CRISTIAN ZAMORANO
Peoria,AZ
Summary
Experienced claims professional with extensive background in negotiation and regulatory compliance. Skilled in resolving complex claims efficiently, fostering client trust, and maintaining high customer satisfaction through effective communication and problem-solving.
Overview
11
11
years of professional experience
Work History
APD Claim Representative II
Auto Club Group/AAA
Burnsville, MN
10.2018 - Current
- Essential Insurance Act (Michigan)
- Fair Trade Practices Act as it relates to claims
- Subrogation procedures and processes
- Intercompany arbitration
- Negligence Law
- No-Fault Law
- Collision repair techniques
- Handle claims to the line Claim Handling Standards
- Follow and apply ACG Claim policies, procedures and guidelines
- Work within assigned ACG Claim systems including basic PC software
- Perform basic claim file review and investigations
- Demonstrate effective communication skills (verbal and written)
- Demonstrate customer service skills by building and maintaining relationships with insureds/claimants while exhibiting understanding of their problems and responding to questions and concerns
- Analyze and solve problems while demonstrating sound decision-making skills
- Prioritize claim related functions
- Process time sensitive data and information from multiple sources
- Manage time, organize and plan work load and responsibilities
- Research analyze and interpret subrogation laws in various states
- Strong negotiating skills
- Member of Arbitration Forums, Inc
- Certified Arbitrator
Claims Resolution Manager
Gallagher Bassett
Bloomington, MN
03.2018 - 10.2018
- Exercises proper judgment and decision making to analyze the claims exposure, to determine the proper course of action and to appropriately settle the claim.
- Interacts extensively with various parties involved in the claim process.
- Clearly communicate concise action plans, and present plans for moving the case to conclusion.
- Complete knowledge of the claim file process through presentation of actions and responses to client questions.
- Processes claims consistent with clients' and corporate policies, procedures and "best practices" and also in accordance with any statutory, regulatory and ethics requirements.
- Ability to comply with carrier reporting and threshold requirements.
- Recognize and pursue excess insurance recoveries. Incumbents will have the ability to handle a full case load, with proven ability to handle cases of increased severity
Auto Claim Concierge Representative
American Family Insurance
Eden Prairie, MN
02.2017 - 03.2018
- Primary accountabilities include securing factual evidence, coverage investigation and policy interpretation to satisfy claims for auto and property damage.
- Process non-injury claims nationwide in accordance with state specific policies and statutes.
- Secure recorded statements for examination of coverage to support 3rd party comparative negligence investigations, coverage and auto theft.
- Assist customers with claim related needs including discussing repair options and coordinating auto rental reservations.
- Investigate 1st party coverages and interpret policy to support coverage decisions.
- Identify, investigate and evaluate subrogation and contribution opportunities.
- Generate coverage denial letters when applicable.
- Provide moderate estimate and total loss process and damage details, valuations and supplements to customers.
- Secure, preserve and maintain all evidence necessary to complete a thorough claim investigation and determine proper course of action.
- Knowledge of underwriting guidelines to satisfy coverage investigation.
ADP Claims Representative
Mendota Insurance Co.
Eagan, MN
11.2015 - 02.2017
- Efficiently handled low to complex property damage cases to mitigate loss.
- Researched facts to evaluate coverage, liability and damages.
- Identified subrogation and salvage opportunities in timely manner.
- Established and maintained appropriate claim reserves.
- Effectively evaluated claims to ensure cost effective resolutions for both the claimant and insurer.
- Identified and coordinated potential fraud investigations with Special Investigative Unit.
- Complied with state specific and state fair claim practice requirements.
- Managed expenses through appropriate vendor oversight with focus in the defense council.
- Represented the claim department to our customers, retail agents, regulatory authorities.
- Maintained quality claim files in accordance with appropriate best practices.
Education
Bachelor of Science - Business Administration with a concentration in Business Information Systems
DeVry University
06-2015
Associate of Science - Printing Technologies
Hennepin Technical College
06-1992
Skills
- Microsoft office
- Word
- Excel
- Adobe
- Power Point
- Outlook
- Claims Management Processes
- Client Communication
- Insurance Policy Analysis
- Regulatory Compliance
- Conflict Resolution
Languages
- Fluent in English
- Fluent in Spanish
Timeline
APD Claim Representative II
Auto Club Group/AAA
10.2018 - Current
Claims Resolution Manager
Gallagher Bassett
03.2018 - 10.2018
Auto Claim Concierge Representative
American Family Insurance
02.2017 - 03.2018
ADP Claims Representative
Mendota Insurance Co.
11.2015 - 02.2017
Bachelor of Science - Business Administration with a concentration in Business Information Systems
DeVry University
Associate of Science - Printing Technologies
Hennepin Technical College