Diana Marroquin
Insurance Claims, Banking, Clerical, Research, Workers Compensation
Phoenix,United States
Summary
Known for resolving issues effectively while being compassionate and a positive demeanor. Pursuing a role where hard work and dedication is valued. Talented, with desire to work with an array of team(s). Engaging, and personable. Enthusiastic and want to contribute to team success through hard work, attention to detail and organization. Understanding the importance of values and ongoing learning. Moved and looking for an opportunity to be part of this work family.
Overview
26
26
years of professional experience
Work History
Fraud and Claims Analyst
Wells Fargo Bank
Tempe, AZ
07.2019 - Current
- Use of Bank applications such as: Comm/Recon, Hogan, OIB, Interaction Console, SOTA, PAC.
- Intake incoming calls of 30+ daily, all while maintaining company values, passing audits, delivering exceptional customer service and patiently listening to issues while deescalating irate customers.
- Provide upbeat, positive atmosphere.
- Being flexible with work schedule to provide proper coverage as needed.
- Assist management with reports
- Educating customers regarding claim status and its outcome.
Operations Processor 3
Wells Fargo Bank
Chandler, AZ
04.2010 - 07.2019
- Increased customer satisfaction by listening and resolving their issues.
- Conducted research, gathered information from multiple bank sources and presented results.
- Worked with customers to understand needs and provide excellent service.
- Eliminated downtime and maximized customer experience.
- Improved operations through consistent hard work and dedication.
- Helped customers understand claims process all while maintaining guidelines, intaking 45+ calls daily, deescalating irate customers, passing audits and providing exceptional customer service.
- Provide positive, fun atmosphere for department to include nearby other areas.
- Sought out by peers as a positive influencer and confidant, to include as a liaison with management.
- Report and escalate possible fraudulent activity to assist with company risk.
Bilingual Claims Adjuster
American Family Insurance
Phoenix, AZ
01.2000 - 02.2010
- Interviewed witnesses and claimants to correct errors or omissions and investigate questionable claims.
- Testified on behalf of company as part of subrogation.
- Maintained contact with claimants and attorneys to determine treatment status.
- Followed up on potentially fraudulent claims initiated by claims representatives.
- Answered customer questions regarding deductibles and educating on claims process.
- Reviewed police reports, medical treatment records and physical property damage to determine extent of liability.
- Answered questions posed by insured and attorneys.
- Verified insurance claims and determined fair amount for bodily injury settlement.
- Handle case load of approx. 120+ claims.
- Travel to other states to assist with catastrophe hit areas.
- Handle auto claims for states of AZ, NV, OR, UT and CO
- Report possible fraud to SIU as well as working closely with SIU to bring claim to a resolution.
- Review of attorney demands regarding bodily injury and respond in timely manner.
- Meet with customers in person to settle auto theft claims.
Claims Specialist
Crawford And Company
Phoenix, AZ
12.1995 - 01.2000
- Maintained knowledge of basic medical terminology to better understand case by case claims.
- Made contact with insurance carriers to discuss policies and individual benefits.
- Verified client information.
- Generated, posted and attached information to claim files.
- Processed and recorded new policies and claims.
- Calculated payables according to AZ fee schedules.
- Conducted full claim investigations and reported updates to include referrals to PI for possible fraud.
- Customer liaison
- Clerical functions to include dictation.
- Accounts receivable.
- Medical Claims adjuster.
Education
Associate of Arts -
South Mountain Community College
Phoenix, AZ Skills
Claims
Claims review
Coverage determination
Insurance policy coverage knowledge
Customer Service
Timeline
Fraud and Claims Analyst
Wells Fargo Bank
07.2019 - Current
Operations Processor 3
Wells Fargo Bank
04.2010 - 07.2019
Bilingual Claims Adjuster
American Family Insurance
01.2000 - 02.2010
Claims Specialist
Crawford And Company
12.1995 - 01.2000
Associate of Arts -
South Mountain Community College