Trina Pacheco
Pomona,CA
Summary
Dynamic Claims Adjuster with a California license and proven expertise at Sedgwick in negotiating settlements and managing high caseloads. Recognized for exceptional customer service and critical thinking, successfully reducing claim turnaround time while fostering positive client relationships. Highly motivated to deliver effective solutions in fast-paced environments.
Overview
6
6
years of professional experience
Work History
Claims Adjuster
Sedgwick
07.2019 - Current
- Negotiated favorable settlements with claimants, attorneys, and other insurance carriers.
- Maintained detailed records of claims activities, ensuring data accuracy and timely reporting.
- Resolved escalated client issues, providing effective solutions while maintaining positive relationships.
- Able to maintain a large caseload, while prioritizing monthly closures.
- Maintain thorough records of all claims activities, including interactions, decisions, and outcomes, to ensure accurate processing and compliance with audits.
- Worked productively in fast-moving work environment to process large volumes of claims.
- Conducted detailed assessments of claims documents, ensuring accuracy and completeness before submission for approval.
- Reduced turnaround time for claim settlements by prioritizing tasks and managing deadlines effectively.
- Provided exceptional customer service, addressing concerns and resolving issues promptly.
Claims Assistant
Sedgwick
07.2019 - Current
- Collaborated with adjusters to gather necessary documentation for claim resolution.
- Supported management in audits by providing detailed reports on claims processed within specified timelines.
- Prepared files, letters and notices.
- Completed Expedited Medical Referrals/Documentation in timely manner.
- Scheduled medical appointments and claims depositions.
- Followed up with customers on unresolved issues.
- Carried out administrative tasks by communicating with clients, distributing mail, and scanning documents.
- Assisted in training new team members on claims processing procedures and best practices.
- Prepared insurance claim forms or related documents and reviewed for completeness.
- Posted payments to accounts and maintained records.
Education
GED -
Gardena Adult School
Los Angeles, CASkills
- Critical thinking
- Claims investigation
- Highly motivated
- Settlement negotiation
- Decision-making
- Caseload management
- Customer service
- Problem-solving
- Multitasking and organization
- Empathy and patience
- California claims adjuster license
Accomplishments
- SIP certified on May 14, 2025
- Received a Certificate for Appreciation for receiving compliments from multiple claimants with on month.
Timeline
Claims Adjuster
Sedgwick
07.2019 - Current
Claims Assistant
Sedgwick
07.2019 - Current
GED -
Gardena Adult School