JOSUE LIRA
Dallas,TX
Summary
Analytical claims professional with a background in bodily injury evaluation, medical and financial review, and settlement negotiation. Applies quantitative analysis, risk assessment, and clear communication to investigate complex claims, manage reserves, and resolve files in line with company guidelines and regulations.
Overview
1
1
Language
6
6
years of professional experience
Work History
Bodily Injury Claims Specialist
STATE FARM
Richardson, TX
01.2021 - Current
- Manage and evaluate bodily injury claims from initial investigation through resolution while applying company guidelines, policies, and applicable regulations.
- Analyze medical records, accident information, liability factors, financial data, and other documentation to evaluate claim exposure and determine appropriate settlement strategies.
- Investigate complex claims by reviewing evidence, identifying relevant facts, and assessing potential liability and damages.
- Negotiated settlements with claimants, attorneys, medical providers, and other involved parties to reach favorable outcomes.
- Made financial decisions regarding claim reserves, settlement values, and overall claim exposure to mitigate risk.
- Use analytical and problem-solving skills to identify inconsistencies, evaluate risk, and determine appropriate courses of action.
- Communicated complex insurance and claim-related information clearly to customers, attorneys, and other stakeholders, ensuring understanding and compliance.
Education
Bachelor of Science - Mathematics, Business Management
UNIVERSITY OF NORTH TEXAS AT DALLAS
Dallas, TexasSkills
- Insurance Claims Analysis
- Risk Assessment
- Settlement Evaluation
- Liability Analysis
- Financial Analysis
- Data Analysis
- Mathematical & Quantitative Analysis
- Microsoft Excel
- Negotiation
- Documentation & Case Management
- Problem Solving & Critical Thinking
- Decision Making
- Experienced in evaluating complex situations and making informed decisions
- Strong written and verbal communication skills
- Able to translate analytical findings into practical business decisions
- Adaptable and able to learn complex systems and processes quickly
Personal Information
Title: Mathematics | Insurance | Claims | Analytics
CAREER INTERESTS
Actuarial Analysis | Risk Management | Insurance Analytics | Data Analysis | Business Analysis | Financial Analysis | Operations
Languages
Spanish
Native/ Bilingual
Timeline
Bodily Injury Claims Specialist
STATE FARM
01.2021 - Current
Bachelor of Science - Mathematics, Business Management
UNIVERSITY OF NORTH TEXAS AT DALLAS