Claims Adjuster

Published on January 2017 | Categories: Documents | Downloads: 48 | Comments: 0 | Views: 440
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Paul J. Prebe 3559 Sawtelle Blvd, Apt. 8 Los Angeles, CA 90066 Liability Claims Professional

[email protected] 310-883-5342

Leveraging extensive liability claims experience with an instinctive dedication to safety and prevention to effect greater overall client satisfaction. Solid and dependable experience in varying capacities of claims and safety manag ement. Creative and articulate leader dedicated to risk reduction through the co nstant review and improvement of safety and health management systems and claims handling processes. Reliable persistence in collaborating with multiple departm ents to execute prompt and thorough claims investigations leading to timely and cost-effective resolutions. Proven ability to manage professional relationships in a fast-paced, multi-cultural environment. * Liability Exposure Evaluation * General & Professional Liability * Workplace S afety Excellence * Risk Reduction * Root Cause Analysis * Hazard Elimination & Control * Best Practices * Cross-Functional Collaboration * Litigation Management * Cost-Effective Resolution * iVOS Claims Management Software * Fluent in Manda rin Chinese Professional Experience Supervisor, Claims and Workplace Safety 2008 - Present Crystal Cruises, Inc., Los Angeles, CA Managed all guest and crew (Jones Act seaman) bodily injury claims for internati onal, ultra-luxury cruise line. Consistently upheld commitment to six-star servi ce standards both on and off ships. Performed all aspects of claims management f or non-litigated claims. Collaborated with Protection & Indemnity (P&I) Club claim representatives and le gal correspondents to manage litigation internationally. Presented detailed loss notices to P&I Club for covered events such as guest illness outbreaks and ship diversions for medical evacuations. Reviewed and approved all vessel incident reports. Provided direct guidance to s afety officers on investigation, evidence retention, documentation, root cause a nalysis and corrective action. Analyzed comprehensive incident data to identify trends and propose further review and/or corrective measures to shipboard manage ment. Improved quality of vessel incident reports by empowering safety officers to tak e ownership of investigations, ensuring that all incidents were thoroughly inves tigated and well documented. Advanced shipboard management commitment to analyzing root causes of common work place injuries and implementing more effective hazard control measures. Established new claim handling guidelines, which improved guest claim response a nd resolution times by 50% and virtually eliminated escalation to litigation by American guests. Developed strategic proactive approach to managing minor known liabilities to gu ests by promptly offering preemptive goodwill gestures through Guest Relations d epartment.

Mandarin Chinese Student / English Teacher 2005 - 2008 National Cheng Kung University / Li-Ming Jr. High School, Taiwan (R.O.C.) Embarked on three-year journey abroad to gain comprehensive understanding of Man darin Chinese language. Upon completion of university-level language study, serv ed as ESL teacher to honors students in grades 7-9. Implemented innovative langu age development strategies including pen-pal program and flag-football club.

Octagon Risk Services, Inc. (now Sedgwick CMS), Los Angeles, CA 1997 - 2004 Successfully achieved progressive advancement and increasing claims responsibili ty with third-party claims administrator for University of California's Professi onal Liability program. Earned reputation for strong initiative, great persisten ce and intuitive problem solving skills. Known for inquisitive nature and abilit y to learn new skills quickly and accurately. PL Claims Specialist, 2003 - 2004 Awarded promotion to newly created career advancement position based on proven r ecord of claims management aptitude, reliability, organizational skills and atte ntion to detail. Successfully managed individual caseload of professional liabil ity (medical and dental malpractice) claims in accord with established claims ha ndling guidelines. Upheld client's esteemed reputation while conducting detailed inquiries with cla imants, physicians, nurses, and other healthcare representatives. Consistently obtained favorable judgments representing physicians in Small Claim s court cases. Ensured that client was kept abreast of key developments and noteworthy concerns . Senior Claims Assistant, 1998 - 2003 Provided claims and administrative support to operations manager and three accou nt executives in the management of professional liability claims. Assessed medic al reports, legal documentation, and claims requirements to ensure complete accu racy in the set-up of new claim files. Managed all AP for claim file expenses an d coordinated client funds on issuance of indemnity checks. Improved overall operational efficiency throughout state-wide program by authori ng Claims Database Procedure Guidelines handbook for VOS claims management softw are. Successfully recruited, trained, and supervised new claims assistants in local o ffice and provided on-going training for claims assistants throughout regional offices. File Clerk, 1997 - 1998 Supported both professional liability and general liability programs serving UC client. Managed and maintained medical records, billing, and document filing sys tems ensuring complete accuracy and organization. Professional Development Texas All-Lines Claims Adjuster License

Advanced Safety Certificate, National Safety Council Associate in Claims (in progress), The Institutes Bachelor of Arts - Liberal Studies, Bowling Green State University, Ohio

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