Francisco Rivera
McKinney,TX
Summary
Talented Claims Adjuster emphasizing effective time management, cost control and mediation. Self-motivated and customer-focused. Energetic and enthusiastic insurance professional motivated to succeed in fast-paced and deadline-driven professional environment. Comprehensive knowledge of claims adjustments with special knowledge of auto appraisals and CCC pathways estimations. Licensed Claims Adjuster focused on construction inspections and workers' compensation claims. Positive attitude and exceptional problem solving skills.
Overview
23
23
years of professional experience
1
1
Certification
Work History
Property Damage Adjuster
Seaharbor insurance
Farmer's Branch, Texas
04.2024 - Current
- Calculated estimated costs of repairs using cost estimation software programs.
- Interpreted complex policy language as it relates to liability issues associated with property damage claims.
- Provided training sessions for new adjusters on best practices concerning handling of property damage claims.
Claims Adjuster
Amica Insurance
Dallas, TX
04.2022 - 04.2024
- Investigated insurance claims, reviewed coverage and liability, prepared reports and recommended payment or denial of claims.
- Researched relevant laws, regulations, legal decisions and precedents to determine appropriate course of action.
- Interpreted policy language to determine coverage for insureds under various lines of business.
- Reviewed medical records, police reports and other documents related to claim investigations.
- Conducted interviews with claimants, witnesses and medical professionals to obtain additional information about the claim.
- Analyzed facts of loss including photographs, diagrams and other evidence to identify potential sources of recovery.
- Negotiated settlements with claimants or their representatives in order to resolve disputes quickly and economically.
- Presented cases at mediations or arbitrations as needed in order to facilitate dispute resolution process.
- Maintained accurate documentation of all claim activity within designated system.
- Provided training sessions for new adjusters on best practices for adjusting claims.
- Utilized computer systems such as Microsoft Office Suite and specialized software programs used by the company.
- Adhered strictly to departmental guidelines; ensured that all activities were compliant with applicable state laws.
Social Media Content Manager
Genpact, LLC
04.2019 - 04.2022
- Manage a team of 15-17 social media content review agents
- Participate in 'Lean Program' by submitting idea plans to better work processes for agents
- Help agents with constructing lean ideas and submission
- Produce weekly and monthly reports for teams and agents, outlining line production level, adherence and compliance
- Identify trends in team and individual performances and construct 'Action Plans' to maintain/improved performances
- Review and implanted actions place through 1:1 and team huddles
- Collaborate with agents who desire to grow within company on developing and executing career plans.
Sr. Technical Rep
FRONTIER COMMUNICATIONS
03.2013 - 09.2018
- Began as an entry level technician and promoted to SR
- Technician
- Guide customer though trouble shooting steps for minor Windows processor related issues
- Utilized 'Log into me' for remoting into customer systems to resolved anti-virus corruptions, software installations and advance other advance system issues
- Resolved escalated calls and tickets by utilizing deescalating techniques
- Produced monthly reports for completed and pending escalated tickets
- Observe under performing agents and construct an action plan to improve performance per supervisors' request.
Sales & Service MANAGER
TIME Warner Cable
04.2008 - 08.2013
- Manage a team of 20 sale representatives
- Construct daily reports detailing team's service upselling record for day
- Provided Bi-weekly individual reports outlining personal adherence and compliance
- Implemented 'action plans' for team and individuals to improve/maintain performance.
Retail Store Manager
Nextel/Sprint Communication
05.2002 - 07.2005
- Delivered excellent customer service by greeting and assisting each customer
- Addressed customer inquiries and resolved complaints
- Opened a new store location and assisted in recruiting and training new staff
- Stocked and restocked inventory when shipments were received
- Reorganized the sales floor to meet company demands
- Directed and supervised employees engaged in sales and reconciling cash receipts
- Produce weekly schedules according to payroll policies
- Addressed and corrected sales staff communication issues in a tactful and effective manner.
Education
Bachelor Of Business -
Shaw University
Raleigh, NC05-2025
High school diploma -
Newburgh Free Academy
06.1998
Skills
- Team Management and development
- I-Log ticketing system
- Problem solving
- Apply policy to work process
- Customer service and support
- Critical Thinking
- Claims Negotiation
- Claims File Management Processes
- Evidence Reviews
- Claims Processing
- Claims File Documentation
- Insurance Policy Coverage Knowledge
Certification
Property and Casualty insurance licenses
Timeline
Property Damage Adjuster
Seaharbor insurance
04.2024 - Current
Claims Adjuster
Amica Insurance
04.2022 - 04.2024
Social Media Content Manager
Genpact, LLC
04.2019 - 04.2022
Sr. Technical Rep
FRONTIER COMMUNICATIONS
03.2013 - 09.2018
Sales & Service MANAGER
TIME Warner Cable
04.2008 - 08.2013
Retail Store Manager
Nextel/Sprint Communication
05.2002 - 07.2005
Bachelor Of Business -
Shaw University
High school diploma -
Newburgh Free Academy