Linda L. Sifuentes-Martinez
Summary
Accomplished Property Claims Examiner with a proven track record at Vanguard Claims Administration, enhancing customer satisfaction through prompt and accurate property damage evaluations. Skilled in Xactimate and bilingual communication, adept at caseload management and settlement negotiations. Licensed in 26 states, significantly reduced fraudulent claims, ensuring compliance and meticulous documentation.
Interested in a non-call center setting, to include work from home and open to contract employment.
Overview
22
22
years of professional experience
Work History
Property Claims Examiner
Vanguard Claims Administration
04.2022 - 03.2023
- Desk adjust moderate to complex claims, to include homeowners, flood, mobile home, condo and commercial building.
- Work from Home employee.
- Utilized Guidewire, VCA and FileTrac claims programs.
- Improved customer satisfaction by providing prompt, accurate, and thorough evaluations of property damage claims.
- Streamlined claims processing for faster settlement times through diligent investigation and assessment of property damages.
- Utilized advanced technology tools for more accurate assessments of damages in complicated or large-scale loss situations.
- Maintained an organized workflow by prioritizing tasks effectively, leading to timely completion of claim examinations.
- Developed excellent rapport with policyholders by providing clear communication on claim progress and potential outcomes.
- Collaborated with adjusters, appraisers, and other professionals to ensure thorough evaluation of property damage cases.
- Conducted comprehensive reviews of insurance policies to determine appropriate coverage levels for various types of property damage incidents.
- Reduced fraudulent claims activity by conducting in-depth investigations and collaborating with law enforcement agencies when necessary.
- Managed a high volume of cases simultaneously while maintaining accuracy and attention to detail throughout the examination process.
- Provided exceptional customer service during claim inquiries, fostering trust between policyholders and insurance providers.
- Maintained accurate records of claim files, ensuring proper documentation for audit purposes, and contributing to the company''s adherence to industry standards.
Property Claims Examiner
Davies - IAS
05.2019 - 03.2022
- Desk adjust moderate to complex claims, to include homeowners, flood, mobile home, condo and commercial building.
- Work from Home
- Contract Employee
- Improved customer satisfaction by providing prompt, accurate, and thorough evaluations of property damage claims.
- Streamlined claims processing for faster settlement times through diligent investigation and assessment of property damages.
- Developed excellent rapport with policyholders by providing clear communication on claim progress and potential outcomes.
- Utilized advanced technology tools for more accurate assessments of damages in complicated or large-scale loss situations.
- Maintained an organized workflow by prioritizing tasks effectively, leading to timely completion of claim examinations.
- Maintained accurate records of claim files, ensuring proper documentation for audit purposes, and contributing to the company''s adherence to industry standards.
- Collaborated with adjusters, appraisers, and other professionals to ensure thorough evaluation of property damage cases.
- Conducted comprehensive reviews of insurance policies to determine appropriate coverage levels for various types of property damage incidents.
Property Claims Adjuster II
U.S.A.A.
09.2001 - 11.2012
- Desk adjust simple to moderately complex homeowners claims with emphasis on wind, hail and water losses.
- Exercised proper judgment and decision making to analyze over 50 claims per week in a call center environment.
- Streamlined the claims process for increased efficiency by consistently updating claim files and maintaining accurate records.
- Reduced company expenses by accurately determining coverage and negotiating cost-effective settlements with policyholders.
- Maintained compliance with state regulations and company guidelines through diligent adherence to policies and procedures.
- Managed high caseloads effectively by prioritizing tasks based on complexity and urgency of claims.
- Collaborated with contractors to verify repair estimates, ensuring fair settlements for both policyholders and company.
- Assisted policyholders with understanding their coverage, providing clear explanations on policy terms and conditions throughout the claims process.
- Continuously improved industry knowledge through ongoing professional development opportunities, staying current on trends and changes within the insurance field.
- Enhanced customer satisfaction with prompt communication and consistent follow-up on claim status updates.
- Achieved timely resolution of property claims by investigating, evaluating, and settling a variety of cases.
Property Claims Adjuster II
U.S.A.A.
11.2012 - 05.2019
- Desk adjust simple to moderately complex homeowners claims with emphasis on wind, hail and water losses.
- Exercised proper judgment and decision making to analyze over 50 claims per week in a call center environment.
- Streamlined the claims process for increased efficiency by consistently updating claim files and maintaining accurate records.
- Reduced company expenses by accurately determining coverage and negotiating cost-effective settlements with policyholders.
- Maintained compliance with state regulations and company guidelines through diligent adherence to policies and procedures.
- Managed high caseloads effectively by prioritizing tasks based on complexity and urgency of claims.
- Collaborated with contractors to verify repair estimates, ensuring fair settlements for both policyholders and company.
- Assisted policyholders with understanding their coverage, providing clear explanations on policy terms and conditions throughout the claims process.
- Continuously improved industry knowledge through ongoing professional development opportunities, staying current on trends and changes within the insurance field.
- Enhanced customer satisfaction with prompt communication and consistent follow-up on claim status updates.
- Achieved timely resolution of property claims by investigating, evaluating, and settling a variety of cases.
Education
Associate of Science - Nursing
San Antonio College
San Antonio, TXSkills
- Xactimate Proficient
- Advanced oral and written communication skills, to include Spanish
- Licensed in 26 states
- Claims Investigation
- Caseload Management
- Policy Interpretation
- Claims Processing
- Property Damage Assessment
- Critical Thinking
- Insurance policy coverage knowledge
- Settlement Negotiations
- Denied claims identification
- Microsoft Office Suite
Timeline
Property Claims Examiner
Vanguard Claims Administration
04.2022 - 03.2023
Property Claims Examiner
Davies - IAS
05.2019 - 03.2022
Property Claims Adjuster II
U.S.A.A.
11.2012 - 05.2019
Property Claims Adjuster II
U.S.A.A.
09.2001 - 11.2012
Associate of Science - Nursing
San Antonio College
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