Maria Fernanda Villegas
Miami,FL
Summary
I am a competitive and collaborative claims examiner manager with extensive experience in handling insurance claims for over 4 years, strong analytical skills and the ability to handle complex claims efficiently.
I am an expert in driving growth and raising a good team to complete the necessary steps to investigate claims and advocating for fair resolutions.
Seeking to leverage expertise to contribute to the success of your company as a claims examiner manager.
Overview
5
5
years of professional experience
Work History
Property Claims Examiner
Supreme Claim Consultants
10.2022 - Current
- Evaluated insurance policies and analyzed damages to determine coverage.
- Directed claims negotiations
- Conduct thorough investigations to assess the extent of damage.
- Evaluate documentation to determine claim validity.
- Negotiate settlements within authority limits and refer complex claims to senior adjusters or legal counsel when necessary.
- Ensure compliance with company policies, procedures, and regulatory requirements.
- Collaborate with internal departments such as underwriting and legal to address claim-related issues.
- Maintain accurate records of claim activities and update claim files regularly.
Claims Examiner
911 Claims
01.2019 - 05.2021
- Assisted senior adjusters in processing insurance claims and resolving inquiries.
- Reviewed claim documentation and entered data into the claims management system.
- Responded to customer inquiries via phone, email, and in-person meetings.
- Coordinated with external vendors and service providers to facilitate claim resolution.
- Prepared correspondence and documentation for claim files.
- Assisted in the preparation of settlement offers and negotiation strategies.
Education
Bachelor of Business Administration -
Fermin Toro University
Venezuela05.2014
Skills
- Caseload Management
- Claim Form Analysis
- Customer service and support
- Relationship Building
- Strong analytical and problem-solving abilities
- Excellent communication and interpersonal skills
- Attention to detail and accuracy
- Ability to work independently and in a team environment
- Knowledge of insurance policies, regulations, and procedures
- Management and organizational skills
Languages
Spanish
Native or Bilingual
English
Professional Working
Timeline
Property Claims Examiner
Supreme Claim Consultants
10.2022 - Current
Claims Examiner
911 Claims
01.2019 - 05.2021
Bachelor of Business Administration -
Fermin Toro University
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