Cosme Tijerina

• Assisted customers with complaints, inquiries, and billing issues while maintaining a high level of customer satisfaction.
• Performed customer negotiations to reach fair conclusion for both business and customer.
• Performed regular follow-up calls with customers to ensure their satisfaction with products and services.
• Implemented creative solutions to deal with special circumstances.
• Identified potential risks associated with retaining existing customers and developed action plans accordingly.

• Investigate fire and theft claims.
• Review damages, create estimates, to settle claims.
• Evaluated insurance claims for accuracy and compliance with policy guidelines.
• Utilized claims management software to track and manage open files efficiently.
• Maintained detailed records of all claim activities in a timely manner.
• Partner with SIU to rule out fraud.
• Evaluated subrogation opportunities to identify recoverable funds.
• Negotiated total loss settlements by reasonably applying company estimates to benefit both client and company needs.
• Ensure that payments and settlements are made in accordance with company practices and procedures.

• Create training and development plans.
• Administer programs that improve the skills and knowledge of their employees.
• Supervised a team of insurance retention specialists.
• Ensure a deep, comprehensive understanding of all life insurance policies and train others.
• Conducted audits of processed applications to ensure adherence to internal policies.
• Analyzed medical records to assess risk and determine insurability of applicants.
• Provided advice and guidance to customers regarding their existing or proposed life insurance plans.
• Reviewed policies to determine appropriate levels of coverage and assist with approval or denial decisions.

• All lines insurance adjuster.
• Managed multiple cases and lines of businesses simultaneously while meeting established deadlines.

Property:

• Ensured compliance with state laws and insurance policies.
• Evaluated property damage claims for damages resulting from everyday events, to natural disasters.
• Assessed the extent of damages caused by the named peril, and estimated repair costs.
• Investigated liability claims, interpreted insurance policies in order to accurately assess liability, and identify potential areas of fraud or misrepresentation.
• Prepared detailed reports outlining the investigation process, findings, recommendations, and settlement amounts.

Auto:

• Investigated and analyzed auto insurance claims to determine validity, liability, and coverage.
• Interviewed claimants, witnesses, police officers, medical professionals and other parties involved in the claim.
• Evaluated vehicle damage to create accurate repair estimates using multiple software programs.
• Determine liability based on facts gathered from investigations, and secure settlements.

• Intake new auto insurance claims over the phone.
• Take the initial recorded statement from the first-party insured.
• Report and document all suspicious information.
• Create an FNOL report with all pertinent information for the field adjuster.
• Follow up with customers after an automobile collision for property damage inspection.
• Documented claim findings in the company's management system accurately.
• Performed special projects upon request from management; completed tasks efficiently while meeting deadlines.