ALEX AGUILAR
Portland,OR
Summary
Complex Claims Adjuster bringing skilled analytical investigative experience with commercial insurance underwriting and training experience with exceptional communication skills. Background includes commercial P&C multiline products, Auto and special lines and project management organization.
Overview
11
11
years of professional experience
Work History
Multiline Representative Intermediate
Progressive
05.2018 - Current
- Obtained, Reviewed and analyzed insured recorded statement surrounding facts of documenting the investigation to determine validity of claims and to detect and defer fraud/misrepresentation.
- Drafted investigative research reports covering all phases of coverage review in each case to confirm policy coverage and intent when in question, managing 90-120 different claim cases.
- Evaluated and interpreted multiple product policies and analyzed damages to corroborate statements to determine coverage in multiple states to comply with state regulatory laws.
- Independent investigative work to resolve coverage investigations, identify and prevent fraud and misrepresentation while building relationships with customers and vendors to obtain information to assist with investigations.
- Assisted team members and less tenured reps with questions, resources and tools to drive claim investigation to completion and adhering to company metrics increasing accuracy/efficiency by 8%.
Project Manager
PKNW Construction
10.2017 - 05.2018
- Successfully managed multiple projects simultaneously by prioritizing tasks according to urgency, resource availability, and alignment with organizational goals.
- Collaborated with cross-functional teams to draft project schedules and plans while adhering to state and local laws/regulations.
- Developed and initiated projects, managed costs, and monitored performance to provide feedback/coaching when needed.
- Negotiated and managed third-party contracts related to project costs and compliance.
- Provided detailed technical and operational direction in project challenges, consistently meeting deliverables according to deadlines.
Commercial Underwriter Service Analyst
Farmers Insurance
01.2014 - 01.2017
- Maintained risk selection integrity by analyzing and processing advanced policy service transactions to increase BOP territory profitability by 3% YOY.
- Developed and instructed new hire training program for specific, assigned job tasks, including new business underwriting, fraud detection and regulatory compliance.
- Coached and developed new hire training class for policy services P&C commercial BOP/auto from onboarding to entry level CSR.
- Negotiated terms and conditions of coverage with clients and sales agents to acquire exposures within company appetite.
- Present investigative reports/review to support acceptance of new business and/or denial or renewal of existing business at mid level market.
Education
High School Diploma - General Studies
Vernonia High School
Vernonia, OR2007
Skills
Policy Interpretation
- Evidence collection
- Claim Analysis
- Interrogation Tactics
- Investigative Interviewing
Timeline
Multiline Representative Intermediate
Progressive
05.2018 - Current
Project Manager
PKNW Construction
10.2017 - 05.2018
Commercial Underwriter Service Analyst
Farmers Insurance
01.2014 - 01.2017
High School Diploma - General Studies
Vernonia High School
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