Client and examiner centric and accomplished with extensive experience in dealing with complex claims while overseeing claims accounts to acquire client satisfaction and reduce losses.
Overview
27
27
years of professional experience
Work History
Claim Examiner II
California FAIR Plan
08.2021 - Current
Improved customer satisfaction by providing timely and accurate claim updates throughout the process.
Negotiated fair settlements between insurance providers and policyholders to resolve disputes amicably.
Reviewed written estimates for repair costs, ensuring accuracy before issuing payments to vendors or policyholders.
Assisted policyholders in understanding their coverage options, guiding them through the claims process stepbystep.
Mentored junior staff members on effective negotiation strategies, helping them achieve better outcomes for both policyholders and the company itself.
Directed claims negotiations within allowable limit of $100,00.00 and supported successful litigations for advanced issues.
Streamlined communication channels between internal departments for faster decision-making on complex cases.
Managed high-volume caseloads, maintaining organization and attention to detail for each individual case.
Enhanced team productivity with consistent coaching, training sessions, and performance evaluations.
Property Field Specialist II
Mercury Insurance Group
01.2018 - 07.2021
Managed overall field operations by meticulously inspecting insured properties and monitoring emergency services as well as contractors by using ClaimXperience and Livegenic to attain various organizational objectives in compliance with company guidelines
Evaluated properties and ensured accurate repair estimate reporting of insured assets by utilizing Xactimate in professional manner.
Conducted in-depth scene investigations to gather crucial evidence, such as photographs and witness statements, to support claim resolutions.
Increased efficiency in claim processing by utilizing industry-standard software for documentation and communication.
Balanced workload effectively while maintaining a high level of accuracy, prioritizing tasks based on urgency and importance for overall business objectives.
Improved customer satisfaction by promptly addressing property damage claims and providing accurate assessments.
Maintained company field response vehicle stocked with repair and replacement parts valued over $500,000.00.
Senior Account Specialist
Enterprise Rent a Car
01.1998 - 01.2018
Enhanced work efficiency by developing impactful connections with insurance partners and assigned body shops
Increased customer base and maximized client retention and trustworthiness while efficiently promoting enterprise benefits.
Improved client satisfaction by delivering tailored financial solutions and maintaining strong relationships.
Managed high-value accounts with exceptional attention to detail, ensuring all deliverables met or exceeded expectations.
Collaborated closely with sales teams to identify new business opportunities within existing accounts, leading to additional revenue streams.
Presented detailed reports on key account achievements during quarterly business review meetings, highlighting successes and areas for improvement.
Implemented innovative techniques for monitoring and analyzing key account metrics, driving continuous improvement.
Resolved escalated issues quickly, maintaining positive client relationships while safeguarding company interests.
Streamlined account management processes for increased efficiency and productivity.
Established trust-based partnerships with clients by consistently demonstrating expertise in their industries and understanding their unique needs.
Education
Bachelor of Arts - Fashion Merchandising and Design
The American College For Applied Arts
Los Angeles, CA
1991
Skills
Team motivation
Customer Expectations Management
Customer Service
Teamwork and Collaboration
Willing to Learn
Problem-solving abilities
Multitasking Abilities
Excellent Communication
Critical Thinking
Decision-Making
Task Prioritization
Staff Management
Coaching and Mentoring
Accomplishments
Achieved largest number of completely satisfied, customer service surveys within the claims department by providing excellent customer service with with accuracy and efficiency.
Successfully Supervised Claim Teams of 5 or 6 Examiners while various supervisors were on vacation.
Key Qualifications
Demonstrated success in monitoring claim life-cycle by inspecting determining coverage, coordinating with insurance adjusters, negotiating with contractors, and recommending suitable solutions.
Instrumental in examining insurance claims, collecting evidence, liaising with field experts, processing documents, disbursing funds to claimers, and implementing filing procedures through calls and emails while prioritizing and meeting stringent deadlines.
Adept at communicating property claim cases to relevant insurance companies for covering damages and updating approval/denial status while resolving customer's complex claims in line with service quality standards.
Possess outstanding interpersonal, persuasion, and communication skills to foster impactful relationships with national frequency claims team and perform well in fast-paced environment. Proficient in MS Office Suite, Guidewire, XactAnalyis, Xactimate, ClaimXperience, and Livegenic.
Timeline
Claim Examiner II
California FAIR Plan
08.2021 - Current
Property Field Specialist II
Mercury Insurance Group
01.2018 - 07.2021
Senior Account Specialist
Enterprise Rent a Car
01.1998 - 01.2018
Bachelor of Arts - Fashion Merchandising and Design