Maritza Rivera
Southbridge,MA
Summary
Enthusiastic Bilingual professional motivated to resolve claims quickly to reduce loss ratios. Skilled researcher proficient in total claim investigation and processing. Seasoned Adjuster with background in insurance claims and case management. Possess strong negotiation skills, adept at interpreting and applying policy terms to resolve disputes effectively. Able to maintain composure under pressure and consistently meet deadlines while managing high volume caseloads. Outcomes include reduced claim resolution times and improved customer satisfaction ratings in previous roles.
Overview
29
29
years of professional experience
1996
1996
years of post-secondary education
Work History
Senior Subrogation Adjuster
MAPFRE Insurance
Southbridge, MA
01.2017 - 10.2025
- Evaluated insurance claims for property damage and liability incidents.
- Collaborated with policyholders and agents to gather necessary documentation and information.
- Analyzed claim files to determine coverage and eligibility for payment.
- Evaluated and negotiated demands to determine reasonable reimbursement settlements.
- Filed Arbitration responses when coverage, liability, damages, and/or rental days were disputed.
- I obtained Arb Forums Arbitrator license and heard 12 cases monthly for other Insurance companies.
- Handled review of any suits received, assigned to counsel, negotiated suit files to avoid litigation by working closely with attorneys.
- Handled coverage issue investigations, conducted recorded statements, worked closely with field investigators to conclude investigations.
- Negotiated settlements with claimants to resolve disputes amicably.
- Maintained accurate records of claims processing and communications.
- Trained junior adjusters on claims management processes.
Senior Total Loss Adjuster
MAPFRE Insurance
Southbridge, MA
03.2012 - 12.2016
- Evaluated total loss claims for accuracy and compliance with company policies.
- Collaborated with clients to clarify details and gather necessary documentation.
- Analyzed complex insurance policies to determine coverage and claim validity.
- Prepared detailed reports outlining findings and recommendations for adjustments.
- Negotiated settlements with policyholders to reach fair resolutions efficiently.
- Led training sessions for new adjusters on best practices and procedures.
- Implemented process improvements to enhance claims handling efficiency and effectiveness.
- Investigated and documented liability, coverage, and damages related to total loss claims.
- Ensured that all paperwork associated with total loss claims were completed accurately and submitted on time.
- Litigated claim settlements when needed.
Senior Physical Damage Adjuster
MAPFRE Insurance
Southbridge, MA
03.1999 - 02.2012
- Evaluated insurance claims to determine validity and coverage.
- Collaborated with clients to gather necessary documentation and information.
- Communicated findings and recommendations to stakeholders effectively.
- Conducted thorough investigations into claims involving property damage, liability, coverage.
- Worked closely with Agents to investigate coverage issues.
- Evaluated subrogation opportunities to identify recoverable funds.
- Reviewed policies to ensure compliance with company standards and regulations.
- Maintained detailed records of claims processing activities for reference.
- Assisted in training new adjusters on company procedures and tools.
- Utilized technology systems for efficient claim tracking and management. Used the MA registry to investigate coverage issues.
Claims Representative
MAPFRE Insurance
Southbridge, MA
12.1996 - 02.1999
- Entered 1st reports of claims efficiently using advanced claims management systems.
- Assigned Appraisals and provided claims procedures.
- Collaborated with adjusters to inform of any coverage concerns.
- Communicated with clients to gather necessary information for processing claims.
Education
Certificate - Business Secretary Program
McKinnon Training Center
07.1996 - 10.1996
Southbridge High School
Southbridge, MASkills
- Claim evaluation
- Bilingual
- Coverage analysis
- Settlement negotiations
- Documentation management
- Arbitrator
- Dispute resolution
- Effective communication
- Attention to detail
- Team collaboration
- Critical thinking
- Training and development
- Time management
- Damage assessment
- Claims investigation
- Conflict resolution
- Negotiation techniques
- Policy investigations
- Advanced computer skills
- Quality control
- Risk assessment
- CCC reports
- Advanced oral and written communication skills
- Insurance fraud expertise
- Caseload management
- Multitasking and organization
- Efficient in Microsoft, Word, Arbitration Forums, MA Registry system, Outlook, FNOL, Claimworks, Guidewire, CCC, Legal X, AS400
Languages
Spanish
Native/ Bilingual
References
References available upon request.
Timeline
Senior Subrogation Adjuster
MAPFRE Insurance
01.2017 - 10.2025
Senior Total Loss Adjuster
MAPFRE Insurance
03.2012 - 12.2016
Senior Physical Damage Adjuster
MAPFRE Insurance
03.1999 - 02.2012
Claims Representative
MAPFRE Insurance
12.1996 - 02.1999
Certificate - Business Secretary Program
McKinnon Training Center
07.1996 - 10.1996
Southbridge High School