Lauren E. Arredondo
San Antonio,TX
Summary
Insurance professional with 4+ years of experience in auto claims investigation, policy analysis, risk evaluation, and regulatory compliance within high-volume environments. Skilled in analytical decision-making, contract interpretation, customer relationship management, and problem-solving. Seeking to leverage firsthand claims experience and analytical skills in an underwriting role to strengthen risk assessment and coverage decisions earlier in the insurance process.
Overview
1
1
Certification
14
14
years of professional experience
Work History
Senior Non-Injury Auto Adjuster – Complex Claims
USAA
San Antonio, TX
10.2023 - Current
- An experienced-level role with increased decision-making responsibility, managing a high-volume inventory of more than 200 highly complex auto claims that extend beyond standard or routine cases.
- Apply analytical decision-making and critical thinking to investigate complicated accident details, assess risk factors, determine liability, and applicable coverages.
- Evaluate the extent of damages per claim to determine any potential for high financial exposure. Claims often involve multiple private and/or commercial autos, commercial property damage, and low liability limits per accident.
- Negotiate first-party and third-party total loss settlements while balancing financial exposure within policy limits to ensure a fair and accurate resolution.
- Analyze policyholder claim history and utilize industry databases such as ISO (Insurance Services Office, Inc.) to identify risk patterns, loss trends, and potential indicators of fraud.
- Interpret insurance policy provisions, exclusions, and endorsements to make informed coverage decisions aligned with contractual obligations.
- Prioritize and manage multiple competing tasks in a fast-paced environment while maintaining compliance with the auto policy, state laws and regulations, and company standards.
- Build and maintain professional relationships with insureds, claimants, repair facilities, third-party carriers, and internal business partners through responsive communication and problem resolution.
- Maintain accurate, fully documented, compliant claim files to support audit and regulatory requirements.
Non-Injury Auto Claims Adjuster
USAA
San Antonio, TX
12.2021 - 10.2023
- Completed extensive training and obtained Property & Casualty Adjuster licenses in all 50 states within 90 days.
- Investigated claims by reviewing contracts, accident details, recorded statements, and supporting documentation to determine liability and coverage.
- Developed strong analytical and problem-solving skills through evaluation of moderate accident scenarios and claim exposures.
- Communicated coverage decisions and claim processes professionally to insureds, claimants, and business partners.
- Served as a mentor for new team members by providing onboarding support, coaching, and guidance.
Pharmacy Care Coordinator
UnitedHealth Group
San Antonio, TX
09.2019 - 12.2021
- Reviewed medication prior authorization approvals and patient information to evaluate medication costs and financial assistance eligibility.
- Analyzed medical documentation and case notes to identify appropriate coverage solutions and projected medication expenses.
- Communicated with patients and providers regarding authorization approvals, billing options, and prescription fulfillment strategies.
Certified Pharmacy Technician
H-E-B Pharmacy
San Antonio, TX
08.2012 - 09.2019
- Assisted patients and pharmacists in medication processing, maintained accuracy in data entry, and provided customer service in a fast-paced, regulated environment.
Education
Bachelor of Business Administration -
Texas A&M University- San Antonio
San Antonio, TX12-2016
Skills
- Risk Analysis
- Policy Interpretation
- Investigative Research
- Regulatory Compliance
- Analytical Decision-Making
- Relationship Management
- Financial Exposure Evaluation
- Customer Communication
- Negotiation
- Problem Solving
- LexisNexis
- ISO (Insurance Services Office, Inc)
- Salesforce
- Guidewire
- SharePoint
- Microsoft Word, Excel, OneNote, PowerPoint, Outlook
Certification
Texas Property & Casualty Adjuster License — Active
Timeline
Senior Non-Injury Auto Adjuster – Complex Claims
USAA
10.2023 - Current
Non-Injury Auto Claims Adjuster
USAA
12.2021 - 10.2023
Pharmacy Care Coordinator
UnitedHealth Group
09.2019 - 12.2021
Certified Pharmacy Technician
H-E-B Pharmacy
08.2012 - 09.2019
Bachelor of Business Administration -
Texas A&M University- San Antonio