Years of Adjuster experience
Mariquilla Lopez
Krugerville,TX
Summary
Accomplished at CIS Group Of Companies, I leveraged claims management expertise and team motivation to enhance department efficiency and customer satisfaction. Skilled in policy interpretation and utilizing tools like Xactimate and Evolve (FileTrac), I led teams to streamline processes, achieving significant improvements in claims processing times. My proactive approach and attention to detail ensured high-quality outcomes and positive client relationships.
Overview
5
5
Work History
Claim Supervisor
CIS Group Of Companies
07.2022 - Current
- Assisted in the recruitment and selection of new claims Adjusters and Employees, ensuring they possessed the necessary skills and expertise to excel in their roles.
- Monitored performance metrics regularly, identifying areas for improvement and implementing corrective measures accordingly.
- Managed a diverse workload, prioritizing tasks effectively to maintain quality standards.
- Enhanced team productivity by providing ongoing training and mentorship to claims Adjusters.
- Reduced claim processing time by implementing efficient workflow improvements and streamlining processes.
- Optimized resources allocation by monitoring workload distribution among team members, leading to increased efficiency within the department.
- Resolved complex claims issues with thorough investigation, resulting in fair settlements for all parties involved.
- Determined proper course of action for claims processing.
- Played a key role in successful completion of critical projects by working closely with stakeholders (including Directors, Account Managers, IT and President of CIS Group) to gather requirements, identify constraints, propose viable solutions.
- Developed and maintained rapport with Insurance Carriers through account development (including AAA, Allstate, AmFam, FIGA, Wellington, Catalytic and others)
- Oversaw a team of claims professionals, fostering a collaborative work environment focused on achieving common goals.
- Supported the implementation of new process/systems by providing technical expertise and coaching to colleagues as needed.
- Analyzed monthly client feedback/scorecards to identify areas for improvement and implemented changes accordingly.
Claims Examiner 1
CIS Group Of Companies
07.2020 - 07.2022
- Handled sensitive information with discretion, ensuring confidentiality of personal and financial details for claimants throughout the claims examination process.
- Participated in cross-functional team meetings to address organizational challenges related to claims management and develop solutions collaboratively.
- Enhanced customer satisfaction by promptly addressing inquiries and providing accurate information on claim status.
- Maintained detailed records of all claims activities, ensuring compliance with regulatory requirements and company policies.
- Interpreted policy provisions, endorsements, and exclusions to accurately determine coverage for claims.
- Provided exceptional customer service by empathetically addressing claimants'' concerns and effectively explaining the claims process to them.
- Examined photographs and statements.
- Achieved streamlined communication between departments by collaborating closely with underwriters, agents, and other stakeholders throughout the claims handling process.
- Collaborated with insurance adjusters to expedite claim settlements, ensuring fair resolutions for all parties involved.
- Read over insurance policies to ascertain levels of coverage and determine whether claims would receive approvals or denials.
Customer Service Assistant
CIS Group Of Companies
07.2019 - 07.2020
- Oversaw route and availability of field Adjusters to manage daily schedules
- Adapted quickly to changing situations, ensuring uninterrupted dispatch operations during emergencies.
- Received new orders, assigned field Adjuster then reviewed product in order to bill Client for services rendered.
IT Supervisor
Sku2u Fulfillment
06.2013 - 06.2018
- Boosted customer satisfaction through timely order fulfillment and accurate inventory tracking.
- Increased warehouse efficiency by implementing new inventory management systems and procedures.
- Collaborated closely with senior management to align project objectives with strategic company initiatives, ensuring that efforts contributed to overall business growth
- Oversaw IT department operations and training..
- Wrapped pallets in plastic wrap and attached merchandise tags to prepare for shipping.
- Operated forklift in compliance with OSHA guidelines and organizational policies.
Pawnbroker
First Cash Pawn
05.2009 - 05.2013
- Welcomed customers to shop and offered to answer questions on merchandise.
- Organized store shelves to display most attractive inventory.
- Negotiated fair prices for both buying and selling items while maintaining profitability goals for the business.
- Enhanced customer satisfaction by providing efficient and knowledgeable service in evaluating various items, such as jewelry, electronics, tools, and antiques, based on market conditions.
- Handled cash management duties effectively maintaining accuracy in daily reconciliations deposit preparations.
Education
High School Diploma -
Irving High School
Irving, TX06.2008
Skills
- Claims Management Expertise
- Policy Interpretation
- Claims Processing
- MS Office Suite
- Willing to Learn
- Teamwork and Collaboration
- Problem-Solving
- Attention to Detail
- Proactive and Focused
- System Proficiency:
Xactimate/XactAnalysis, Salesforce, Evolve (FileTrac), VCA, SharePoint, Excel, PowerPoint, ImageRight, Guidewire, weather websites, Microsoft Teams, Carrier specific portals
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