Perla Ruiz
Hidalgo,TX
Summary
Results-oriented Claims Adjuster with Supervisor expertise in investigation and adjustment of diverse cases. Develops high-performing claims departments through strategic planning and effective staff training. Ensures compliance with policies and regulations while managing a high claim volume in a fast-paced environment. Excels in communication and multitasking to meet daily objectives.
Overview
13
13
years of professional experience
Work History
Claims Adjuster
Trexis Insurance
Nashville, Tennessee
2024.10 - Current
- Evaluated insurance claims for accuracy and compliance with policy terms.
- Collaborated with clients to gather necessary information for claim processing.
- Investigated complex claims to determine validity and assess damages.
Claims Supervisor
Fred Loya Insurance Company
2016.03 - Current
- Reduced claim processing time by implementing efficient workflow improvements and streamlining processes.
- Enhanced team productivity by providing ongoing training and mentorship to claims adjusters.
- Resolved complex claims issues with thorough investigation, resulting in fair settlements for all parties involved.
- Achieved high customer satisfaction ratings by maintaining open lines of communication and addressing concerns promptly.
- Increased accuracy in claim evaluations through comprehensive documentation and attention to detail.
- Collaborated with various departments to develop and implement strategies for improving overall claims handling process.
- Managed a diverse caseload, prioritizing tasks effectively to meet strict deadlines and maintain quality standards.
- Conducted regular audits of claim files, ensuring compliance with company policies and industry regulations.
- Monitored performance metrics regularly, identifying areas for improvement and implementing corrective measures accordingly.
- Maintained up-to-date knowledge on industry trends, best practices, and regulatory changes to ensure optimal decision-making in the claims management process.
- Fostered a positive work environment that promoted collaboration, teamwork, and open communication among staff members.
- Assisted in the recruitment and selection of new claims adjusters, ensuring they possessed the necessary skills and expertise to excel in their roles.
- Contributed to the development and implementation of departmental goals and objectives, aligning them with broader organizational strategies.
- Monitored team performance, enforcing compliance with corporate claims processes and procedures.
- Built talented teams of 6 claims administrators dedicated to timely and compliant resolutions.
Customer Service Representative
Fred Loya Insurance Company
2014.03 - 2016.03
- Handled customer inquiries and suggestions courteously and professionally.
- Actively listened to customers, handled concerns quickly and escalated major issues to supervisor.
- Answered constant flow of customer calls with minimal wait times.
- Increased policy sales by developing and maintaining strong relationships with clients.
- Boosted client retention rates by providing exceptional customer service and addressing concerns promptly.
- Educated clients on various insurance products, empowering them to make informed decisions that suit their needs.
- Exceeded sales targets consistently, utilizing effective closing techniques and persuasive communication skills.
Education
High School Diploma -
PSJA Sonia M. Sotomayor High School
Pharr, TXSkills
- Claims management
- Fraud Detection
- Performance Monitoring
- Claims Team Management
- Claims Training
- Team Leadership
- Problem Solving
- Decision Making
- Attention to Detail
- Organizational Skills
- Time Management
- Adaptability
- Effective Communication
- Team Performance
- Customer Service
Languages
- English
- Spanish
Timeline
Claims Adjuster
Trexis Insurance
2024.10 - Current
Claims Supervisor
Fred Loya Insurance Company
2016.03 - Current
Customer Service Representative
Fred Loya Insurance Company
2014.03 - 2016.03
High School Diploma -
PSJA Sonia M. Sotomayor High School