Anay Ramos
Homestead,FL
Summary
Seasoned Auto Claims Adjuster with a 10-year background in preparing insurance claims for vehicle damages. Superb knowledge of resolution and claim settlement procedures. Familiarity with general liability procedures and auto insurance policies. Ethical Auto Claims Adjuster with excellent customer service skills to take on multiple cases while meeting strict deadlines. Adept at determining the level of loss for auto claims cases and deciding on a fair compensation for clients. Strong organizational and communication traits. Appraiser adept at completing high volume of appraisals quickly and accurately. Motivated to exceed business expectations while delivering highly accurate results. Proven history of streamlining processes for maximized productivity. Practical professional skilled at establishing reasonable repair costs through accurate inspections. Highly knowledgeable in vehicle design and salvage values. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals. Hardworking and passionate job seeker with strong organizational skills eager to secure entry-level experinced position. Ready to help team achieve company goals. Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy. To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills.
Overview
17
17
years of professional experience
1
1
Certification
Work History
Auto Claim Adjuster
Christopher Auto Sales And Body Shop
03.2016 - 12.2023
- Acted as a reliable point of contact for customers throughout the claims process, addressing their concerns with empathy and professionalism.
- Demonstrated expert knowledge of auto insurance policies and coverages, allowing for accurate assessment of damages and appropriate claim payouts.
- Documented all findings in concise reports.
- Enhanced customer satisfaction by efficiently managing auto claims and providing prompt resolutions.
- Provided exceptional customer service at all stages of the claims lifecycle while adhering to strict confidentiality guidelines regarding sensitive client information.
- Utilized strong negotiation skills to settle disputed liability cases in a fair and reasonable manner, ultimately minimizing company exposure to financial risk.
- Assisted clients with navigating complex insurance policies, ensuring they understood the extent of their coverage and benefits available to them during the claims process.
- Streamlined the claims process by effectively coordinating with repair shops and rental car companies.
- Negotiated with claimants to settle claims.
- Issued payouts to claimants.
- Contributed to continuous improvement initiatives within the department by sharing insights gained from personal experience and ongoing professional development activities.
- Increased overall efficiency in claims handling by utilizing advanced technology tools for documentation, record-keeping, and data analysis.
- Expedited claim settlements by maintaining open lines of communication with all parties involved, fostering trust, and ensuring a smooth process.
- Negotiated fair settlements with both customers and third-party claimants, balancing empathy with fiscal responsibility to protect company assets.
- Assessed complex claims and accurately determined value of damages.
- Analyzed complex data and prepared accurate and comprehensive reports for clients.
- Created detailed assessments of damages to property and vehicles.
Claim Examiner
Christopher Auto Body Work
01.2007 - 01.2015
- Managed high-volume caseloads, maintaining organization and attention to detail for each individual case.
- Conducted thorough investigations into complex claims, gathering detailed evidence and interviewing involved parties to reach fair conclusions.
- Analyzed data trends to identify areas for improvement in claims handling procedures and adjuster performance.
- Implemented new software systems that improved efficiency in tracking claims progress and status updates.
- Reduced claim processing time by streamlining workflow and prioritizing tasks efficiently.
- Established strong working relationships with independent adjusters during large-scale catastrophe claims, ensuring efficient and accurate assessments.
- Negotiated fair settlements between insurance providers and policyholders to resolve disputes amicably.
- Collaborated with medical professionals to verify treatment plans and ensure proper reimbursement levels.
- Developed positive relationships with clients, maintaining open lines of communication for prompt issue resolution.
- Mentored junior staff members on effective negotiation strategies, helping them achieve better outcomes for both policyholders and the company itself.
- Ensured compliance with state regulations by conducting regular audits of claim files and documentation.
- Streamlined communication channels between internal departments for faster decision-making on complex cases.
- Coordinated with legal counsel for defending insurance companies against litigated claims when necessary.
- Participated in industry conferences and workshops to stay informed about changing regulations and best practices in claims management.
- Identified fraudulent claims through thorough investigation and collaboration with law enforcement agencies.
- Reviewed written estimates for repair costs, ensuring accuracy before issuing payments to vendors or policyholders.
- Improved customer satisfaction by providing timely and accurate claim updates throughout the process.
- Assisted policyholders in understanding their coverage options, guiding them through the claims process stepbystep.
- Examined claims forms and other records to determine insurance coverage.
- Delivered exceptional customer service to policyholders by communicating important information and patiently listening to issues.
- Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
- Read over insurance policies to ascertain levels of coverage and determine whether claims would receive approvals or denials.
- Conducted day-to-day administrative tasks to maintain information files and process paperwork.
- Researched claims and incident information to deliver solutions and resolve problems.
- Analyzed information gathered by investigation and reported findings and recommendations.
- Conducted comprehensive interviews of witnesses and claimants to gather facts and information.
- Investigated and assessed damage to property and reviewed property damage estimates.
- Reviewed police reports, medical treatment records, and physical property damage to determine extent of liability.
- Reviewed questionable claims by conducting agent and claimant interviews to correct omissions and errors.
- Reviewed new files to determine current status of injury claim and to develop plan of action.
- Determined liability outlined in coverage and assessed documentation such from police and healthcare providers to understand damages incurred.
- Identified suspicious losses and contacted manager for investigative assistance.
- Maintained contact with claimants and attorneys to determine treatment status.
- Organized, planned and documented materials for Auto, RV, Motor Home claims.
- Documented information gathered in field and uploaded data to company database for efficient processing using CCC one, Mitchell, and web-est .
- Clarified coverage of losses to policyholders and provided assistance in itemizing damages and finding alternative living arrangements.
- Maintained suspicious claims database and prepared reports for supervisors.
- Followed up with insured individuals regarding premium and deductibles payments.
- Collected information from customers to complete claims and legal files.
- Followed up on potentially fraudulent claims initiated by claims representatives.
- Established productive working relationships with public officials and law enforcement officers.
Education
No Degree - Certificated in Associate in Claims
Associate in Claims (AIC)
Malvern, PA03.2023
Associate of Science - Nursing
MDC
Miami, FL01.2015
High School Diploma -
Hialeah High School
Hialeah, FL06.1998
Skills
- Claims Handling
- Policy Interpretation
- Claims Investigation
- Insurance regulations knowledge
- Gathering information/investigations
- Managing a high workload and difficult customer interactions
- Multi-line phone system
- Claims process explanation
- Repair Cost Estimation
- Vehicle inspections
Accomplishments
- Resolved product issue through consumer testing.
- Achieved overpaying a claim by completing an exhaustive review of the entire escenerio with accuracy and efficiency.
Certification
- All line License
- AIC certification
Fishing, Reading and listen good music
fishing its a great outdoor activity to free up my mind from the daily mental strain. The stress levels down are directly proportional to my mind being in a much better and comfortable space. As a result, it helps me to reduce anxiety, fight off depression, and promote relaxation. that is why i have it as part of my activities.
Reading is very important for me because it develops my mind and gives me excessive knowledge and lessons of life. i feel that It helps me understand the world around you better. It keeps my mind active and enhances my creative ability. i think it helps me with Communication Skills: Reading helps me improves my vocabulary and develops my communication skills.
Music provides me total brain workout. when i listening to music i feels that i can reduce anxiety, blood pressure, and pain as well as improve sleep quality, mood, mental alertness, and memory. those 3 activities are vase for me as an adjuster.
Additional Information
i understand that life is like a field that before sowing and harvesting you have to prepare and thus you will obtain a beautiful harvest.
Languages
Spanish
Native or Bilingual
English
Professional Working
Timeline
Auto Claim Adjuster
Christopher Auto Sales And Body Shop
03.2016 - 12.2023
Claim Examiner
Christopher Auto Body Work
01.2007 - 01.2015
No Degree - Certificated in Associate in Claims
Associate in Claims (AIC)
Associate of Science - Nursing
MDC
High School Diploma -
Hialeah High School
- All line License
- AIC certification
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