Otilia Derrick
Anthony,NM
Summary
Skilled Injury Claims Associate with background in handling and negotiating personal injury claims. Strong understanding of auto insurance policies, procedures, and legal aspects related to injury claim settlements. Possess distinctive problem-solving skills, ability to manage high caseloads while maintaining quality standards. Proven record in effective negotiation and mediation between parties for fair compensation outcomes.
Overview
6
6
years of professional experience
1
1
Certification
Work History
Claims Adjuster
Progressive
El Paso, TX
02.2022 - Current
- Attended continuing education classes in order to stay abreast of changes in industry standards.
- Maintained accurate documentation of all claim activity within designated system.
- Evaluated performance metrics regularly; suggested modifications where necessary for increased efficiency.
- Communicated effectively with policyholders, providing updates and explaining claim processes.
- Interpreted policy language to determine coverage for insureds under various lines of business.
- Delivered exceptional customer service to clients by communicating information and actively listening to concerns.
- Presented cases at mediations or arbitrations as needed in order to facilitate dispute resolution process.
- Participated in training and mentoring of new claims adjusters, sharing knowledge and expertise.
- Coordinated with law enforcement and other agencies as needed for claims investigation.
- Resolved claim disputes through mediation and negotiation, minimizing the need for litigation.
- Worked closely with repair facilities and contractors to ensure quality repairs for policyholders.
- Reviewed medical records, police reports and other documents related to claim investigations.
- Developed relationships with attorneys, experts and vendors in order to ensure prompt service when necessary.
- Investigated questionable claims to determine payment authorization.
Relationship Manager
TaxJar
Santa Teresa, NM
07.2020 - 02.2022
- Maintained accurate records of all client interactions within the company's CRM system.
- Completed month-end and year-end closings, kept records audit-ready and monitored timely recording of accounting transactions.
- Managed portfolio of client accounts, ensuring high levels of satisfaction and loyalty.
- Developed and maintained strong relationships with clients to ensure satisfaction and loyalty.
- Analyzed competitors and market trends to facilitate business growth.
- Resolved escalated customer issues efficiently and effectively within established timelines.
- Analysed client financial statements to offer tailored advice and products.
- Conducted regular review meetings with clients to assess their needs and adjust services accordingly.
Claims Adjuster
Allstate Corp
Las Cruces, NM
04.2019 - 07.2020
- Ensured timely follow-up on all open matters; kept stakeholders informed regarding status updates.
- Conducted interviews with claimants, witnesses and medical professionals to obtain additional information about the claim.
- Analyzed and audited open claims to calculate additional payments owed.
- Assisted colleagues with difficult cases; provided guidance regarding complex issues or scenarios.
- Reviewed, evaluated and adjusted claims to promote fair and prompt settlement.
- Assisted in fraud detection and prevention efforts by identifying suspicious claim activities.
- Utilized claim handling software to document and manage claim files efficiently.
- Explained premiums owed to policyholders, agents and underwriters.
Education
MBA - Business
University of Phoenix
Tempe, AZ02-2013
Skills
- Rules of evidence
- Automobile appraisals
- Exposure analysis
- Casualty and property loss
- Property claims
- Accident scene investigations
- Damage assessment
- Workflow management
- Insurance fraud expertise
- Automobile claims specialist
- Policy investigations
- Tme management
- Highly motivated
- Quality control
- Allocating claims
- Customer service
- File auditing
- Legal compliance
- Multitasking and organization
- Claims processing
- Data analysis
- Claims investigations
- Team collaboration
- Empathy and patience
- Insurance policy coverage expertise
- Medical coding
- New Mexico claims adjuster license
- Verbal and written communication
- Claims file management processes
- Decision-making
- Policy interpretation
- Evidence reviews
- Active listening
- Report writing
- Data entry
- Critical thinking
- Fact finding
Languages
English
Professional
Spanish
Professional
Certification
- I am licensed in Texas and New Mexico for claims handling
References
References available upon request.
Timeline
Claims Adjuster
Progressive
02.2022 - Current
Relationship Manager
TaxJar
07.2020 - 02.2022
Claims Adjuster
Allstate Corp
04.2019 - 07.2020
- I am licensed in Texas and New Mexico for claims handling
MBA - Business
University of Phoenix
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