Nicholas Ortega
Fontana,CA
Summary
Proven expertise in claim investigation and a knack for exceptional customer service define my tenure at Mercury Insurance. Skillfully managed complex auto claims, enhancing process efficiency by 30%. A mentor and team collaborator, I excel in problem-solving and communication, ensuring accurate and empathetic resolutions. Proactive and goal-oriented professional with excellent time management and problem-solving skills. Known for reliability and adaptability, with swift capacity to learn and apply new skills. Committed to leveraging these qualities to drive team success and contribute to organizational growth.
Overview
10
10
years of professional experience
Work History
Claims Senior Auto Adjuster
Automobile Club of Southern California
10.2023 - Current
- Managed a high volume of claims efficiently, prioritizing tasks for maximum productivity.
- Achieved timely and accurate claim settlements by conducting thorough investigations and damage assessments.
- Reviewed police reports, photographs and other documentation to gain complete understanding of accident.
- Acted as a reliable point of contact for customers throughout the claims process, addressing their concerns with empathy and professionalism.
- Enhanced customer satisfaction by efficiently managing auto claims and providing prompt resolutions.
- Responding to Arbitrations timely and securing all evidence for review of the arbitrator.
- Investigating coverage in question claims timely and fairly to stay compliant with department of insurance.
- Went through training to work watercraft claims for our members with water policies.
- Used critical thinking to break down problems, evaluate solutions and make decisions.
Claims Specialist II
Mercury Insurance
03.2022 - 10.2023
- Excellent communication skills, both verbal and written.
- Skilled at working independently and collaboratively in a team environment.
- Improved claims processing efficiency by meticulously reviewing and validating each claim for accuracy and completeness.
- Conducted detailed investigations into complex insurance claims to establish liability, contributing to more informed decision-making.
- I was the back up "floater" whom I assisted with voicemails, activities etc, while the file handler was out of the office.
- Evaluated injury claims, reviewed policy limit demand, meeting conditions, negotiated reasonably and fairly.
- I was also the mentor of my team, which I was open to providing assistance with questions, desk management, and feedback
Claims Representative II
Mercury Insurance
04.2021 - 03.2022
- Reviewed claims for coverage investigations
- Obtained facts of loss from both insureds and claimants.
- Set up vehicle inspections
- Set up rental reservations when applicable
- Communicated with appraisers and body shops as needed to confirm damage presented, and keeping up to date with repair status
- Issued payments timely and accurately
- I was the floater of the branch to assist with other peer's desks while they were out of the office.
Medical Payment Specialist
Mercury Insurance
04.2018 - 04.2021
- Went over Medical Payment coverage with the insureds, and provided a detail explanation of how the coverage works.
- Requested medical authorizations
- Ordered itemized medical bills and explanation of benefits from health providers
- Issued payments timely and accurately accordingly
- Resolved claims efficiently while working alongside other departments
- Referred claims to SIU as needed to look into potential fraudulent claims
Hospital Security Guard
Allied Universal
07.2016 - 04.2018
- Provided excellent customer service when interacting with patients, visitors, and staff alike.
- Participated in ongoing training programs to stay current on best practices in hospital security operations.
- Maintained order during high-stress situations such as medical emergencies or evacuations, keeping all parties calm and informed.
- Managed access control systems, ensuring only authorized individuals entered restricted areas of the facility.
- Greeted guests professionally and courteously to cultivate welcoming atmosphere while making safety top priority.
- Patrolled internal building spaces and facility grounds to identify and deter threats to assets.
- Responded swiftly to alarms or calls for assistance, effectively diffusing potentially dangerous situations.
- Conducted thorough investigations into reported incidents, providing detailed reports for management review.
- Enforced security policies and removed violators and unauthorized individuals from premises to maintain safe environment.
- Monitored CCTV cameras and alarm systems for security breaches.
Construction Assistant
Dunn-Rite
06.2014 - 07.2016
- Utilized construction tools and machinery to effectively complete job site projects.
- Established positive relationships with clients through regular communication and attentive service, leading to repeat business opportunities.
- Distributed supplies to skilled workers to maintain job site productivity.
- Maintained tools and equipment in good working condition.
- Followed safety protocols on job sites.
- Removed debris and waste from job sites.
- Worked independently in fast-paced environment while meeting productivity and quality expectations.
- Studied plans for each job to gain understanding of materials, tools and work required.
- Followed orders closely to help prepare for jobs, ready sites, complete assignments and clean up work areas at completion.
- Performed demolition work on existing structures.
- Painted walls, ceilings and other surfaces.
- Performed roofing installations.
- Mixed mortar and concrete.
- Assisted with plastering, tiling and carpentry.
- Set up ladders and other access equipment.
Education
Some College (No Degree) - Criminal Justice
Rio Hondo College
Whittier, CAHigh School Diploma -
Charter Oak High School
Covina, CA05.2014
Skills
- Insurance policy knowledge
- Claim investigation
- Auto repair knowledge
- Insurance regulations knowledge
- Teamwork and Collaboration
- Customer Service
- Problem-Solving
- Time Management
- Attention to Detail
- Multitasking
- Reliability
- Excellent Communication
Timeline
Claims Senior Auto Adjuster
Automobile Club of Southern California
10.2023 - Current
Claims Specialist II
Mercury Insurance
03.2022 - 10.2023
Claims Representative II
Mercury Insurance
04.2021 - 03.2022
Medical Payment Specialist
Mercury Insurance
04.2018 - 04.2021
Hospital Security Guard
Allied Universal
07.2016 - 04.2018
Construction Assistant
Dunn-Rite
06.2014 - 07.2016
Some College (No Degree) - Criminal Justice
Rio Hondo College
High School Diploma -
Charter Oak High School
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