Janelle Rueda
Redlands,USA
Summary
Service-oriented Claims Adjuster with a proven ability to apply innovative strategies for resolving complex issues. Expertise in developing and implementing processes that prioritize quality while driving profitability. Committed to delivering exceptional service and fostering positive relationships with clients and stakeholders. Recognized for a proactive approach that enhances operational efficiency and customer satisfaction.
Overview
6
6
years of professional experience
1
1
Certification
Work History
Workers' Compensation Claims Adjuster
Sedgwick
Ontario, CA
12.2024 - Current
- Administered management of 100-150 workers' compensation claims to maintain compliance with California labor code requirements and uphold audit standards.
- Facilitated communication between injured employees, healthcare providers, legal counsel and employers to streamline claim processes.
- Conducted thorough investigations into claims, identifying fraud and inconsistencies to protect company interests.
- Executed settlement negotiations and stipulated agreements with plaintiff attorneys to effectively resolve claims while adhering to authority limits and minimizing litigation costs.
Fulfillment Operations Manager
Target
Orange, CA
02.2024 - 12.2024
- Managed daily and weekly workload planning using data analytics to drive store profitability.
- Implemented guest-first service strategies to enhance customer satisfaction and cultivate a culture of exceptional service.
- Implemented coaching strategies to address skill gaps among team members, fostering continuous improvement and ensuring safety compliance.
Area Manager
Nordstrom
San Bernardino, CA
02.2021 - 10.2023
- Oversaw a team of 20-25 associates, coordinating operations in receiving, picking, packing, and shipping to enhance productivity and service quality.
- Designed and implemented comprehensive strategies aimed at optimizing productivity, reducing operational costs, and improving efficiency.
- Monitored key performance metrics to support operational efficiency. Assisted in analyzing operational data to identify improvement opportunities. Contributed to continuous process optimization efforts.
Special Education Teacher Assistant
California State University, San Bernardino
San Bernardino, CA
12.2019 - 09.2021
- Designed and implemented support resources aimed at equipping families with valuable skills for achieving success and fostering global connections.
- Coordinated monthly meetings to produce detailed reports, enhancing organizational assessment processes.
- Facilitated regular communication with parents and caregivers to ensure awareness of important developments.
Education
Master of Science - Business and Data Analytics
California State University, San Bernardino
San Bernardino, CA12-2024
Bachelor of Arts - Economics
California State University, San Bernardino
San Bernardino, CA05-2023
Skills
- Data Analysis
- Project Management
- Claims management
- Policy interpretation
- Warehouse Management Systems (WMS)
- Claims investigation
Certification
- CA Self Insurance (SIP)
Timeline
Workers' Compensation Claims Adjuster
Sedgwick
12.2024 - Current
Fulfillment Operations Manager
Target
02.2024 - 12.2024
Area Manager
Nordstrom
02.2021 - 10.2023
Special Education Teacher Assistant
California State University, San Bernardino
12.2019 - 09.2021
Bachelor of Arts - Economics
California State University, San Bernardino
Master of Science - Business and Data Analytics
California State University, San Bernardino