Summary
Overview
Work History
Education
Skills
Timeline
Generic

Quincy Quinajon

San Diego,CA

Summary

Dynamic Insurance Claims Adjuster with extensive experience at GEICO, excelling in claims processing and negotiation. Proven ability to enhance customer satisfaction through effective communication and problem-solving skills. Adept at managing high-volume inquiries while ensuring compliance and maintaining data integrity, consistently achieving timely resolutions and fostering strong client relationships.

Overview

25
25
years of professional experience

Work History

Insurance Claims Specialist

GEICO, Government Employees Insurance
Poway, California
10.2022 - 08.2025
  • Reviewed insurance claims to ensure compliance with company policies.
  • Processed claim submissions using proprietary software and tools.
  • Investigated claims by collecting relevant information and documentation.
  • Communicated with customers to clarify claim details and expectations.
  • Collaborated with team members to resolve complex claim issues.
  • Maintained accurate records of all claim activities and correspondence.
  • Processed requests for additional documentation from customers in a timely manner.
  • Assisted customers in filing new insurance claims and provided status updates on existing ones.
  • Maintained detailed records of all claim activities including correspondence, decisions, payments.
  • Resolved customer complaints related to insurance claim processing.
  • Determined liability, compensability, and benefits due on each claim.
  • Managed high-volume inbound customer inquiries and resolved issues promptly.
  • Provided accurate product information to assist customers in making informed decisions.
  • Answered incoming calls and provided highest level of professionalism and knowledgeable service to every customer.
  • Demonstrated strong communication skills while addressing diverse customer concerns.
  • Maintained high levels of professionalism while interacting with customers via phone or email.
  • Navigated through computer systems to review information and respond appropriately to callers.

Telephone Claims Representative 2

GEICO, Government Employees Insurance
Poway, California
10.2018 - 10.2022
  • Evaluated bodily injury claims for adherence to company policies and regulations.
  • Collaborated with medical professionals to assess treatment plans and associated costs.
  • Negotiated settlements with claimants to resolve disputes efficiently and amicably.
  • Documented all interactions and findings accurately in claims management software.
  • Conducted investigations to gather evidence supporting validity of claims.
  • Communicated updates regarding claim status and processes to clients effectively.
  • Reviewed medical bills for accuracy and appropriateness of services rendered.
  • Maintained detailed documentation on all activities related to each claim file.
  • Decided whether claims can be negotiated.
  • Negotiated settlements with claimants or their representatives in accordance with state laws and insurance policies.
  • Drafted reports outlining findings from investigations into bodily injury claims.
  • Interacted with claimants, witnesses, attorneys and other parties involved in the claim process.
  • Provided timely updates to clients regarding status of claims being handled by the office.
  • Assessed medical records and other relevant documents to determine the extent of injuries sustained.
  • Analyzed data obtained from accident reports, witness statements, medical bills in order to make appropriate decisions on claim resolution.
  • Investigated liability issues related to bodily injury claims.
  • Reviewed, evaluated and adjusted claims to promote fair and prompt settlement.
  • Completed required investigations on referred files within established timeframes.
  • Identified and obtained evidence to ascertain claim value.
  • Managed caseload effectively, prioritizing urgent or high-value claims for prompt attention.
  • Interpreted insurance policy language to apply appropriate coverage.
  • Analyzed and determined fault in auto accidents based on evidence and applicable laws.
  • Managed high-volume inbound customer inquiries and resolved issues promptly.
  • Demonstrated strong communication skills while addressing diverse customer concerns.
  • Answered incoming calls and provided highest level of professionalism and knowledgeable service to every customer.
  • Navigated through computer systems to review information and respond appropriately to callers.
  • Maintained strong call control and quickly worked through scripts to address problems.
  • Engaged actively with callers, confirming or clarifying information and diffusing anger.
  • Performed follow-up calls as necessary to ensure satisfactory resolution of customer inquiries.

Telephone Claims Representative 1

GEICO, Government Employees Insurance
Poway, California
06.2018 - 10.2018
  • Processed telephone claims inquiries from customers efficiently and accurately.
  • Evaluated liability claims by analyzing incident reports and relevant documentation.
  • Communicated with clients to provide updates on claim status and processes.
  • Reviewed insurance policies to determine coverage and liability issues.
  • Documented findings and maintained accurate case files in claims management systems.
  • Ensured timely processing of claims through regular follow-up on outstanding issues.
  • Reviewed policies issued by the company to ensure compliance with state regulations governing liability coverage.
  • Investigated liability claims to determine the extent of insurance company's responsibility for payment.
  • Assessed potential subrogation opportunities for recovering payments from third parties who were liable for losses incurred by insureds.
  • Conducted interviews with claimants, witnesses, and medical providers to obtain information concerning claim circumstances.
  • Performed administrative duties such as preparing correspondence, reviewing invoices, and tracking expenses, as required.
  • Negotiated and settled claims according to information presented through reports, research, and data verification.
  • Completed required investigations on referred files within established timeframes.
  • Drafted statement of loss to summarize damages, payments and underlying policy coverage.
  • Communicated effectively with policyholders, providing updates and explaining claim processes.
  • Managed high-volume inbound customer inquiries and resolved issues promptly.
  • Examined medical records, bills, and other documents related to personal injury protection claims.

Claims Service Representative 2

GEICO, Government Employees Insurance
Poway, California
06.2005 - 10.2018
  • Managed high-volume inbound customer inquiries and resolved issues promptly.
  • Provided accurate product information to assist customers in making informed decisions.
  • Conducted follow-up calls to ensure customer needs were met effectively.
  • Assisted in training new representatives on company policies and procedures.
  • Answered incoming calls and provided highest level of professionalism and knowledgeable service to every customer.
  • Demonstrated strong communication skills while addressing diverse customer concerns.
  • Maintained high levels of professionalism while interacting with customers via phone or email.
  • Maintained strong call control and quickly worked through scripts to address problems.
  • Engaged actively with callers, confirming or clarifying information and diffusing anger.
  • Met or exceeded call speed, accuracy and volume benchmarks on consistent basis.
  • Evaluated liability claims and determined coverage based on policy terms.
  • Communicated with claimants to gather necessary information and clarify details.
  • Investigated incidents by reviewing reports, interviews, and evidence documentation.
  • Implemented best practices for managing large volumes of pending claims efficiently.
  • Provided customer service support by responding promptly to inquiries from claimants or their representatives.
  • Maintained accurate records of all activities related to each claim file.
  • Analyzed claim data including police reports and other documentation.

Payment Recovery Specialist

GEICO, Government Employees Insurance
Poway, California
10.2010 - 06.2013
  • Managed claim files for recovery from third-party insurance providers.
  • Analyzed complex claims to determine subrogation potential and liability.
  • Investigated third-party liability claims by obtaining witness statements, conducting research on property damage, and reviewing applicable laws.
  • Reviewed and evaluated subrogation claims to determine potential recovery opportunities.
  • Communicated regularly with policyholders about their claims status throughout the entire process.
  • Negotiated settlements with responsible parties to maximize subrogation recoveries.
  • Prepared comprehensive subrogation demand packages for presentation to responsible third parties.
  • Entered insurance claim data into the subrogation system.
  • Identified and pursued opportunities for subrogation to recover funds from third parties responsible for losses.
  • Communicated effectively with clients regarding their respective roles in the subrogation process.
  • Represented clients in arbitration proceedings when required.
  • Developed strategies for resolving disputes through arbitration.
  • Organized materials necessary for arbitration hearings related to disputed claims.
  • Monitored compliance with terms established through arbitration awards or settlement agreements.

Claims Service Representative 1

GEICO, Government Employees Insurance
Poway, California
10.2002 - 06.2005
  • Assisted customers with claims processing and inquiries for insurance coverage.
  • Reviewed claim documentation for accuracy and completeness before submission.
  • Educated policyholders on coverage options and claims procedures.
  • Resolved customer issues related to claims through effective communication.
  • Managed high-volume inbound customer inquiries and resolved issues promptly.
  • Assisted in training new representatives on company policies and procedures.
  • Demonstrated strong communication skills while addressing diverse customer concerns.
  • Answered incoming calls and provided highest level of professionalism and knowledgeable service to every customer.
  • Maintained high levels of professionalism while interacting with customers via phone or email.
  • Updated customer accounts, addresses and contact information within call management databases.
  • Maintained strong call control and quickly worked through scripts to address problems.
  • Engaged actively with callers, confirming or clarifying information and diffusing anger.
  • Met or exceeded call speed, accuracy and volume benchmarks on consistent basis.
  • Managed customer expectations by clarifying needs, identifying options, and recommending products and services.
  • Performed follow-up calls as necessary to ensure satisfactory resolution of customer inquiries.

Electronic Billing Specialist

GEICO, Government Employees Insurance
Poway, California
10.2000 - 10.2002
  • Managed high-volume inbound customer inquiries, resolving issues promptly and efficiently.
  • Provided accurate product information to facilitate informed customer decisions.
  • Demonstrated exceptional communication skills while addressing diverse customer concerns.
  • Answered incoming calls, delivering professional and knowledgeable service to each customer.
  • Updated customer accounts, addresses, and contact information within call management databases.
  • Maintained strong call control, effectively navigating scripts to resolve problems.
  • Trained new staff on billing systems and best practices for enhanced accuracy.
  • Processed credit card transactions through Point-of-Sale terminals or online systems.

Education

Associate of Arts - Liberal Studies

Southwestern College
Chula Vista, CA

Skills

  • Claims processing
  • Risk assessment
  • Policy analysis
  • Documentation management
  • Software navigation
  • Customer relationship management
  • Regulatory compliance
  • Negotiation techniques
  • Case investigation
  • Effective communication
  • Problem solving
  • Attention to detail
  • Conflict resolution
  • Team collaboration
  • Technical writing
  • Claims investigation
  • Policy interpretation
  • Organizing and prioritizing work
  • Data management
  • Appointment scheduling
  • Multitasking Abilities
  • Reliability
  • Continuous improvement
  • Professionalism
  • Customer service
  • Adaptability and flexibility
  • Data integrity
  • Client interviews
  • Time management
  • Written communication
  • Professional demeanor

Timeline

Insurance Claims Specialist

GEICO, Government Employees Insurance
10.2022 - 08.2025

Telephone Claims Representative 2

GEICO, Government Employees Insurance
10.2018 - 10.2022

Telephone Claims Representative 1

GEICO, Government Employees Insurance
06.2018 - 10.2018

Payment Recovery Specialist

GEICO, Government Employees Insurance
10.2010 - 06.2013

Claims Service Representative 2

GEICO, Government Employees Insurance
06.2005 - 10.2018

Claims Service Representative 1

GEICO, Government Employees Insurance
10.2002 - 06.2005

Electronic Billing Specialist

GEICO, Government Employees Insurance
10.2000 - 10.2002

Associate of Arts - Liberal Studies

Southwestern College

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