Mario Ruiz
Summary
Resourceful Adjuster known for high productivity and efficient task completion. Possess specialized skills in claims investigation, damage assessment, and negotiation. Excel in critical thinking, problem-solving, and communication, ensuring optimal outcomes in complex scenarios. Committed to maintaining integrity and empathy in client interactions, fostering trust and facilitating smooth resolution processes.
Overview
5
5
years of professional experience
Work History
PIP/Medical Management Adjuster
United Automobile Insurance Group
08.2022 - 01.2025
- Evaluated medical documentation, including bills, reports, and records to determine claim eligibility and payment approval
- Conducted thorough investigations of claims, evaluating circumstances and coordinating with legal teams when necessary
- Managed and closed claims efficiently, maintaining a weekly closing percentage of 100% or higher
- Collaborated with medical professionals to assess injuries for claim resolution
- Utilized Guidewire Claims Platform to track and manage claim processes
- Leveraged Mitchell International to assess medical bills and issue PIP payments
PIP Adjuster
Responsive Auto Insurance Company
05.2021 - 08.2022
- Coordinated with defense attorneys to analyze statements and determine courses of action for claim resolution
- Conducted Examination Under Oath (EUO) and recorded statements from claimants to determine coverage approval or denial
- Communicated with insureds and claimants to evaluate injury claims, ensuring accurate documentation and claims resolution
- Used ISO for loss analysis and fraud detection to support claim investigations
Claims Associate
The Morgan Law Group
06.2020 - 05.2021
- Reviewed various legal and claims documents, including Letters of Representation, disbursement statements, and litigation complaints
- Entered claims data into case management systems (Clio) and generated accurate reports to maintain updated records
- Supported attorneys in preparing and serving legal documents, ensuring proper documentation and compliance with regulations
- Utilized TransUnion for background checks and investigation support during claims analysis
Education
Skills
- Claims Investigation and Evaluation
- Coverage analysis
- Negotiation and Conflict Resolution
- Customer Service and Relationship Building
- Insurance Policies and Regulations
- Data Entry and Reporting
- Legal and Medical Documentation Review
- Mitchell International
- ISO
- TransUnion
- Guidewire Claims Platform
- Clio
Timeline
PIP/Medical Management Adjuster
United Automobile Insurance Group
08.2022 - 01.2025
PIP Adjuster
Responsive Auto Insurance Company
05.2021 - 08.2022
Claims Associate
The Morgan Law Group
06.2020 - 05.2021
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