HEIDI RIVERA
Gilbert,Arizona
Summary
Licensed adjuster with experience in complex auto claims and financial crimes. Ability to handle high volume case loads, incoming/ outbound calls, and all productivity targets while maintaining good customer relations. Looking to continue my career with Liberty Mutual where I may utilize my professional background and personal experience to advance and continue to learn.
Overview
20
20
years of professional experience
1
1
Certification
Work History
Claims Resolution Specialist
Liberty Mutual
Chandler, Arizona
03.2024 - Current
- • Manage complex auto claims from initial investigation through resolution, ensuring timely and accurate handling in compliance with policy terms and state regulations.• Specialize in high-severity cases including fatalities, auto fire losses, and claims involving specialty vehicles (e.g., RVs, custom or high-value autos, motorcycles or ATV’s).• Handle claims with low liability limits, navigating sensitive negotiations and settlements with precision and professionalism.• Investigate and process pro rata claims, coordinating with other insurers to ensure equitable liability distribution.• Evaluate and resolve lost business income claims related to commercial auto losses, and independent employee losses, while collaborating with financial experts when necessary.• Conduct detailed scene investigations, obtain witness statements, consult with appraisal team, as well as SIU team when warranted, to support claim proper coverages and liability accuracy.• Maintain strong communication with policyholders, attorneys, insurance carriers and repair shops to drive efficient claim outcomes and maintain customer satisfaction.
Total Loss Claims Adjuster
Liberty Mutual
05.2022 - Current
- Verified insurance claims and determined fair amount for settlement.
- Conducted comprehensive interviews of witnesses and claimants to gather facts and information.
- Researched and analyzed policy contracts to verify proper payment of claims.
- Reviewed police reports, medical treatment records, and physical property damage to determine extent of liability.
- Answered customer questions regarding deductibles.
- Successfully negotiated settlements with claimants and insurers.
- Reviewed police reports, photographs and other documentation to gain complete understanding of accident.
- Coordinated with local body shops to assign repair jobs and obtained rental vehicles for customers for duration of restoration process.
Auto Claims Adjuster Complex Liability/Total Loss
Liberty Mutual
07.2021 - Current
- Negotiated with claimants to settle claims.
- Examined photographs and surveillance and any other documents relating to claims.
- Issued payouts to claimants.
- Documented all findings in concise reports.
- Determined salvage value on total-loss vehicle.
- Identified suspicious claims, escalating issues to SIU for further investigation and analysis.
- Coordinated with local body shops to assign repair jobs and obtained rental vehicles for customers for duration of restoration process.
Auto Claims Adjuster/ Worker's Comp
Liberty Mutual/ ProUnlimited/ Contractor
10 2020 - 07.2021
- Evaluated and investigated auto claims and decided whether insurer should pay claim.
- Issued payouts to claimants.
- Enhanced customer satisfaction by delivering honest advice to policyholders in regards to repair work and body shop processes.
- Identified suspicious claims, escalating issues to SIU for further investigation and analysis.
- Coordinated with local body shops to assign repair jobs and obtained rental vehicles for customers for duration of restoration process.
- Maintained claims data in Guidewire/ Navigator system.
- Received 25-40 new claims each week.
- Negotiated with claimants to settle claims.
- Determined salvage value on total-loss vehicle.
- Conducted recorded interviews with any and all parties involved, or who were witness to incidents.
- Determined liability on clear liability claims, as well as complex liability claims where determination could be 0-100%.
- Communicated decisions to all parties and attorneys.
Auto Claims Adjuster
MetroMile Inc.
09.2019 - 02.2020
- Evaluated original investigation reports and documents to resolve secondary concerns.
- Conducted thorough property investigations to identify and classify damages for customer claims.
- Reviewed questionable claims by conducting agent and claimant interviews to correct omissions and errors.
- Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
- Issued payouts to claimants.
- Examined photographs and surveillance and any other documents relating to claims.
- Documented all findings in concise reports.
- Reviewed police reports, medical treatment records and physical property damage to determine extent of liability.
- Investigated and assessed damage to property and reviewed property damage estimates.
- Interviewed agents and claimants to correct errors or omissions and investigate questionable claims.
- Assisted other team members with incoming que calls when needed.
- Interviewed drivers, claimants, witnesses and other sources, documenting verbatim.
Auto Claims Adjuster
LIberty Mutual Insurance
01.2018 - 09.2019
- Evaluated extent of damage and documented findings.
- Researched and verified insurance policy coverage.
- Prepared claim files to be sent to subrogation /other insurance companies.
- Checked into questionable claims, reviewing for any recommendations for claims to be referred to SIU department /collaboration.
- Determined insurance coverage levels and restrictions by thoroughly examining claims forms and associated records.
- Conducted secondary evaluations of original investigations documentation and reports to facilitate smooth resolutions.
- Promoted client retention through high-quality service and follow through.
- Pursued continuing education and training programs to continue professional development.
- Interviewed subjects, targets and witnesses for information verification and corroboration.
- Reported results of investigations with written observations and photographs, and produced final reports
- Collaborated with Special Investigations Unit to conduct investigations
- Issued payouts to claimants.
- Examined photographs and surveillance and any other documents relating to claims.
- Reviewed police reports, interviews and physical property damage to determine extent of liability.
Commercial Loan Servicing Specialist III
WELLS FARGO BANK
10.2012 - 03.2013
- Handle commercial loan set up and maintenance for auto dealerships
- Process automobile flooring loan set up, data entry, funding setup, phone interviews, wire transfers and GL balancing
- Performed a variety of loan documentation duties on complex commercial loans, using comprehensive knowledge of policies and procedures for loan products
- Functions include: processing; closing and compliance for loan products; interpreting policies while establishing and maintaining deep customer relationships
- Set up database with commercial loan builds, including flooring vehicles, setting up payment schedules, reviewing all required verifications, documentation and subsequent follow ups
- Respond to written and phone inquiries from clients and internal personnel regarding loans
- Process wire transfers and GL balancing of amounts up to $20M
- Answering questions from internal personnel, researching and analyzing problems and inquiries sent in via fax and email
- Maintain and clear all email inquiries to department daily
- Additional duties such as answering phones, procedures related to disbursements and funding, and special duties as rotated within department
Assistant Trainer and Exceptions Analyst
WELLS FARGO
05.2011 - 10.2012
- Organize and develop, or obtain, training procedure manuals and guides and course materials such as handouts and visual materials.
- Present information using a variety of instructional techniques or formats, such as role playing, simulations, team exercises, group discussions, videos, or lectures.
- Develop or implement training programs related to efficiency, recycling, or other issues with environmental impacts.
- Assess training needs through surveys, interviews with employees, focus groups, or consultation with managers, instructors, or customer representatives.
- Present information using a variety of instructional techniques or formats, such as role playing, simulations, team exercises, group discussions, videos, or lectures.
- Attend meetings or seminars to obtain information for use in training programs or to inform management of training program status.
- Participated in the Associates Program within the TOG DCO.
- While in this program, assisted in training of new hires and conversion agents from the Wachovia claims department at the Charlotte, Roanoke and Sioux Falls sites.
- Working as part of 3-5 agents dedicated to IC3 exceptions.
- Complete and clear up to 5 different types of exceptions within IC3, including those from all sites.
- Analyze data monthly and report findings to Sr management and Training department.
- Assisting in developing new strategies to reduce exceptions.
Financial Crimes Specialist III
WELLS FARGO BANK
06.2008 - 05.2011
- Handle Claims in whichcustomers claim fraudulent transactions via debit card charges, atm withdrawals, and ACH transactions
- Also process / investigate non fraudullent merchant disputes
- Process claimswithin Regulation E rules and timelines.Issue credits, process chargebacks, reviewdocuments, compare signatures, view surveillance video/photos, and conduct interviews with any parties involved
- Decisionclaims based on evidence provided bycustomer and merchant
- Reviewed, verified and identified customer transactions to detect and prevent financial crimes activities
Small Business Account Specialist
CHASE BANK
07.2005 - 04.2006
- Solicit sales of new or additional services or products.
- Confer with customers by telephone or in person to provide information about products or services, take or enter orders, cancel accounts, or obtain details of complaints.
- Managed portfolio of 300-500 accounts with incoming new business/ accounts daily.
Education
No Degree - General Studies
University Of Phoenix
Tempe, AZHigh School Diploma -
TEMPE HIGH SCHOOL
Tempe, AZSkills
- MS Office, including MS Word, PowerPoint, Microsoft Access, Outlook, skype, Navigator, Microsoft Teams, N2record, Comsearch, ISO, ExPRS, Copart, Reading Estimates, ADD, Docusign, MS Excel, CCC, creating payments of high dollar amounts with little supervision
- Ability to make sound decisions using evidence, photos , recorded statements , review of damages and accounts/ financial records
- Maintain/build Databases
- Create reports to show trends in agent errors and follow up with recommendations in training for improving those results
- Loan documentation, processing, funding
- Financial crimes investigations
- Deadline and results-oriented
- Conduct Interviews
- Proven ability to successfully train classes independently on new material, systems and skillsets, procedures and regulations
- Insurance regulations knowledge
- Excel, Hogan, Eclipse, Novell , Lotus Notes, DAT, VISA Online, Internet, Falcon, Guidewire, SMS
- Experience working on teams to achieve targeted goals
- Experience involving basic accounting, accounts payable, GL balancing, check creation, settlement balancing, pro rata calculations
- Atm/ credit card and ACH Fraud Investigations
- Opening/ Closing Bank Branch
- Assisting in Developing Training programs
- Billing Procedures
- Liability Determination
- Insurance Policy Coverage Knowledge
- Regulatory Compliance
Certification
- Adjuster license- Florida + multiple states. Renewed 04/2022
Additional information
Currently working on Total Loss Backup Team assisting other Total Loss adjusters who are out of office.
Participated in women’s mentoring group at Liberty Mutual 2022.
Timeline
Claims Resolution Specialist
Liberty Mutual
03.2024 - Current
Total Loss Claims Adjuster
Liberty Mutual
05.2022 - Current
Auto Claims Adjuster Complex Liability/Total Loss
Liberty Mutual
07.2021 - Current
Auto Claims Adjuster
MetroMile Inc.
09.2019 - 02.2020
Auto Claims Adjuster
LIberty Mutual Insurance
01.2018 - 09.2019
Commercial Loan Servicing Specialist III
WELLS FARGO BANK
10.2012 - 03.2013
Assistant Trainer and Exceptions Analyst
WELLS FARGO
05.2011 - 10.2012
Financial Crimes Specialist III
WELLS FARGO BANK
06.2008 - 05.2011
Small Business Account Specialist
CHASE BANK
07.2005 - 04.2006
Auto Claims Adjuster/ Worker's Comp
Liberty Mutual/ ProUnlimited/ Contractor
10 2020 - 07.2021
No Degree - General Studies
University Of Phoenix
High School Diploma -
TEMPE HIGH SCHOOL