Orlando Hernandez
Indianapolis,IN
Summary
Claims professional well-versed in intricacies of claim management and resolution. Known for strategic approach to resolving disputes and ensuring compliance with industry standards. Reliable team collaborator with focus on achieving optimal outcomes and adapting to changing requirements. Skilled in negotiation and critical thinking.
Experienced with analyzing and processing diverse claims accurately and efficiently. Utilizes strong investigative skills and attention to detail to ensure fair settlements. Track record of maintaining compliance with industry regulations and providing excellent customer service.
Overview
7
7
years of professional experience
1
1
Certification
Work History
Auto Injury Claim Specialist
State Farm Mutual Automobile Insurance Company
05.2022 - Current
- Enhanced customer satisfaction with timely communication, empathy, and clear explanations of claim outcomes.
- Managed a high volume of claims effectively by prioritizing tasks and maintaining excellent organizational skills.
- Developed strong working relationships with external partners such as adjusters, legal counsel, and medical professionals to facilitate efficient claim resolution processes.
- Settled complex claims fairly by applying critical thinking, negotiation skills, and detailed knowledge of insurance policies.
- Handled high-pressure situations with professionalism and composure, consistently achieving positive outcomes for both clients and the organization.
- Followed up with customers on unresolved issues.
- Collaborated with cross-functional teams to optimize claims handling procedures, resulting in improved productivity.
- Provided exceptional customer service during stressful situations by offering empathy and support while resolving issues efficiently.
- Reviewed insurance and claims documents to verify required information and secure any missing data for settlements.
Surgical Trauma Patient Care Technician
Medical City Arlington
03.2019 - 05.2022
- Monitored vital signs and reported changes to nursing staff, ensuring timely medical interventions when necessary.
- Assisted nurses with essential tasks, streamlining workflow and increasing efficiency in the healthcare setting.
- Enhanced patient satisfaction by providing compassionate and attentive care.
- Assisted in training new Patient Care Technicians, sharing knowledge and best practices to ensure consistency in care delivery.
- Performed blood draws, EKGs, and other diagnostic tests accurately and efficiently for prompt analysis by healthcare professionals.
- Provided high-quality personal care to patients, promoting comfort and dignity during their hospital stay.
Education
High School Diploma -
Green B Trimble Technical High School
Fort Worth, TX06-2020
Skills
- Claims
- Claims processing
- Claims investigation
- Verbal communication
- Policy interpretation
- Settlement determinations
- Compliance management
- Claims analysis
- Accident investigations
- Documentation review
- Complex claims consulting
- Negotiation leadership
- Settlement management
- Liability denials
- Allocating claims
- Claims trend analysis
- Critical thinking
- Decision-making
- Attention to detail
- Problem-solving
- Claims adjustment
- Insurance coverage verification
- Active listening
- Claim amount calculations
- Data entry
- Coverage determination
- Denied claims identification
- Small claims payouts
Certification
Licensed Claims Adjuster in
- Texas
-Oklahoma
-Vermont
- Rhode Island
- Delaware
-South Carolina
-North Carolina
- Kentucky
- Louisiana
- Florida
- New Mexico
- Wyoming
- Connecticut
- Georgia
- West Virginia
Languages
Spanish
Native or Bilingual
Timeline
Auto Injury Claim Specialist
State Farm Mutual Automobile Insurance Company
05.2022 - Current
Surgical Trauma Patient Care Technician
Medical City Arlington
03.2019 - 05.2022
High School Diploma -
Green B Trimble Technical High School