MARTHA CALDERA
Miami,Florida
Summary
Service-oriented professional skilled at applying creative approaches to solving complex problems. Adept at developing profitable and quality-focused processes. Organized and detail-oriented Investigator dedicated to improving efficiency, productivity and profitability through continuous process improvement. Analytical thinker skilled at developing innovative solutions to complex problems.
Overview
14
14
years of professional experience
Work History
Bodily Injury Adjuster (ISA)
Kemper
Miami, FL
02.2020 - Current
- Conduct liability investigations by obtaining recorded statements from involved parties, interpreting police reports, analyzing scene investigations and expert reports and interpreting state negligence laws, statutory provisions and case law.
- Develop and implement negotiation strategies when communicating settlement related information to insured’s, claimants, body shop personnel, medical providers and other parties.
- Conduct analyses of property damage claims presented for repair and replacement using a consistent and thorough estimate review process. Establish accurate loss reserves, and when applicable, subrogation and salvage reserves relative to the damages analyzed.
- Conduct analyses of property damage claims presented for repair and replacement using a consistent and thorough estimate review process. Establish accurate loss reserves, and when applicable, subrogation and salvage reserves relative to the damages analyzed.
- Referred extreme cases to Special Investigation Unit (SIU) for further review.
Claims Generalist Associate
Progressive Casualty Insurance Co
Miami, Florida
08.2016 - 02.2020
- Determine who is at fault.
- Determine the most effective and efficient sequence of activities to make timely contact with all relevant parties and ensures that conditions are set for a timely and accurate assessment of damages, including the movement of vehicles to the appropriate location for inspection and repair.
- Interviews, collects and documents information from customers, agents, witnesses, police reports, etc.
- Interprets policies and analyzes information gathered to determine courses of action.
- Ensures that all damage is consistent with the report of the accident.
- Recognizes applicable exposures and endorsements.
- Refers questionable claims for further investigation.
- Resolves total losses to include execution of total loss paperwork.
- Recognizes subrogation opportunities and refers accordingly.
- Manages claim inventory workload which includes paperwork associated to claim, diaries, mail, phones, and issues payments as needed.
- Handle total losses, pd excess claims.
Patient Account Representative I, Patient Account Representative II
BCA Financial Services
Miami, Florida
12.2014 - 08.2016
- Receiving inbound and making outbound calls with a focus on inbound calls and maintain clear and concise documentation of all attempts and/or contacts directly on the computerized collection system.
- Research and analyze accounts by gathering records and examining historical data, using intuition and experience to compliment data with goal of resolving obstacles to payment.
- Determining the most effective and efficient means of collection for each account and apply industry standard due diligence to collect monies owed.
- Identifying and resolving problems in a timely manner, developing alternative solutions, use reason even when dealing with emotional situations.
- Verifying and/or obtaining demographic and financial information on each contact.
Account Representative/Debt Collector
Jorge M. Abril ,PA / MAS
Miami, Florida
10.2011 - 11.2014
- Make at least 100 calls per day to debtors.
- Inform debtors by telephone about their pending past due accounts to avoid further complications.
- Documented and maintained accurate and pertinent information on debtor’s accounts.
- Responsible for communicating with insurance companies for the payment of the claims.
- Answer the debtor’s problems and complaints and also identify solutions.
- Resolve customer billing disputes.
- Sending itemized bills, first and final demands letters.
- Receive payments and post amounts paid to debtors accounts.
- Perform various administrative functions for assigned accounts, such as recording address changes and purging the records of deceased debtors.
Team Leader
Target
Miami, FL
11.2008 - 08.2011
- Mentored and guided employees to foster proper completion of assigned duties.
- Built strong relationships with customers through positive attitude and attentive response.
- Cross-trained and provided backup support for organizational leadership.
- Led team of 7-8 members while providing exceptional customer service.
- Established open and professional relationships with team members to achieve quick resolutions for various issues.
Education
Medicine Workshop Certificate of Completion -
University of Miami Miller School of Medicine
Miami, FLHS Diploma - Medical Assisting
Miami Senior High Miami
MiamiMedical Assistant - Health
Miami Children's Hospital Internship
MiamiAssociates - Arts, Pre-Nursing
Miami Dade College Miami
Miami, FLBachelors - Arts, Psychology/Occupational Therapy
Florida International University Miami
MiamiSkills
- Bilingual in English and Spanish, small proficiency in Italian
- Computer Proficiency in Microsoft Products: Word, Excel, Power point, Publisher & Outlook
- Leadership skills that reach maximum potential
- Profound ability to communicate effectively in writing and speaking, typing skills of 60-85wpm
- Great customer service skills
- Ability to multitask
- Can operate in a fast-paced environment
- Can operate perfectly with multi lined phones
- Knowledge in medical terminology and abbreviations
- Ability to input data on computer
- Profound capability to learn new material if necessary
- Florida Claims Adjuster License
Timeline
Bodily Injury Adjuster (ISA)
Kemper
02.2020 - Current
Claims Generalist Associate
Progressive Casualty Insurance Co
08.2016 - 02.2020
Patient Account Representative I, Patient Account Representative II
BCA Financial Services
12.2014 - 08.2016
Account Representative/Debt Collector
Jorge M. Abril ,PA / MAS
10.2011 - 11.2014
Team Leader
Target
11.2008 - 08.2011
Medicine Workshop Certificate of Completion -
University of Miami Miller School of Medicine
HS Diploma - Medical Assisting
Miami Senior High Miami
Medical Assistant - Health
Miami Children's Hospital Internship
Associates - Arts, Pre-Nursing
Miami Dade College Miami
Bachelors - Arts, Psychology/Occupational Therapy
Florida International University Miami