Summary
Overview
Work History
Education
Skills
Corecomponent
Corequalification
Security
References
Certification
Languages
Timeline

Oneida Rivera

Summary

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. Service-oriented Claims Adjuster skilled at applying creative approaches to solving complex problems. Adept at developing profitable and quality-focused processes.

Overview

24
24
years of professional experience
1
1
Certification

Work History

Claims Adjuster

GEICO
03.2022 - Current
  • Examined claims forms and other records to determine insurance coverage.
  • Answered customer questions regarding deductibles.
  • Verified insurance claims and determined fair amount for settlement.
  • Reviewed police reports, medical treatment records, and physical property damage to determine extent of liability.
  • Established an effective system for tracking and monitoring claims from initial report to final resolution, ensuring timely updates were provided to all relevant parties.
  • Mitigated potential litigation risks through careful attention to detail in documenting evidence gathered during investigations and claim evaluations.
  • Demonstrated expert knowledge of auto insurance policies and coverages, allowing for accurate assessment of damages and appropriate claim payouts.
  • Issued payouts to claimants.
  • Enhanced customer satisfaction by efficiently managing auto claims and providing prompt resolutions.
  • Examined photographs and surveillance and any other documents relating to claims.
  • Streamlined the claims process by effectively coordinating with repair shops and rental car companies.
  • Assisted clients with navigating complex insurance policies, ensuring they understood the extent of their coverage and benefits available to them during the claims process.
  • Provided exceptional customer service at all stages of the claims lifecycle while adhering to strict confidentiality guidelines regarding sensitive client information.
  • Contributed to continuous improvement initiatives within the department by sharing insights gained from personal experience and ongoing professional development activities.
  • Acted as a reliable point of contact for customers throughout the claims process, addressing their concerns with empathy and professionalism.
  • Expedited claim settlements by maintaining open lines of communication with all parties involved, fostering trust, and ensuring a smooth process.
  • Managed a high volume caseload without sacrificing quality or timeliness in delivering resolutions to clients'' auto accident-related issues.
  • Documented all findings in concise reports.
  • Identified suspicious claims, escalating issues to supervisor for further investigation and analysis.
  • Enhanced customer satisfaction by delivering honest advice to policyholders in regards to repair work and body shop processes.
  • Reviewed police reports, photographs and other documentation to gain complete understanding of accident.

Bilingual Customer Service Senior Representative

Infinity Insurance/Kemper
07.2018 - 03.2022
  • Provide comprehensive support to English and Spanish speaking customers and Employees of multiple businesses using expert interpersonal and intercultural communication skills
  • Answered state specific questions regarding non-standard insurance policies for both insureds and agents across United States
  • Effectively and accurately processed payments through debit cards, Echeck payments, cash sweeps from agents
  • Process immediate endorsements such as adding, removing or replacing vehicle/driver, SR-22
  • Processes renewals, policy cancellation/non-renewals timely and accurately
  • Provided quotes based on potential endorsements to calculate future premiums increased/decreased
  • Follow up with underwriting processes
  • Review complex issues and exceptions with a Senior, QA, or Supervisor
  • When appropriate, forwards escalated calls, non- routine inquiries, and issues requiring inter-departmental action to a Senior, QA, or Supervisor, and/or logs requests of complex issues in a timely and efficient manner
  • Forwards written correspondence to appropriate personnel
  • Documents/maintains various internal records and reports, as needed
  • Provide superior customer service, responding to requests for interpretation of guidelines/procedures, acceptability of risk, rating inquiries, and/or premium discrepancies in a prompt and professional manner
  • Adhere to the assigned schedule and demonstrate dependability and reliability on a regular basis with regular and predictable attendance.

Payroll Administrator

United Cerebral Palsy of Southern Tucson, AZ
08.2008 - 11.2017
  • Managing electronic timekeeping systems or manually collecting and reviewing timesheets
  • Providing information and answering employee questions about payroll related matters
  • Calculating payable hours, commissions, bonuses, tax withholdings, and deductions
  • Preparing and issuing earnings statements
  • Issuing paychecks and managing direct deposits
  • Maintaining employee records
  • Providing administrative assistance to the accounting department
  • Coordinating with the HR department to ensure correct employee data.

Director of Operations

Palm View Tucson, AZ
07.2007 - 08.2008
  • Contribute to corporate strategy in the areas of production, purchase, distribution and supply chain to ensure that the company achieves its short and long-term objectives
  • Direct and oversee operations staff to ensure that they are motivated and trained to carry out their responsibilities to the required standard
  • Develop and implement policies and procedures to ensure that core operational functions achieve their business objectives
  • Develop and control operational budgets to promote profitability and ensure the company has all the resources required to meet its objectives within agreed financial parameters
  • Direct and control production to ensure that finished goods of the required standard are available to customers within agreed costs and at the right times
  • Oversee purchasing to ensure that the company has the goods and services required for production purposes within agreed costs and quality standards and at the right times
  • Direct and control warehousing and distribution functions to ensure that customers are supplied with the right quantities of goods at the right times
  • Direct and control supply chain operations
  • Develop all necessary policies and procedures to ensure safe and healthy working environments across all company locations
  • Maintain working relationships with all other directors to ensure effective co-ordination of all company activities in support of corporate objectives
  • Evaluate overall company performance by gathering, analyzing and interpreting data and metrics
  • Act as the company's main adviser on all issues relating to operational functions and keep abreast of latest developments to ensure that the company maintains its competitive position.

Human Specialist II

State of Arizona Tucson, AZ
06.2000 - 07.2007
  • Complete a service needs assessment through interviews for intake or reviews based on assigned caseload
  • Verify eligibility factors and determine eligibility for multiple CCA programs based on financial and non-financial factors and additional cross program involvement (I.e., TANF and DCS) within required time frames
  • Use time management techniques to plan and prioritize service delivery on a complex diverse case load
  • Maintain case records per policy with complete and accurate information/data
  • Maintain professional contact with clients, employers, other agencies
  • Determine and/or update eligibility information
  • Coordinate services based on information from other agencies to ensure timely and accurate service
  • Operate multiple automated computer systems in order to authorize client services, input, and update and retrieve confidential client information and to receive and send information to other departments and contracted staff
  • Maintain professional contact with contracted providers to authorize, change or stop services
  • Assist both provider and client with resolution of nonpayment of co-payment issues
  • Counsel clients about the availability of different types of childcare providers
  • Provide website or phone contact information to Child Care Resource & Referral or complete referral process to certification unit for relative provider selection
  • Travel will be required to assist other offices, attend meetings and trainings.

Education

Computer Science -

Interamerican University of Puerto Rico
01.1989

Skills

  • Highly motivated
  • Claims Investigation
  • Insurance policy coverage knowledge
  • Caseload Management

Corecomponent

  • Budget Expenses Tracking
  • Analyzing Information
  • Accounting
  • Time Management
  • Vendor Relationships
  • Expense Reports
  • Advances
  • Checks
  • Recording entries
  • Accounts Payable
  • Customer Service
  • MS Office

Corequalification

  • Keeping track of all payments and expenditures, including payroll, purchase orders, invoices, statements, etc.
  • Reconciling processed work by verifying entries and comparing system reports to balances.
  • Maintaining historical records.
  • Paying employees by verifying expense reports and preparing pay checks.
  • Paying vendors by scheduling pay checks and ensuring payment is received for outstanding credit; generally responding to all vendor enquiries regarding finance.
  • Preparing analyses of accounts and producing monthly reports.
  • Continuing to improve the payment process.

Security

Fingerprint clearance

References

Available upon request

Certification

  • Texas and Florida adjuster License

Languages

Spanish
Native or Bilingual

Timeline

Claims Adjuster - GEICO
03.2022 - Current
Bilingual Customer Service Senior Representative - Infinity Insurance/Kemper
07.2018 - 03.2022
Payroll Administrator - United Cerebral Palsy of Southern Tucson, AZ
08.2008 - 11.2017
Director of Operations - Palm View Tucson, AZ
07.2007 - 08.2008
Human Specialist II - State of Arizona Tucson, AZ
06.2000 - 07.2007
Interamerican University of Puerto Rico - Computer Science,

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