Summary
Overview
Work History
Education
Skills
Languages
Timeline
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Rosario Robles

Salt Lake City,Utah

Summary

Accomplished Senior Fraud and Claims Analyst with a proven track record at Wells Fargo & Company, adept in claims analysis and enhancing customer satisfaction. Leveraged interpersonal communication and NEXIDIA expertise to significantly improve process efficiency. Known for meticulous attention to detail and a collaborative approach, consistently achieving and surpassing goals. Results-driven professional effective in implementing positive change while overseeing multiple tasks. A team player with great time management and organizational skills. Pursuing a Claims Analyst position with an established company. Dedicated claims analyst remaining calm and poised in all types of situations. Bilingual and offering a great set of skills. Pursuing a similar role with a great organization. . Skilled Claims Analyst with experience in analyzing and processing complex insurance claims. Possess strong analytical, problem-solving, and communication skills for effective liaison between clients and administrative personnel. Have demonstrated ability to streamline processes, improving efficiency and customer satisfaction in previous roles. Meticulous Claims Investigator effective at collecting and analyzing data used to devise fair and cost-effective settlements. Highly-motivated employee with desire to take on new challenges. Strong work ethic, adaptability, and exceptional interpersonal skills. Adept at working effectively unsupervised and quickly mastering new skills. Hardworking employee with customer service, multitasking, and time management abilities. Devoted to giving every customer a positive and memorable experience. Committed job seeker with a history of meeting company needs with consistent and organized practices. Skilled in working under pressure and adapting to new situations and challenges to best enhance the organizational brand. Experienced in fast-paced environments and adaptable to last-minute changes. Thrives under pressure and consistently earns high marks for work quality and speed. Experienced and dependable general worker with a proven track record of efficiently completing tasks in various settings. Skilled in manual labor, equipment operation, and maintaining a clean and organized workspace. Safety-conscious with a strong work ethic and the ability to adapt to different environments. Ready to contribute to a dynamic team and make a positive impact. Results-oriented individual with a passion for continuous learning and innovation. Known for leveraging analytical thinking and creativity to solve problems and deliver high-impact solutions in fast-paced environments.

Overview

22
22
years of professional experience

Work History

Senior Fraud and Claims Analyst

Wells Fargo & Company
Salt Lake City, UT
01.2020 - 11.2024
  • Reviewed customer claims, identified discrepancies and determined appropriate course of action.
  • Conducted investigations to gather evidence in support of claims resolution.
  • Analyzed claim data to identify trends and recommend process improvements.
  • Verified documents to ensure accuracy of information provided by customers.
  • Researched applicable laws and regulations related to insurance policies and procedures.
  • Investigated fraudulent claims by gathering evidence from various sources.
  • Prepared detailed reports summarizing claims outcomes and trends for management review.
  • Investigated potentially fraudulent claims with focus on thoroughness, quality, and cost control.
  • Discussed current cases and issues in claim committee meetings.
  • Drafted statement of loss to summarize damages, payments and underlying policy coverage.

Online Customer Service Representative

Wells Fargo & Company
Salt Lake City, UT
05.2003 - 06.2019
  • Answered customer inquiries via phone, email and live chat.
  • Assisted customers with account maintenance issues such as password resets, order tracking and payment processing.
  • Demonstrated excellent communication skills when handling difficult customer service situations.
  • Monitored incoming calls to ensure quality standards were met.
  • Developed strategies to improve customer service experience.
  • Escalated complex queries or complaints to senior staff members for resolution.
  • Assisted customers with troubleshooting website navigation issues.
  • Assisted customers with questions regarding products and services, delivering exceptional experiences through responsive service.
  • De-escalated problematic customer concerns, maintaining calm, friendly demeanor.
  • Retained high level of knowledge of company's products and services to deliver information on complementary offerings and increase cross-selling.
  • Identified cross-selling opportunities and communicated promotions to customers to increase sales.
  • Improved customer satisfaction and retention by proactively reviewing new customer accounts and reaching out to offer assistance.
  • Built trusted partnerships through open and interactive communication to earn positive customer feedback.
  • Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
  • Enhanced productivity and customer service levels by anticipating needs and delivering outstanding support.
  • Exceeded established service goals while leveraging customer service, sales and employee management best practices.
  • Strengthened customer retention by offering discount options.
  • Increased customer satisfaction ratings by effectively answering questions, suggesting effective solutions, and resolving issues quickly.
  • Determined accurate prices for customer services, consistently searching for deals and best prices.
  • Updated system with order specifics and customer details, preferences, and billing information.

Education

Bachelor of Arts - Psychology

University of Arizona Global Campus
Chandler, AZ
06-2020

Skills

  • Telephone Communication Skills
  • Interpersonal and written communication
  • Skilled in [software]
  • Claims analysis
  • Claims history analysis
  • Claims review
  • Claims
  • Document workflow
  • Data interpretation
  • Case reporting
  • Liability determination
  • Client interviewing
  • Problem-solving
  • Attention to detail
  • Teamwork skills
  • Accredited claims professional (ACP)
  • MS office
  • Check claims
  • Accredited claims adjuster (ACA)
  • PREVENT
  • ACH
  • ETRAN
  • NEXIDIA
  • CIV
  • ZELLE CASE PORTAL

Languages

Spanish
Professional

Timeline

Senior Fraud and Claims Analyst

Wells Fargo & Company
01.2020 - 11.2024

Online Customer Service Representative

Wells Fargo & Company
05.2003 - 06.2019

Bachelor of Arts - Psychology

University of Arizona Global Campus
Rosario Robles