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Experienced Claims Examiner with over 8 years in managing complex auto bodily injury and litigation claims. Develops effective litigation and settlement strategies, evaluates liability and damages, and collaborates with defense counsel for favorable outcomes. Skilled negotiator resolving high-exposure claims while ensuring regulatory compliance and enhancing customer experience.

Qualified Manager versed in investigating claims, verifying information and managing settlements. Friendly and upbeat team player with organized and disciplined approach. Offering 26 years of insurance and claim experience. To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills. Experienced in Medicare claims, workers compensation and medical claims.

Objective: To secure a responsible and challenging position that allows me to use my experience, knowledge and expertise to the advantage of my employer and our clients/customers. I am currently retired and preferably seeking part time employment.

I am a loyal and dedicated employee eager to learn new skills. Always interested in taking on new tasks as assigned. Over 40 years of experience in customer service that includes contact with clients, injured workers, medical providers, etc. Heavy computer experience including Microsoft Word, Microsoft Outlook, Excel and Valley Oak Systems (VOS). Experience in medical terminology, ICD9, ICD10, CPT codes, medical billing and medical terminology.

Proven Senior Claims Specialist with a robust background at The Hartford, adept in leveraging organizational skills and critical thinking to drive efficiency and mentor team members. Excelling in communication, I spearheaded initiatives that significantly enhanced claims processing, demonstrating a strong blend of leadership and adaptability. Results-driven professional with proven ability to effectively manage high-volume claims while maintaining accuracy and efficiency. Skilled in determining coverage, verifying facts, negotiating settlements, and preparing clear, concise reports. Excellent communicator with strong customer service and problem-solving capabilities. Proven ability to provide excellent customer service and resolve customer complaints in a timely manner. Possesses strong problem-solving skills and the ability to multitask in a fast-paced environment. Aiming to leverage my abilities to successfully fill the [Job Title] role on your team.

GABRIEL DUARTE

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Senior Claims Examiner

Customer Service

Sales Consultant

Legal Assistant

Payments Analyst

Customer Service Agent and Language Specialist Supervisor (Portuguese)

Commercial Analyst

Marketing Intern

Financial Analyst

Education

Master of Business Administration - International Business

Bachelor of Science - Business Administration

Coursework in Bachelor of Science - Law