Provide daily claims technical and tactical management oversight and leadership of the claims operational teams ignorer to meet the companies objects. In compliance with the companies processes and procedures.*Cultivates and promotes a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.*Directs and assists the team in carrying out department responsibilities and collaborates with the leadership team and staff to support short- and long-term goals/priorities for the department.*Ensures compliance with applicable internal policies and procedures. Tracks and trends teams performances by way of dashboards, monitoring of day-to-day activities of each claim operational area.*Serves as the primary point of contact to answer questions related to various claim issues and resolves complex claims*Maintains quality goals and production level within the department. Works with Claims department leadership teams and ensure that performance goals are consistently met and/or exceeded.*Manages all aspects of running an efficient team, including hiring, supervising coaching, training, disciplining and motivating direct reports.*Establishes and manages teams to a set of standards and governance to improve performance and support effective development and outputs.*Completes other projects and duties as assigned. Provide guidance for the handling of all claims as needed.*Direction over counsel through litigation process.*Direct experts in other disciplines (scene reconstruction, civil engineering, forensics, biomechanics, etc.)*Evaluate claims with a focus on mitigation of risk*Monitor the management of legal aspects through timely assignment of litigated cases to defense counsel, and on-going evaluation of legal process and expenses.*Represents the company at litigation related settlement conferences, mediation, and arbitration when needed.

Manage a team of adjusters who handle moderate to complex auto injury claims that include serious injury, questionable damages liability and coverage issues. Provides oversight of claims adjusters' work while offering guidance and advice on claims settlements. Establishes and implements "best practices" standards and procedures for the claim team and ensures compliance through period file review.*Hire, lead, develop, and mentor a team of associates responsible for investigating and settling property and casualty claims. *Communicate, evaluate, and reinforce productivity standards and performance expectations. 
*Provide ongoing coaching and direction to associates and support a culture of teamwork, commitment, productivity, and superior quality. *Participate in establishing/defining short- and long-term goals and plans for the work group. *Ensure complete and sound claim settlements, and investigations when necessary. *Resolve non-routine and escalated customer calls. 
Research and respond to customer complaints, *take appropriate action and ensure follow-up communications occur.*Request information and/or provide updates as needed. *Conduct monthly reviews with team members. Identify trends and provide appropriate direction.*Manage all aspects of claim activities with peers, to ensure achievement of department goals.*Managing team’s inventory of auto bodily injury claims to include: *Ensuring team conducts thorough investigations to determine coverage and liability. *Ensuring proper reserves are set for exposure to the Company. *Ensuring appropriate evaluating, negotiating, and settling bodily injuries within authority levels.*Recommends payment, evaluates and reserves claims and reports to manager cases in excess of *designated authority*Identify claim files that merit SIU and/or subrogation referral for supplemental claim handling.

Providing valuable input and assistance with critical business functions of training, monitoring reports, setting goals, tracking trends, assigning work, and assisting with escalated issues and special projects. Perform various claims duties while supervising, train, and mentor a team of 10 customer service team representatives.➢ Supervise a highly dedicated team of claims adjusters. ➢ Consult, supervise day to day interactions. ➢ Monitor high call volume in call center. ➢ Conduct individual and team meetings to manage performance and adherence to company policies and practices. ➢ Oversee day-to-day operations of the call center, including scheduling, maintaining coverage and assisting claims adjusters with their calls. ➢ Act as a liaison to Account Management and non-business hours teams. ➢ Respond to escalated issues to ensure seamless service to our members. ➢ Update team on new workflows and policy/procedure changes.➢ Train new employees.➢ Responsible for managing claims personnel to include hiring, training, performance assessment, planning and delegation of work load, coaching and motivating to improve quality and quantity of work performed.➢ Conducts Open and Closed File Reviews to evaluate and document overall operational value.➢ Participates in developing and executing Department strategies and plans.

Investigate, evaluate and adjust Commercial General and Automobile Liability claims. Assigned claims generally consisting of medium to high exposure, first and third party automobile bodily injury and property damage claims, as well as total losses.➢ Provided AUTO/CASUALTY claims service via internal channels (phone/email/fax/mail/other electronic channels) to members and third party customers.➢ Evaluate insurance coverage based on claim report, the insurance policy and applicable statutes and case law to determine if a claim can be accepted as being within coverage.➢ Interviews, telephones, and/or corresponds with claimant and witnesses; obtains and reviews police hospital records, appraisals and repair estimates to evaluate injuries property damage; Reports to client as required by contractual account instructions; utilize appropriate methods of investigation according to type of coverage➢ Obtain, review and evaluate medical records.➢ Identify key coverage, damage and liability issues and plan investigation as required in accordance with contractual obligations and prevailing professional standards.➢ Comply with all statutory and regulatory requirements of all applicable jurisdictions.➢ Meet detailed quality assurance standards of performance➢ Obtain and keep in effect all required licenses and certifications and meet all continuing training and certification requirements.➢ Determine extent of the client’s financial exposure with respect to claims; set case reserves for use by clients and applicable regulatory authorities➢ Revise case reserves based on developments in the course of adjusting the claims.➢ Settle claims within assigned levels of authority as set forth in client account instructions➢ Select and manage experts with limited input from supervisor➢ Work with and provide claim-specific guidance to Field Adjuster.➢ Evaluate negotiate and settle total losses.

Investigates, evaluates, negotiates and adjusts complex auto claims presented by or against insured to confirm coverage, determine legal liability and equitably settle/defend in compliance with all state regulatory requirements. Worked under limited supervision to perform work assignments and problem resolution. Recognize life events, understands member's needs and provides advice in order to deliver appropriate solutions to members.➢ Provided AUTO/CASUALTY claims service via internal channels (phone/email/fax/mail/other electronic channels) to members and third party customers. ➢ Adjusted complex auto/injury claims, including collision, property damage, body damage, UM/UIM and PIP/Med Pay. ➢ Negotiate and handle files in suit. ➢ Acquired and applied intermediate knowledge of P&C insurance industry products, services, and processes to include P&C insurance policy contracts and coverages, and USAA claim handling process and procedures. ➢ Collaborated with team members to resolve issues and to identify appropriate issues for escalation. ➢ Partnered and directed vendors and internal business partners to facilitate claims resolution. ➢ Contributed to business goals, performance metrics and effectively uses tools & technology. ➢ Supported workload surgers and/or Catastrophe Operations as needed to include working significant overtime during designated CATs.

Act as right had to Customer Service Representative Supervisor providing valuable input and assistance with critical business functions of training, monitoring reports, setting goals, tracking trends, assigning work, and assisting with escalated issues and special projects. Perform various claims duties while supervising, train, and mentor a team of 10 customer service team representatives. Expert in the investigation, analysis, processing and completion of various types of claims including: auto claims including bodily injury, diminished value, complex claims, fraudulent property damage claims, diminished value claims, and other various fraudulent claims; proficient in subrogation and arbitration, suit files, and handling complaints.Served as vital team member for several improvement committees including:Texas Zone Unification Committee: collaborated with team members to create and refine best practices of workflow resulting in improved website, establishment of information database and initiation of transition into new Enterprise claim system.Subrogation Committee: as Subrogation Liaison collaborate with team members to increase knowledge and awareness of workflow; have increased subrogation activity over 20% since inception, exceeding company's stated goal.As Team Leader oversee trend analysis, acquire and analyze information garnered through file review and peer/subordinate interviews; have significantly contributed to 40% reduction of phone wait times.

Provide guidance and problem resolution direction certifying accuracy and compliance with department Standard Operating Procedures, Texas Department of Insurance, and regulatory guidelines.Establish and maintain strong interpersonal relationships as liaison with internal and external team members including customer service estimates, claims department, special investigation unit and insurance agency to ensure transparency among all departments and shared commitment to company goals and mission. Build team cohesion and moral through developing programs centered on increasing performance, satisfaction and ownership; lead team meetings with CST and other claim groups to further communication and unity.Exercise excellence in providing customer service assisting with escalated calls and internal/external customer issues; research and document problem situations verifying copies of supporting documentation are properly maintained.Partner with Regional Supervisor to review Quality Assurance spreadsheets in preparation with meetings with claims specialist; monitor error trends utilizing for training purposes with claims specialists; and maintain QA Error Correction Log for each claims specialist to ensure timely completion of error corrections.Serve as Training Protocol Expert depended upon to train and mentor all new hires; training style has improved learning time and retention, as well as confidence in new hires able to perform more efficiently immediately after completing training. Function as the "go to" lead person for South Texas due to knowledge of the south Texas venue, fluency in Spanish, communication and interpersonal skills and ability to lead decisively. Committed leader with company community events; contribute to United Way campaigns, member of Security Council as well as serve as team lead for Activity Committee over the past 4 years.