PA Insurance Department - Claim Evaluator II Resume Example

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Liam Johnson

XXX XXXXXXXXX XXXXX, Mechanicsburg, PA 17055

Ph: XXXXXXXXXXXX

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Professional Summary

Claim professional with over 24 years insurance experience, 8 with Underground Storage Tank Indemnification Fund (USTIF) seeking a position as Insurance Claim Manager.

Experience

Claim Evaluator II Dec 2006－Present PA Insurance Department, Bureau Special Funds, USTIF － Harrisburg, PA Initiate losses for underground storage tank release alerting Account Manager with the Third Party Administrator (TPA) of any special issues.
Provide technical supervision and oversight to the TPA's claim staff consisting of 2 supervisors, 9 adjusters, and 5 administrative assistants.
Interpret provisions of the Storage Tank Spill and Prevention Act and regulations.
Coordinate and participate in meetings to resolve complex claim issues.
Assist Claim Manager with information in response to inquiries from the Legislature and Right to Know Requests.
Supervise third party claims taking into consideration damages and protecting participant with a defense.
Coordinate and participate in litigation strategy meetings providing support and testify at hearings.
Serve as substitute for the Claim Manager at board meetings providing oral presentation of claim statistics and special issues.
Travel and attend stakeholder meetings involving owners, operators, installers, DEP offices and environmental consultants.
Serve as administrator for USTIF's website.
Assist with preparation and participate on RFB committees.
Assist with implementation of RFB contracts for claims.

Claim Specialist, Sr. Claim Specialist Jun 1997－Dec 2006 Broadspire Services, formerly Kemper National Services/Lumbermens Mutual Casualty Company － Mechanicsburg, PA Specialized in the investigation, evaluation and resolution of workers' compensation claims for the states of Delaware and Pennsylvania with increasing complexity and responsibility.
In 2003, selected to serve as designated adjuster for Liz Claiborne, Kraft Foods, E I DuPont, and Pfizer. In 2004, selected as dedicated adjuster for E I DuPont, Wilmington, DE until 2006. Specialized in asbestos subrogation and surveillance program for Delaware claims. Chosen repeatedly for quarterly bonuses by branch claim manager for exemplary claim practices. Followed Third Party Administrators (TPA) for contract compliance and service level agreements. Prepared and traveled to claim reviews providing strategy for resolution of claims. Controlled all aspects of claim process within claim authority provided by accounts. Controlled expenses by managing legal activity, manage care, surveillance and independent medical examiners.

College Intern, M&P Analyst, Claim Adjuster Dec 1983－Jan 1990 Penn National Insurance Company － Harrisburg, PA Assisted Marketing with employee newsletter and compiled data for advertising expense project as college intern. Promoted to Methods & Procedures Analyst assisting with the temporary project of reorganizing the Claim Department by writing job descriptions. Transferred to Claims in 1986 as a Claims Adjuster dealing with a range of claims including general liability, homeowners, auto and workers' compensation until 1990.

Education