Samantha S.
Casualty Claims Adjuster @PMA Companies
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WORK HISTORY
Casualty Claims Adjuster @PMA Companies
In my current role as a Bodily Injury Adjuster, I: • Oversee a high-volume caseload of 100 to 125 active bodily injury, auto, and property damage claims while maintaining compliance with policy terms, jurisdictional regulations, and internal service standards.• Evaluate coverage applicability and liability exposure through detailed policy review, legal research, and fact-finding to support accurate claim determinations and defensible outcomes.• Conduct thorough claim investigations, including documentation review and evidence analysis, and collaborate with Special Investigation Unit teams to support the development of fraud-related cases when warranted.• Drive timely claim resolution by prioritizing urgency, managing competing deadlines, and maintaining consistent communication to meet client expectations and service commitments.• Support onboarding and development of new hires and peers by reinforcing standard claim workflows, procedural expectations, and organizational best practices specific to PMA operations• Monitor and adjust claim reserves based on evolving exposure, investigative findings, and statutory considerations to ensure financial accuracy and risk control.* Other positions held: Claims Adjuster I, 06/2023-03/2024
EDUCATION
Liberty University
Bachelor of Science - BS, Criminal Justice/Strategic Intelligence
Colorado Technical University
Bachelor's degree, Criminal Justice - Cyber Crime & Security
ABOUT SAMANTHA S.
My name is Samantha.I’m an experienced Investigator and Claims Adjuster with a strong track record supporting fraud identification, investigative reporting, and claim resolution within the financial sector and commercial insurance environment. I bring a disciplined, detail-oriented approach to high-volume casework, including balancing speed, accuracy, and compliance while ensuring each decision is well-supported and defensible.I’m known for my ability to analyze complex information, identify inconsistencies, and recognize red flags that may indicate fraud or misrepresentation. I’m skilled at gathering and reviewing documentation, organizing evidence, and producing clear, thorough reports that support internal decision-making and, when needed, escalation to specialized investigative teams or external partners. I focus on facts, follow the process, and document everything with integrity.I’ve successfully managed large caseloads by prioritizing urgency, tracking multiple timelines, and staying proactive in communication with stakeholders. I keep expectations clear and ensure progress doesn’t stall, especially when the details are sensitive or the situation is escalating.I also bring strong negotiation skills and a customer-focused mindset. I work to resolve claims fairly and efficiently while protecting the organization’s interests and maintaining professionalism in challenging conversations. I’m comfortable explaining complex decisions in simple terms, de-escalating tense situations, and finding practical paths forward that align with policy, procedure, and regulatory standards.I take pride in operating with a compliance-first mindset while continuously improving how I work, looking for better ways to spot patterns, reduce risk, and improve outcomes across the claims and investigative process.Core skills: Fraud & Financial Crime Investigations Transaction Monitoring & Alert Review Investigative Research & Analysis Data Analysis & Pattern Recognition Case Documentation & Reporting KYC / AML Compliance Regulatory Compliance & Due Diligence Digital Intelligence & OSINT Evidence Collection & Case Support Case Management Cross-Functional CollaborationConnect with me today!
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