YOLIMA MENDOZA
Hialeah,FL
Summary
Experience Auto Claims Adjuster with a solid background handling insurance claims and providing efficient and fair resolutions. Emphasizing effective time management, conducting investigations, and negotiating settlements. Achieved 100% accuracy in claim assessments and demonstrated exceptional customer service skills.
Overview
6
6
years of professional experience
Work History
Liability Adjuster
Kemper Insurance
Doral, FL
01.2020 - Current
- Accuracy: 100% of accuracy on all national audits performed, and 96-100% of accuracy on all internal audits performed.
- Achieved 100% of same day contact metric.
- Time-to-resolution: Reduced average time-to-resolution from 14 days to 7 days, improving the overall claims process and customer experience.
- Claims Processed per day: consistently processed 5-10 auto claims, reducing backlog and improving workflow efficiency.
- Accuracy Rate: Achieved a 100% accuracy rate in assessing claims and determining the appropriate settlement, minimizing errors and rework.
- Leadership: Participated in a training program, mentoring junior adjusters, and an internship on claim processes, improving employee engagement.
- Negotiated Early Settlements: Successfully negotiated settlements, reducing the need for litigation, and increasing overall claim resolution efficiency.
- Closing Ratio: Consistently reached 100% of the closing ratio, achieving property damage and collision resolution within 30 days.
- Investigated auto claims to determine coverage, liability, and damages.
- Analyzed facts of loss, including photographs, diagrams, and other evidence, to identify potential sources of recovery or fraud.
- Negotiated settlements with claimants in order to resolve disputes quickly and economically.
- Determined reserves for each claim based on estimated costs of settlement or defense.
- Developed relationships with attorneys, experts and vendors in order to ensure prompt service when necessary.
- Attended continuing education classes in order to stay abreast of changes in industry standards.
- Interpreted insurance policy language to apply appropriate coverage.
Auto Claims Adjuster
Windhaven Insurance
Doral, FL
10.2018 - 01.2020
- Investigated insurance claims, reviewed coverage and liability, and recommended payment or denial of claims.
- Gather supporting documents to determine facts of loss.
- Review policies for coverage and terms of policies.
- Ensure that contact is made within 24-48 hours after the claim is received.
- Set up appraisal assignments.
- Answer calls from policyholders, claimants, attorneys, and insurance offices.
- Review police reports, estimates, Attorney's representation letters, and medical bills.
- Coordinate rental vehicles.
- Meet with management to discuss daily performance and goals.
Education
620 - Adjuster License - All-Lines / Active -
Florida Department of Financial Services
03-2019
Associate of Science - Basic X-Ray Machine Operator
Vocational Institute of Florida
Miami, FL01-1989
Skills
- Guidewire
- LexisNexis
- Strong Organizational Skills
- Excellent Investigation Skills
- Knowledge of insurance policies
- Data Collection and Analysis Skills
- Though Leadership
- Self Motivated and Detailed Oriented
Languages
English
Full Professional
Spanish
Native/ Bilingual
Timeline
Liability Adjuster
Kemper Insurance
01.2020 - Current
Auto Claims Adjuster
Windhaven Insurance
10.2018 - 01.2020
620 - Adjuster License - All-Lines / Active -
Florida Department of Financial Services
Associate of Science - Basic X-Ray Machine Operator
Vocational Institute of Florida
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