Rose Navarrette
El Paso,TX
Summary
Results-oriented Insurance Professional with 10 years of expertise in claims management, customer service, and negotiation. Skilled in analyzing complex information, applying guidelines, and delivering clear communication while ensuring quality and timeliness. Prepared to transition into underwriting, leveraging strong background in insurance operations and collaboration with agents, carriers, and internal partners.
Overview
12
12
years of professional experience
Work History
Analyst, Claims Services
Nationwide Insurance
12.2024 - Current
- Serve as an internal subject matter expert for complex claims and customer service matters, supporting frontline associates and handling questions that require deeper policy, process, and service knowledge.
- Assist in the training of new and current employees by providing daily guidance, quality checks, and real-time support to help improve work accuracy and confidence.
- Support new-hire learning and live-call readiness through structured feedback, role-play support, and coaching activities.
- Analyze claim details, workflow requirements, and customer concerns to support accurate decisions, consistent service, and strong customer outcomes.
- Perform quality checks and provide guidance that strengthens accuracy, documentation quality, workflow consistency, and service standards.
- Review workflow changes, releases, procedures, and transmittals and provide feedback on new or updated processes.
- Research system issues, workflow gaps, and processing barriers and document improvement opportunities to support business efficiency.
- Complete Notice of Loss reports and support policyholders, claimants, agents, and internal partners through sensitive and time-sensitive claim situations.
- Resolve customer service complaints, conduct research, and escalate issues appropriately based on business needs and established procedures.
- Provide backup support to leadership and help reinforce operational expectations across the team
Insurance Services Representative II, Claims Servi
Nationwide Insurance
10.2021 - 12.2024
- Handled claims reporting, service inquiries, complaints, and escalations, fostering customer trust and delivering responsive service.
- Reviewed policy coverage using state and regulatory guidelines to support accurate claim setup and customer communication.
- Reviewed policy coverage using state and regulatory guidelines to ensure accurate claim setup and effective customer communication.
- Responded to policyholder and claimant questions, including complex or sensitive situations requiring sound judgment and professionalism.
- Maintained follow-up systems, updated claim records, and contacted customers for additional information, facilitating timely claim handling.
- Assigned claims to specialists and coordinated repair referrals and appointments based on claim needs and service expectations.
- Supported team development by leading lean meetings, creating PowerPoint resources, and sharing process guidance with coworkers.
Texas Works Advisor II
Texas Department of Health and Human Services
01.2020 - 09.2021
- Reviewed eligibility files and interviewed clients to assess needs and explain program requirements and benefits.
- Verified income, resources, and case data to determine eligibility and support accurate case decisions.
- Processed and communicated case updates to clients, families, and authorized representatives, ensuring adherence to deadlines and service expectations.
Subrogation Representative
Allstate Insurance Co
08.2014 - 09.2019
- Reviewed claim files to identify subrogation opportunities and managed cases to achieve successful recovery and resolution.
- Reviewed claim files to identify subrogation opportunities and managed cases through recovery and resolution.
- Investigated claims, gathered and evaluated evidence, and reviewed damage demands and repair estimates to support payouts, reductions, and recoveries.
- Processed recovery payments and credited checks to ensure timely reimbursement of deductible amounts to policyholders post-recovery.
- Processed recovery payments, credited checks, and ensured policyholders were reimbursed for deductible amounts after recovery.
- Met or exceeded performance metrics, reduced cycle times, and maintained compliance with company guidelines, department procedures, and applicable regulations.
- Participated in meetings and shared improvement ideas to foster a positive team environment while staying informed on industry trends and regulations through ongoing training.
Education
Medical Billing And Coding - Medical Technology
The University of Texas At El Paso
El Paso, TX01-2023
Skills
- Claims operations
- Claims investigation
- Claims recovery
- Claims reporting
- Policy coverage review
- Risk evaluation
- Quality assurance
- Process improvement
- MS Excel
- Decision-making analysis
- Customer service and relationship management
- Complaint resolution
Accomplishments
- Helped build the Analyst Standard Work process and organized notes under the Analyst Support tab in OneNote.
- Supported the FNOL New Hire project through kick-off participation, training sessions, daily training summaries, trainee feedback, and trainer observations.
- Supported multiple EXL Auto and Property new-hire classes as an SME, providing coaching during practice scenarios and reinforcing Nationwide brand behaviors and documentation standards.
- Recognized in the 1st Quarter Red Carpet Recognition event for demonstrating Nationwide leadership mindsets and capabilities.
- Traveled to Cebu, Philippines to provide on-site support, transition assistance, and best-practice sharing for EXL training efforts.
- Helped lead the Quality Engagement Project focused on improving Quality Handling results for PL, HUB, and CIA.
- Received multiple Spotlight Express recognitions for job shadowing support, production-efficiency PowerPoints, and workflow creation for claims processes.
Timeline
Analyst, Claims Services
Nationwide Insurance
12.2024 - Current
Insurance Services Representative II, Claims Servi
Nationwide Insurance
10.2021 - 12.2024
Texas Works Advisor II
Texas Department of Health and Human Services
01.2020 - 09.2021
Subrogation Representative
Allstate Insurance Co
08.2014 - 09.2019
Medical Billing And Coding - Medical Technology
The University of Texas At El Paso