Alyssa Hinojosa
San Antonio,TX
Summary
Talented Claims Adjuster emphasizing effective time management, cost control and mediation. Self-motivated and customer-focused.
Overview
3
3
years of professional experience
Work History
Claims Adjuster
Allcat Claims Service
San Antonio, TX
06.2022 - Current
- Reviewed and applied state laws and regulations to ensure compliance in claim handling.
- Reduced loss ratios through fair and prompt processing of claims.
- Reviewed policies to determine appropriate levels of coverage and assist with approval or denial decisions.
- Completed required investigations on referred files within established timeframes.
- Investigated and evaluated property and casualty insurance claims to determine coverage and liability.
- Investigated questionable claims to determine payment authorization.
- Developed relationships with attorneys, experts and vendors in order to ensure prompt service when necessary.
- Evaluated performance metrics regularly; suggested modifications where necessary for increased efficiency.
- Assisted in fraud detection and prevention efforts by identifying suspicious claim activities.
- Negotiated and settled claims according to information presented through reports, research, and data verification.
- Interpreted insurance policy language to apply appropriate coverage.
- Explained premiums owed to policyholders, agents and underwriters.
- Maintained accurate documentation of all claim activity within designated system.
- Analyzed and audited open claims to calculate additional payments owed.
- Utilized claim handling software to document and manage claim files efficiently.
- Investigated insurance claims, reviewed coverage and liability, prepared reports and recommended payment or denial of claims.
- Prioritized and organized tasks to efficiently accomplish service goals.
- Worked successfully with diverse group of coworkers to accomplish goals and address issues related to our products and services.
- Engaged in continuous learning to stay current with industry trends and best practices in claims management.
- Conducted on-site inspections of property damage to assess repair needs and costs.
- Organized files into logical categories; maintained complete records according to established procedures.
- Drafted statement of loss to summarize damages, payments and underlying policy coverage.
- Gathered information from various third parties to determine claim acceptability.
- Worked collaboratively with team members across multiple departments; identified areas where processes could be improved.
- Worked closely with repair facilities and contractors to ensure quality repairs for policyholders.
- Coordinated emergency repair, cleaning companies and contractors to optimize customer claim handling.
- Ensured timely follow-up on all open matters; kept stakeholders informed regarding status updates.
- Performed special projects upon request from management; completed tasks efficiently while meeting deadlines.
- Communicated effectively with policyholders, providing updates and explaining claim processes.
- Delivered exceptional customer service to clients by communicating information and actively listening to concerns.
Dispatcher
AMG plumbing
San Antonio, TX
10.2021 - 05.2022
- Ensured compliance with safety regulations and company policies.
- Organized paperwork associated with deliveries including manifests, bills of lading, packing slips.
- Leveraged GPS devices and computer programs to plan routes, update customers or advise drivers about upcoming issues.
- Answered customer requests with information about product availability, shipping information and status updates.
- Utilized various software systems to facilitate movement, planning and scheduling.
- Scheduled loads according to priority and available equipment.
- Resolved customer complaints related to service issues or delays.
- Matched bills of lading and reconciled quantities to verify items shipped.
- Monitored dispatch board and adjusted call priorities regularly based on caller needs.
- Monitored personnel or equipment locations and utilization to coordinate service and schedules.
- Provided timely updates to customers regarding their orders or requests.
- Recorded results of service calls to create report summaries for senior management.
- Documented services performed, operations information, and dispatch details in system.
- Received or prepared work orders.
- Assigned drivers to appropriate routes based on customer needs.
- Recorded and maintained files or records of customer requests, work or services performed.
- Ordered supplies or equipment to issue to personnel.
- Addressed questions, problems or requests for service or equipment.
- Tracked vehicles using GPS technology and provided real-time status updates as needed.
- Created daily reports detailing response times, call volumes, and other pertinent information.
- Utilized computer systems to locate addresses, calculate estimated arrival times, and provide directions when necessary.
- Set schedules, implemented new policies, and worked with managers to optimize operational procedures and establish clear objectives.
- Trained employees on triaging and dispatching procedures to properly handle daily calls.
- Participated in team meetings discussing changes in procedures or processes.
Education
High School Diploma -
Grace Davis Highschool
Modesto, CA01-2013
Some College (No Degree) -
Modesto Junior College
Modesto, CASkills
- Property claims
- Property adjusting
- Exposure analysis
- Casualty and property loss
- claims adjuster license - 20 states or more
Timeline
Claims Adjuster
Allcat Claims Service
06.2022 - Current
Dispatcher
AMG plumbing
10.2021 - 05.2022
High School Diploma -
Grace Davis Highschool
Some College (No Degree) -
Modesto Junior College