Rachel Paris
Secane,PA
Summary
Insurance Adjuster skilled in investigating and analyzing liability concerning personal, casualty or property loss. Proven history of leveraging excellent negotiation skills to facilitate settlements. Excellent communication skills demonstrated through seventeen (17) years of experience interviewing specialists, witnesses and claimants to compile information.
Overview
18
18
years of professional experience
1
1
Certification
Work History
Claims Resol Spec III
Liberty Mutual
05.2016 - Current
- Demonstrates ability to understand new and unique exposures and coverages.
- Perform coverage analysis to review policy and endorsement language, giving consideration to definitions, exclusions, general conditions, jurisdictional rules/requirements, insurance, and policy period.
- Demonstrates ability to understand key data elements and claims related data analysis.
- Confers directly with policyholders and agents/brokers on coverage and resolution strategy issues.
- Interacts with customers/claimants to obtain facts, explain coverage and claims process, set expectations and provide high quality service to achieve positive customer experience.
- Plan and conduct investigation to determine liability and damages; use claim facts to identify when recorded interview should be obtained, such as when liability or damages are undetermined, subrogation potential exists, or in case of possible fraud or misrepresentation.
- Assesses actual property and injury damages associated with claims and conducts negotiations to settle claims and achieve best possible outcome.
- Establish and maintain reserves based on most probable outcome, i.e., estimate of ultimate financial cost to resolve claim whether through settlement or other adjudication.
- Use judgment and expertise to evaluate claim for potential fraud and subrogation; makes referrals to Special Investigations Unit or Loss Recovery as appropriate.
- Use claims system to properly document files (including initial resolution strategy, evaluation, negotiations, etc.), manage diaries and issue payments
- Assist management files when management is out of office and/or not available
- Main source for system technical difficulties
- Arbitrator for Arbitration Forums
- Exceeding production goals
Claims Specialist I
Liberty Mutual
10.2011 - 05.2016
- Senior Claim Representative Duties
- Audit colleague files for quality handling
- Assist in managerial tasks for senior management
- Implement the New Hire process nationwide
- Garage Keeper/Dealer plates commercial claims handling
- Agency Lead for community service called Serve with Liberty
Diminution of Value expert and negotiator - Mentor for the Auto Claim Services West department
- Made top 10 adjuster 2 years in a row for 2014 and 2015
- System expert for Commercial Insurance Claim Center
- Arbitrator for Intercompany Arbitration
Claim Processor
State Farm
02.2006 - 10.2011
- Highest productivity in the department
- Multi-tasking entailing sending paperwork, customer service on and off phone calls, researching on computer for investigating purposes, and reviewing incoming correspondences.
- Handling estimates and loss of use with customers
- Training new hires
- Making Liability decisions and settling claims
- Utilized specialized software to process incoming claims, enter data and generate reports.
- Followed up with customers on unresolved issues.
- Responded to customer inquiries, providing detailed explanations of insurance policies and claims processes.
Education
High School Diploma -
Upper Darby Senior High School
Drexel Hill, PA06.2003
Skills
- Client Service
- Policy Update Coordination
- Legal Proceedings Knowledge
- Reserve Management
- Automobile Claims Specialist
- Medical Records Management
- Report and Records Review
- Litigation Support
- Policy and Procedure Explanations
- Negotiate Settlements
- Insurance Terminology
- Customer Experience
- Determine Coverage
- Claims Settlement
- Automobile Appraisals
- Claims Evaluations
- Negotiation and Mediation Skills
Certification
- McKinsey Leadership Program completed 06/2023
Timeline
Claims Resol Spec III
Liberty Mutual
05.2016 - Current
Claims Specialist I
Liberty Mutual
10.2011 - 05.2016
Claim Processor
State Farm
02.2006 - 10.2011
High School Diploma -
Upper Darby Senior High School
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