Branli Cruz
Princeton,Tx
Summary
Accomplished Claims Associate adept at managing high caseloads and delivering top-tier customer service in dynamic, fast-paced environments. Highly organized, driven, and adaptable, with exceptional planning and problem-solving skills. Backed by years of experience in handling tough customer situations, with a proven track record of confidently tackling challenges and achieving success.
Overview
2026
2026
years of professional experience
Work History
Claims Associate
State Farm
Richardson, TX
12 2024 - Current
- Delivered a remarkable customer experience throughout the handling of lower complexity claims, identifying and ensuring prompt routing of claims to other functional areas.
- Received and processed claim information, and communicate with internal and external customers via phone and other communication channels.
- Worked in a team environment and handles low complexity/high volume work in contact/call center environment.
- Maintain detailed claim documentation within MAX, ECS, and ECRM systems while meeting productivity, quality, and compliance goals.
- Evaluated claim information to determine coverage and liability accurately.
Retention II
State Farm
Richardson, TX
06 2023 - 12 2024
- Used multiple communication channels to interact and document conversations with concurrent customers, agencies partners, producers and or third party vendors regarding outstanding documentation requests.
- Identified, researched, and responded to insurance policy questions and issues including request related to policy changes, premium information, and transactions involving external companies.
- Responded to inquiries and processes transactions related to billing, policies, and financial services, including electronic fund transfers, illustrations, values/disbursements, and premium inquiries.
Research Specialist
Prime Therapeutics
Dallas, TX
01.2013 - 12.2022
- Resolved complex prescription claims through direct coordination with Blue Cross Blue Shield for employee and individual plans.
- Managed 25–30 daily cases via calls, emails, and escalations.
- Applied deep procedural and system knowledge to efficiently research and resolve cases.
- Consistently exceeded performance metrics and earned top-performer recognition.
Skills
Claims & Policy Expertise:
- Claims Investigation Policy Review
- Coverage Analysis Regulatory Compliance Settlement Negotiation
Customer Service & Communication:
- Empathetic Service Conflict Resolution
- Cross-Functional Collaboration Bilingual
- (English/Spanish) Relationship
- Management
Technical & Analytical:
- MAX ECS ECRM GenAI Data Accuracy
- Documentation Management Process
- Optimization
Professional Strengths:
- Leadership Adaptability Continuous
- Improvement Attention to Detail
- Multitasking Problem Solving
Professional License
Property & Casualty License
Property Adjuster License
Timeline
Research Specialist
Prime Therapeutics
01.2013 - 12.2022
Claims Associate
State Farm
12 2024 - Current
Retention II
State Farm
06 2023 - 12 2024