ALEXIS WESLEY
Lake Charles
Summary
Dynamic and results-driven Senior Claims Examiner with over 10 years of experience in managing complex insurance claims across various sectors, including auto, commercial, healthcare, and general liability. Expertise in risk management, litigation, and negotiation, with a proven ability to drive operational improvements and achieve superior claims outcomes. Skilled in team leadership, strategic planning, and project execution, with a strong background in managing large portfolios in fast-paced, high-pressure environments. Adept at building relationships with clients and stakeholders, and delivering results in both individual contributor and leadership capacities.
Overview
11
11
years of professional experience
1
1
Certification
Work History
Senior Resolution Manager (Temporary)
Gallagher Bassett
08.2025 - Current
- Led resolution initiatives to streamline customer service processes and enhance client satisfaction.
- Implemented strategic solutions to complex customer issues, reducing resolution times significantly.
- Mentored junior team members in best practices for conflict resolution and customer engagement.
- Analyzed data trends to identify recurring problems, driving improvements in service delivery models.
- Analyzed case files to identify legal issues and formulate strategies for litigation.
- Coordinated discovery processes, ensuring timely gathering and organization of evidence.
- Collaborated with attorneys to prepare for depositions and court appearances.
- Developed and maintained comprehensive case management systems to track progress.
- Evaluated settlement offers, providing strategic recommendations based on case strengths.
- Oversaw compliance with court deadlines and procedural requirements across multiple cases.
Senior Claims Examiner
Allianz Global
04.2024 - 05.2025
- (Temporary) Managed complex auto claims for Amazon DSP business affiliates, handling claims with moderate to high severity.
- Developed comprehensive action plans and collaborated with internal/external counsel, TPAs, and insurance companies to determine optimal resolutions.
- Acted as a key liaison between business partners, providing expert guidance and answering technical questions to ensure smooth claims processing.
- Oversaw corporate auto exposures and delivery service provider projects, ensuring claims were managed in line with client expectations.
- Led claims strategy discussions and implemented cost-effective solutions for logistics operations.
Senior Claims Examiner
Broadspire
01.2019 - 01.2024
- (Furloughed in 2020, Rehired in 2022)
- Directed general liability claims for high-profile clients, including national casinos and property management companies, ensuring timely resolution of claims and minimizing financial risk.
- Collaborated with a variety of stakeholders-including insured clients, brokers, and legal teams-to evaluate liability, set appropriate reserves, and determine overall financial exposure.
- Negotiated settlements for property losses, including diminished value and total loss claims, ensuring optimal financial outcomes for clients.
- Provided detailed reporting on claims progress, performance metrics, and case outcomes to senior management, identifying areas for improvement.
- Managed complex claims, including investigating and coordinating with body shops, arranging inspections, and ensuring timely settlements.
Claims Examiner
Gallagher Bassett
01.2021 - 02.2022
- Managed 150 active liability claims, covering general liability, auto, and cargo losses for clients including Whole Foods Market and AmTrust Movers.
- Collaborated with clients to expedite claim resolutions and ensure all parties were well-informed throughout the claims process.
- Mentored and guided junior adjusters, providing training and feedback to help enhance team productivity and claim handling skills.
- Utilized reserve authority of up to $50,000 to promptly resolve claims in compliance with client agreements and industry regulations.
- Conducted onboarding and peer training sessions, creating internal documentation.
SIU Investigator
Centene Management
10.2020 - 10.2021
- Led fraud investigations for Medicaid claims, utilizing pivot tables and Management
- Delivered fraud training, developed SOPs, and recovered over $10K/month in overcharges and expenditures.
- Designed custom queries and reports to track claims data
- Provided actionable insights to senior management and compliance teams.
- Presented fraud detection findings to state representatives
- Worked closely with compliance and legal teams to ensure adherence to Medicaid fraud regulations and reporting standards.
Claims Adjuster
York Risk Services Group
01.2018 - 01.2019
- Managed first- and third-party auto claims for Lyft, handling complex
- Claims, determining liability, and coordinating repairs.
- Ensured low pending claim volume despite receiving 15-20 new claims per day, showcasing strong organizational and time management skills.
- Led the team in monthly claim closure ratio (110%) and exceeded settlement targets, demonstrating a strong command of negotiation and claim resolution techniques.
- Coordinated nationwide auto inspections and follow-up repairs, ensuring smooth claim resolution from start to finish.
Bodily Injury Claims Adjuster
Allstate Insurance
01.2015 - 01.2018
- Acted as On-boarding champion for new hires, implementing strategies for training and providing information on adjuster roles, benefits and any information new hires needed to succeed.
- Managed both minor and complex personal auto and bodily injury claims, maintaining excellent communication with insured clients, third-party carriers, and claimants.
- Delivered outstanding customer service through compassionate communication, ensuring positive outcomes even in difficult claims scenarios.
- Negotiated settlements for property loss, bodily injury, and total loss claims, always striving for the best possible resolution for all parties involved.
- Documented medical records and claim details to ensure compliance with no-fault guidelines, safeguarding client interests.
- Developed and maintained strong relationships with service providers and clients, ensuring timely repairs and minimal claim disruptions.
Education
Bachelor of Arts - Family and Child Studies
McNeese State University
05.2015
Skills
- Insurance Claim Processing
- Stakeholder Management
- Financial Risk
- Managing Client Expectations
- Customer Service
- Fraud Prevention and Detection
- Corporate Litigations
- Insurance Management and Aftercare
Certification
- New York
- Louisiana
- Texas
- Arizona
- Arkansas
- New Mexico
- Connecticut
- North Carolina
- Oklahoma
- Rhode Island
- Florida
- Nevada
- Wyoming
LANGUAGES
English
Timeline
Senior Resolution Manager (Temporary)
Gallagher Bassett
08.2025 - Current
Senior Claims Examiner
Allianz Global
04.2024 - 05.2025
Claims Examiner
Gallagher Bassett
01.2021 - 02.2022
SIU Investigator
Centene Management
10.2020 - 10.2021
Senior Claims Examiner
Broadspire
01.2019 - 01.2024
Claims Adjuster
York Risk Services Group
01.2018 - 01.2019
Bodily Injury Claims Adjuster
Allstate Insurance
01.2015 - 01.2018
Bachelor of Arts - Family and Child Studies
McNeese State University