Omar Martinez-Reyes
Summary
Professional claims specialist with strong record in handling and resolving complex claims efficiently. Adept at analyzing data, identifying discrepancies, and providing solutions that drive positive outcomes. Effective team collaborator with focus on achieving results and adapting to evolving requirements. Skilled in negotiation, customer service, and regulatory compliance, consistently ensuring accuracy and fairness.
Overview
8
8
years of professional experience
1
1
Certification
Work History
Claim Specialist- Auto Injury
State Farm
10.2023 - Current
- Investigate, evaluate, and analyze auto injury claims to support negotiations and settlement decisions, using structured claims data.
- Interpret complex data sets from demand letter, medical records, and Current Procedural Terminology (CPT) codes using internal resources to conduct analysis and determine the direct relationship between incurred treatment and mechanism of injury, supporting financial decision-making.
- Apply extensive knowledge of policies and regulations to analyze and determine coverage & liability, acting as a subject matter expert in data-driven decision-making.
- Communicate complex coverage and liability determinations to customers via phone, written correspondence, and/or electronic media.
- Manage and prioritize a high volume of tasks independently in a fast-paced environment, requiring strong organizational and date management skills.
- Demonstrated adaptability by successfully managing a diverse range of claim types, including property damage, bodily injury, liability disputes, and more with a active caseload of over 150 claims
Underwriting Service Assistant
State Farm
12.2020 - 10.2023
- Process over 50 complex policy changes on a daily basis that often require multiday entries, necessitating precise date input and tracking to ensure accuracy.
- Actively work to mitigate date entry errors during policy adjustments, demonstrating a keen attention to date integrity and process efficiency.
- Communicate with Policyholders, Agents, or third parties and explain complex data processes or changes (e.g., increases/decreases) via various communication media.
- Maintains and updates sensitive policyholder information, adhering to strict standards for data security and management.
- Collaborated with underwriters to assess risk and develop tailored insurance solutions for clients.
Judicial Clerk
Maricopa County Adult Probation
03.2018 - 12.2020
- Conducted legal research and analysis to support the drafting of memoranda and court opinions, effectively acting as an information analyst for complex legal data sets.
- Generated, proofread, and managed data integrity across reports and legal documents, ensuring high accuracy and reliability of final court submissions.
- Operated computer equipment and utilized software to complete required paperwork, reports, and email correspondence, centralizing and structuring administrative data.
- Performed high-level administrative tasks, including conducting research on the internet to gather necessary data and background information for full-time Probation Officers.
Education
Associate in Applied Science - Data Analytics Major
Mesa Community College
Mesa, AZ04.2027
Microsoft SQL Foundations
01.2025
Google AI Essentials
01.2025
Skills
- Proficiency in Excel for Data Analytics
- Adaptability
- Multitasking
- Embracing change
- Comfort with ambiguity
- Flexibility
- Learning agility
- Leadership courage
- Compliance management
- Time management
Certification
Microsoft SQL Foundations
Languages
Spanish
Native or Bilingual
Timeline
Claim Specialist- Auto Injury
State Farm
10.2023 - Current
Underwriting Service Assistant
State Farm
12.2020 - 10.2023
Judicial Clerk
Maricopa County Adult Probation
03.2018 - 12.2020
Microsoft SQL Foundations
Google AI Essentials
Associate in Applied Science - Data Analytics Major
Mesa Community College