Guadalupe Luna
Tucson,AZ
Summary
Organized and motivated employee eager to apply time management and organizational skills in various environments. Experienced with assessing property damage and determining claim validity. Utilizes comprehensive analytical skills to ensure accurate and fair claim resolutions. Track record of effective communication and negotiation with stakeholders.
Overview
12
12
years of professional experience
Work History
Outside Property Claims Adjuster
Travelers Insurance
Tucson, AZ
10.2024 - Current
- Evaluated property damage claims to determine coverage and settlement amounts.
- Collaborated with policyholders to gather necessary documentation for claim processing.
- Conducted on-site inspections to assess damages and verify claimant statements.
- Negotiated settlements with contractors and service providers to expedite claim resolutions.
- Maintained compliance with state regulations and company guidelines through diligent adherence to policies and procedures.
- Prepared sketch of floor plan and roofline and entered data into Xactimate to develop line-by-line item costs of damages.
- Report mileage on company car every month and keep up with maintenance.
- Performed up to, but not limited to, 40 field investigations of damaged properties every month.
Property Claims Adjuster
Farmers Insurance Exchange
Dallas, TX
11.2023 - 09.2024
- Assessed damage to properties.
- Documented and communicated claim activity to clients.
- Scheduled appointments with third party vendors.
- Conducted secondary evaluations of original investigations documentation and reports to facilitate smooth resolutions.
- Coordinated emergency repair, cleaning companies and contractors to optimize customer claim handling.
- Reviewed policies to determine appropriate levels of coverage and assist with approval or denial decisions.
- Explained loss coverage, assisted policyholders with itemizing damages and coordinated alternative living arrangements.
Electronic Manufacturer
Virtex
Plano, TX
03.2023 - 11.2023
- Identified root causes of service failures and implemented appropriate remediation measures to prevent future issues.
- Evaluated problematic conditions to resolve issues and optimize service levels.
- Collaborated with warehouse and other entities to coordinate physical movement of products between internal sites.
- Analyzed client orders and deadlines with available driving personnel to plan and execute assignments.
- Analyzed client orders and available personnel to plan and execute within client needs and expectations.
- Checked items into computer system, printed labels and directed to storage locations.
Pip Insurance Adjuster
Kemper
Lake Mary, Florida
12.2021 - 12.2022
- Input claim data and guide insureds throughout the claim process.
- Obtain accurate information, dissect the policy to assure that the regulations and guidelines are being followed accordingly.
- Based payment or denials of medical claims upon well-established criteria for claims processing.
- Documented file notes clearly and concisely in GuideWire.
- Tracked differences between plans to correctly determine eligibility and assess claims against benefits and data entry requirements.
- Sent clinical request and missing information letters to obtain incomplete information.
- Stayed current on HIPAA regulations, benefits claims processing, medical terminology and other procedures.
- Accurately processed large volume of medical claims every shift.
- Investigated potentially fraudulent claims with focus on thoroughness, quality and cost control.
Case Specialist / Chat Agent
Signet Jewelers
Fairlawn, Ohio
12.2017 - 12.2022
- Resolve escalated situations that will be reasonable and satisfying to both the customer and company.
- Maintained digital and physical records of files and managed timely updates.
- Conducted secondary evaluations of original investigations documentation and reports to facilitate smooth resolutions.
- Analyzed information gathered by investigations and reported findings and recommendations.
- Delivered exceptional customer service to clients by communicating information and actively listening to concerns.
Warehouse Associate
Amazon
Coppell
12.2013 - 12.2014
- Fulfilling the logistics behind receiving, processing, and storing inventory
- Assist as problem solver to correct inventory issues
- Lead up to 9 workers independently while management was away.
Education
High School Diploma -
Lewisville High School
Lewisville, TX05-2013
Skills
- Property Damage Assessment
- Policy investigations
- Coverage Determination
- Property inspection
- Proficient in Xactimate, Claim Platform, and Knowledge Guide
Timeline
Outside Property Claims Adjuster
Travelers Insurance
10.2024 - Current
Property Claims Adjuster
Farmers Insurance Exchange
11.2023 - 09.2024
Electronic Manufacturer
Virtex
03.2023 - 11.2023
Pip Insurance Adjuster
Kemper
12.2021 - 12.2022
Case Specialist / Chat Agent
Signet Jewelers
12.2017 - 12.2022
Warehouse Associate
Amazon
12.2013 - 12.2014
High School Diploma -
Lewisville High School