PEDRO D. LOPEZ
Phoenix,AZ
Summary
Results-oriented Claims Professional with 20 years in customer service and claims management. Specializes in claims evaluation, liability assessment, and fraud investigation to enhance member satisfaction. Experienced in managing diverse projects and mentoring teams to improve performance. Committed to utilizing analytical skills and effective communication to elevate customer service standards.
Overview
1
1
Certification
13
13
years of professional experience
Work History
Non-Injury Senior Auto Adjuster
USAA
Phoenix, Arizona
05.2025 - Current
- Investigated vehicle damage, estimated repair costs and determined liability.
- Completed Total Loss claims.
- Conducted Investigations for liability
- Evaluated auto claims to determine validity and coverage details.
- Resolved limit issues through thorough analysis of claims and policy coverage.
- Investigated accidents by gathering statements and evidence from involved parties.
- Engaged attorneys to facilitate resolution of claims and legal matters.
- Collaborated with repair facilities to assess vehicle damage and repair costs.
- Reviewed policy details to ensure compliance with insurance regulations.
- Documented findings in reports for internal review and decision-making process.
- Utilized claims management software to track progress and updates efficiently.
- Mentored junior adjusters on best practices in claims evaluation and customer service.
- Reviewed and interpreted police reports and witness statements to establish facts for claims.
- Communicated with clients to explain claim processes and required documentation.
- Managed multiple projects simultaneously while meeting strict deadlines.
- Resolved disputes between claimants, insurers and third-party vendors.
- Developed strategies for handling high-risk claims while adhering to applicable laws.
- Provided customer service by responding to inquiries from policyholders regarding their claims status.
- Maintained detailed records of all claim activity and provided updates to management.
- Monitored payment schedules to ensure timely disbursement of funds.
- Identified fraudulent claims through investigations of suspicious behavior or discrepancies.
- Conducted site visits to assess property damages and confirm details.
- Negotiated settlements with claimants in an effort to reduce overall costs for the company.
- Review and adjust claims by claim processing guidelines.
- Provided evidence leading to recovery of insurance overpayments.
- Performed detailed analysis of complex claims to determine the appropriate course of action.
- Interpreted policy language to apply appropriate coverages and exclusions in claims decisions.
- Developed and maintained professional relationships with external partners, including tow companies and rental agencies.
- Trained new claims adjusters on company policies, procedures, and best practices in claims handling.
- Determined salvage value for total-loss vehicles.
- Trained new claims adjusters on company policies, procedures, and best practices in claims handling.
- Determined salvage value for total-loss vehicles.
Non-Injury Auto Adjuster
USAA
Phoenix, Arizona
07.2023 - 05.2025
- Conducted Total Loss walk-throughs with members to facilitate understanding of the claims process.
- Conducting investigations in liability.
- Ensuring that all guidelines and procedures are met.
- Ensured member satisfaction through consistent communication and support.
- Mentored future adjusters, sharing expertise to enhance their skills and knowledge.
- Designed and installed wall decor for various projects.
- Received recognition awards for exceptional service and disposition.
- Evaluated vehicle damage and determined repair costs for insurance claims.
- Reviewed policy coverage and assessed liability in accident claims.
- Communicated with clients to gather necessary information for claims processing.
- Collaborated with repair shops to obtain estimates and timelines for repairs.
- Documented findings and maintained accurate records of claims activity.
- Conducted interviews with claimants to clarify details of incidents reported.
- Provided guidance to junior adjusters on best practices and procedures.
- Assisted in training new employees on claims handling processes and systems.
- Collaborated with attorneys and outside investigators to gather information.
- Provided customer service by responding to inquiries from policyholders regarding their claims status.
- Met regularly with adjusters from other companies in order to exchange information about cases.
- Maintained detailed records of all claim activity and provided updates to management.
- Monitored payment schedules to ensure timely disbursement of funds.
- Investigated vehicle damage, estimated repair costs and determined liability.
- Conducted research on state laws and regulations related to auto insurance claims.
- Assessed salvage values of damaged vehicles prior to offering a settlement amount.
- Resolved disputes between claimants, insurers and third-party vendors.
- Negotiated settlements with claimants in an effort to reduce overall costs for the company.
- Identified fraudulent claims through investigation of suspicious behavior or discrepancies.
- Reviews and adjusts claims by the claim processing guidelines.
- Determined cause and extent of damages by investigating claims with underwriters and insurance agents in the field.
- Managed workload to ensure timely follow-up and resolution of all assigned claims.
- Interpreted policy language to apply appropriate coverages and exclusions in claims decisions.
- Performed detailed analysis of complex claims to determine the appropriate course of action.
- Developed and maintained professional relationships with external partners, including tow companies and rental agencies.
- Coordinated with body shops and repair professionals to validate repair costs and methods.
- Trained new claims adjusters on company policies, procedures, and best practices in claims handling.
Home Mortgage Processor III
Wells Fargo
Phoenix, Arizona
05.2020 - 01.2023
- - Entered loan data into system and managed assigned pipeline to support anticipated closing dates and performance goals.
- - Streamlined home mortgage operations to improve overall process effectiveness and customer experience.
- Reviewed loan applications for accuracy and completeness.
- Verified borrower information and supporting documentation.
- Coordinated with underwriters to resolve outstanding issues.
- Processed loans using proprietary mortgage processing software.
- Calculated debt-to-income ratios, loan-to-value ratios, and other applicable percentages.
- Managed a pipeline of loans from origination through funding stages.
- Managed loan application pipeline by completing and submitting reports within allotted turn-around times.
- Performed quality control reviews on all closed loans prior to delivery.
- Communicated with customers promptly and clearly regarding hmcs updates.
- Communicated with clients to provide updates on loan status.
- Collaborated with team members to streamline processing workflows.
- Provided guidance and training to mortgage processors, enhancing team competency and service quality.
- Trained new staff on mortgage processing procedures and best practices.
- Validated borrower's information against credit bureaus as well as other financial institutions.
- Analyzed financial statements including tax returns and bank statements.
- Developed strong relationships with lenders and brokers in order to facilitate smooth processing of loans.
- Followed up on conditions requested by underwriters or insurers during the loan approval process.
- Coordinated with third party vendors such as title companies, appraisers, surveyors.
- Reviewed post-closing documents for accuracy before submitting them to investors and insurers.
- Reconciled escrow accounts and prepared annual escrow analyses.
- Received recognition for delivering strong customer satisfaction results.
- Received acknowledgment for outstanding customer satisfaction performance.
Manager, Server / Lead Manager
P.F. Chang's China Bistro
12.2013 - 05.2020
- Customer Relations Specialist
- Led employee management initiatives to enhance productivity and engagement.
- Evaluated employee performance and coached and trained to improve weak areas.
- Resolved staff member conflicts, actively listening to concerns, and finding an appropriate middle ground.
- Oversaw financial resources to ensure cost efficiency, to keep business operating within budget and increase profits.
- Maintained a professional, organized, and safe environment for employees and patrons.
- Instructed employees on multiple job roles to enhance operational flexibility.
- Supervised daily operations to ensure efficient restaurant service and guest satisfaction.
- Trained and mentored staff on service standards and menu knowledge.
- Ensured compliance with health and safety regulations in restaurant operations.
- Resolved guest complaints effectively to maintain a positive dining atmosphere.
- Monitored staff performance and addressed issues.
- Enforced customer service standards and resolved customer problems to uphold quality service.
- Completed thorough opening, closing, and shift change functions to maintain operational standards each day.
- Provided leadership during times of organizational change or crisis situations.
- Upsold specials and promotions to enhance the guest dining experience consistently.
Education
Bachelor of Arts - Culinary Arts
Art Institute of Phoenix
Phoenix, AZ05-2010
Skills
- Claims handling
- Claims analysis
- Fraud investigation
- Liability assessment
- Coverage analysis
- Total loss analysis
- Claim investigation
- Damage assessment
- Risk assessment
- Analytical expertise
- Claims software
- Financial services industry experience
- Mortgage industry experience
- Problem solving
- Analytical skills
- Decision-making skills
- Detail orientation
- Communication skills
- Written communication
- Negotiation expertise
- Customer relationship management
- Team collaboration
- Project management
- Professionalism
- Goal setting
- Critical thinking skills
- Problem-solving
- Project management
- Goal setting
Custom
- Settlement agents, brokers, and other counter parties to obtain missing information and documentation for loan files, obtaining and possibly clearing some approval stipulations.
- Submitting loan file to underwriting for review
- Ensuring all compliance and underwriting guidelines are met.
Certification
- Adjuster License
Accomplishments
- Employee if the Week Award in Alaska
- Customer Survey Award
- Customer Service Award
- Metrics Award
Timeline
Non-Injury Senior Auto Adjuster
USAA
05.2025 - Current
Non-Injury Auto Adjuster
USAA
07.2023 - 05.2025
Home Mortgage Processor III
Wells Fargo
05.2020 - 01.2023
Manager, Server / Lead Manager
P.F. Chang's China Bistro
12.2013 - 05.2020
Bachelor of Arts - Culinary Arts
Art Institute of Phoenix