Experience

COMPREHENSIVE RISK SERVICES, LLC

• United States
• Insurance
• 1 - 100 Employee

• Claims Manager

  • Jun 2020 - Present



The Hanover Insurance Group

• Insurance
• 700 & Above Employee

• MCCA Sr. PIP Medical Adjuster

  • Apr 2016 - Present

• Senior PIP Medical Claims Adjuster

  • May 2014 - Present

  Focus in MCCA claims, fatality, and survivor loss wage calculationsResponsible for the investigation, negotiation and resolution of claims in accordance with policy provisions, best practices and jurisdictional requirements. Includes the input of claim data and guiding insureds and claimants through the claim process and options.Responsibilities/Essential Functions:- Secure and maintain appropriate states adjuster license(s) and continuing education credits.- Works within significant limits and authority on assignments of higher technical complexity and coordination.- 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.- Handles claims with greater complexity and will require a higher level of investigation, analysis, evaluation and negotiation including interpretation of commercial coverages.- 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.- Identifies possibly suspicious claims- Claims handing involves moderate to high complexity, severity and exposures including litigation.- Take recorded statements- Works with the Special Investigations Unit to resolve and negotiate settlement Show less

• PIP Medical Claims Adjuster

  • Jan 2012 - Present

  Responsible for the investigation, negotiation and resolution of claims in accordance with policy provisions, best practices and jurisdictional requirements. Includes the input of claim data and guiding insureds and claimants through the claim process and options.Responsibilities/Essential Functions:- Secure and maintain appropriate states adjuster license(s) and continuing education credits.- Works within significant limits and authority on assignments of higher technical complexity and coordination.- 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.- Handles claims with greater complexity and will require a higher level of investigation, analysis, evaluation and negotiation including interpretation of commercial coverages.- 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.- Identifies possibly suspicious claims- Claims handing involves moderate to high complexity, severity and exposures including litigation.- Take recorded statements- Works with the Special Investigations Unit to resolve and negotiate settlement Show less

• ISP- Agent/Customer Service

  • Jun 2010 - Present

  - Meet or exceed monthly sales goals, with a heavy focus on cross selling existing customers - Employ a consultative selling process that identifies and fills coverage gaps.- Employ an “Account” focus and deliver to the customer all relevant products for their household – Home, Auto, Toys.- Identify and Suggest product upgrades and upsell opportunities,- Maintain a follow up database, and X-Date bank of people to contact at the appropriate time.- Outbound calls to monoline customers, and sell the value of the Account Relationship.- Liaison with other departments to gain acceptance and approval of risks that fall outside of established guidelines.- Continuously learn about the Insurance Products Offered, and be able to demonstrate their value to the customers and prospects.- Suggest Products to add to our offerings.- Suggest product and system improvements.- Answer routine to moderately complex telephone inquiries received from customers/clients- Review incoming written correspondence, request additional details when needed and draft written communications in response to service requests received from customers- Process policy changes and some policy issuance transactions received through various channels within specified guidelines- Obtain MVR (Motor Vehicle Report), CLUE, and insurance score or merit rating information- Interpretation and verification of coverage's and data- Provide in depth insurance guidance and education to customers as appropriate- Interpret the rates and rules of Personal Lines policy changes, renewals and new business transactions by accessing resources defining the codes- Recommend and sell additional or increased coverage in appropriate situations and within specified guidelines - dependent upon Regional location- Recommend changes in systems/procedures/workflow to gain process efficiencies and meet changing customer needs Show less



AAA

• Howell, MI

• Insurance Sales Agent/Customer Rep

  • Jan 2008 - Jun 2010

  •Develop and manage all phases of the sales cycle-from prospecting to close and follow-up support. • Represent a full line of insurance and financial products, serving as a trusted advisor to individuals. • Learn new products and systems and help train and develop other team members. •Develop and manage all phases of the sales cycle-from prospecting to close and follow-up support. • Represent a full line of insurance and financial products, serving as a trusted advisor to individuals. • Learn new products and systems and help train and develop other team members.



Nations Title Agency

• Bingham Farms, MI

• Sales /Marketing Account Executive

  • Mar 2005 - Jan 2008

  Sales Account Executive/ Closing Agent • Prospecting a part of the regular routine ensuring that new prospects are being added to the pipeline on a consistent basis • Presenting prospective clients with benefits of NTA • Evaluating customer orders and assessing customer satisfaction • Title Training to staff and clients. • Generate Marketing strategies to generate and improve business • Meet and exceeding set sales quotas • Coach and develop sales individuals so that they have the direction, skills, and tools. Provide regular feedback and conduct performance reviews • Implementation of Company strategy through specific territory plans and sales teams • Understanding customer needs and business and using this knowledge to develop interoffice communication • Continually learning about new products and improving selling skills. • Being well informed about current industry trends. • Effectively using sales force to enter all sales information into database. • Keep abreast of competition, competitive issues and products. • Coordinating trade shows & golf outings. • Assisting in contract and pricing negotiations. • Managing sales pipeline. • Developing positive relationships with other employees and customers. • Miscellaneous – Responsible for training all new operational staff and helping all office staff in day to day operations when needed. Closing and funding loans. Show less