parties; analyzed information, including potential conflicts of interests, interpretation of policies and pertinent state laws.
Determined appropriate actions based on the findings.
Evaluated, reported and recommended corrective actions.
Determined the appropriate settlement amounts and negotiate or deny payments on behalf of the company.
Maintained accurate and current claim file documentation throughout the life cycle of claim cases.
Engaged specialized departments such as Special Investigation Unit and Subrogation as appropriate.
Determined and negotiates settlement amounts for damages claimed within assigned authority limits.
Experience
2-5 Years
Level
Executive
Education
GED
Licensed Claims Adjuster Resume
Headline : Highly motivated Licensed Claims Adjuster professional able to handle high volume of customer calls in a fast paced environment, with minimum supervision. Able to negotiate and problem solve quickly, accurately, and efficiently. Maintain a high level of professionalism patience and efficiency to minimize customer dissatisfaction and increase customer loyalty.
Skills : Microsoft, Customer Service, Management.
Description :
Gathered facts by interviewing all involved parties.
Analyzed information, including potential conflicts of interests, interpretation of policies and pertinent state laws.
Determined appropriate actions based on the findings.
Ensured customer service standards are met or exceeded, which is validated by ICSS (Internal Customer Satisfaction Survey).
Reviewed and resolved customer complaints and volatile situations.
Conducted quarterly meetings to communicate changes and procedures, goals and results.
Worked closely with internal agencies to assist in resolving their policy and procedural problems.
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