Insurance Claims Specialist Resume

Added on July 3, 2011 in Accounting and Banking Resumes, Administrative Resumes, I by admin

Janice Cox

199 Lawrence Street (505) 777-7777

Brooklyn, NY 11223

Career Profile

High-energy, cross-functional background as resourceful fast-track insurance claims specialist with an outstanding record of success in winning settlements and reducing claims payouts to acceptable and just amounts.Investigate, negotiate, and settle complex claims, from beginning stages up to trial, for Erie Insurance Group and Aetna.

Areas of Expertise,


  • organized and effective performance in

high-pressure environments

  • presentation development and delivery
  • word processing and spreadsheet development (type 60 words per minute)
  • claims investigation with meticulous documentation
  • heavy phones/switchboards
  • skilled customer care
  • Microsoft, internet and intranet proficiency

Insurance Claims

  • commercial and personal lines liability
  • property damage and bodily injury claims
  • claimant, attorney, and litigation representation
  • settlement and target value range setting
  • medical and liability evaluation
  • general liability, auto, homeowners, and products liability
  • injury exposure values
  • complex arbitration and mediation negotiation


  • Handle caseload of up to 250 pending commercial and personal lines claims. Establish contact within 24 hours, maintain impeccable documentation, and determine value of case based on liability/injury. Decide claim values up to $50,000. Negotiate/settle cases in mediation, arbitration, or litigation. Productive in judge’s chambers, courtroom or at mediation table
  • Delivered a $20,000 saving to Erie Insurance Group by obtaining a defense verdict on a case that a judge suggested Erie Insurance Group “buy out” for $20,000. Communicated with attorneys, evaluated liability/facts and determined feasibility for trial. Case went to trial and Erie Insurance Group paid nothing but legal costs
  • Saved Aetna $50,000 on complex $120,000 second-degree burn claim by determining case’s suitability for mediation, and meeting with judge and plaintiffs’ attorneys. Case was settled for a fair $70,000 without incurring major legal costs for Aetna
  • Promoted onto Aetna fast-track after only one year; became the youngest adjuster in company history. Track record of positive mediation, arbitration, and litigation outcomes is equal to or better than that of more senior professionals
  • Possess outstanding administrative/organizational skills, superior presentation and negotiation abilities, a passion for excellence, and a contagious enthusiasm. Work well in independent or team environments. Tenacious, with the stamina needed to function in high-pressure environments


Erie Insurance Group Claims Representative 2006- present

Aetna Claims Services

Claims specialist 2005 – 2006

Fast Track representative 2003-2005

Claims assistant 2002-2003

Education and Professional Development

A.A.S. in Business, Insurance, and Real Estate, Hostos Community College

Brooklyn Law University: Two-day Negotiation Seminar

Industry Courses: Commercial General Liability, Claims Statements, Property Casualty Principles, Litigation Guidelines, Medical Terminology and Treatment, How to Handle Cases to Avoid Litigation, Accurate Reserving

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