Edwin Pacheco Diaz
Leicester,MA
Summary
Organized and detail-oriented leader dedicated to improving efficiency, productivity and profitability through continuous process improvement. Analytical thinker skilled at developing innovative solutions to complex problems.
Overview
11
11
years of professional experience
Work History
Senior Claims Manager
EdenRafferty
Worcester, MA
01.2023 - Current
- Managed a team of claims adjusters, ensuring thorough investigations and accurate assessments of cases and case value.
- Mentored junior staff on best practices for claims investigation, handling and resolution
- Evaluated and negotiated contracts to procure favorable financial terms.
- Negotiated favorable settlements on behalf of the company, minimizing potential exposure to costly litigation proceedings.
- Championed continuous improvement initiatives that streamlined processes and enhanced overall department efficiency.
Intermediate Claims Adjuster
Progressive Insurance
Westwood, MA
07.2019 - 01.2023
- Interviewed agents and claimants to correct errors or omissions and investigate questionable claims.
- Examined claims forms and other records to determine insurance coverage.
- Answered questions posed by insured and attorneys.
- Substantiated legitimate claims and denied unjustified claims.
- Reviewed and analyzed suspicious and potentially fraudulent insurance claims.
- Reviewed new files to determine current status of injury claim and to develop plan of action.
Casualty Adjuster /Trainer
Allstate Insurance Co
Coconut Creek, FL
08.2015 - 07.2019
- Collected and tracked evidence in support of legal processes.
- Reviewed new files to determine current status of injury claim and to develop plan of action.
- Determined liability outlined in coverage and assessed documentation such from police and healthcare providers to understand damages incurred.
- Negotiated injury settlement agreements to resolve disputes.
- Delivered exceptional customer service to policyholders by communicating important information and patiently listening to issues.
- Trained new employees on efficient and best practices
- Oversaw a root cause problem team to optimize best business practices.
Education
Bachelor of Science - Political Science
Fitchburg State University
Fitchburg, MA08-2013
Skills
- Highly motivated
- Advanced oral and written communication skills
- Advanced computer skills
- Valuation knowledge
- Legal proceedings knowledge
- Automobile claims specialist
- Personal, casualty and property loss
- Insurance policy coverage knowledge
- Policy investigations
- Risk management
Languages
Spanish
Timeline
Senior Claims Manager
EdenRafferty
01.2023 - Current
Intermediate Claims Adjuster
Progressive Insurance
07.2019 - 01.2023
Casualty Adjuster /Trainer
Allstate Insurance Co
08.2015 - 07.2019
Bachelor of Science - Political Science
Fitchburg State University