Customer Service Insurance
Resume:
NINA LOPEZ
aceazr@r.postjobfree.com
Dedicated Insurance Professional with 27 years’ experience investigating and processing Insurance claims to include automobile, homeowners, commercial and
Workers compensation. Lead reconciliation efforts to collect over $1million dollars each year for USAA. Excel in analyzing damages, interpreting policies and negotiations payment solutions. Extensive experience in business process analysis, improvement and implementations. Effectively manage multiple high priority projects and take pride with providing exemplarily customer service. Has a strong ability to adapted in diverse business environment and communication platforms.
Claims handling and Investigating Risk Assessment and Mitigation
Evaluation of Liability Exposure Confidential Records management
Attorney Negotiating
Business Process Analysis
Requirement specifications gathering and documentation
Time Management
Analytical Problem Solving
Bilingual
PROFESSIONAL EXPERIENCE
USAA Insurance
Sr. Subrogation Analyst 1989- 2003
• Plan, facilitate, and conduct requirements elicitation sessions, meetings, and presentations
• Lead discussions with key stakeholders to investigate workflows and business processes to be augmented or enhanced with technology.
• Negotiated liability with Claimant and Insurance company.
• filed intercompany arbitrations, Collected over a million dollars each year.
• Support Claims Department initiates and participates in and provides support to companywide initiatives.
• Participate in development efforts and system implementations, including analysis, design, development, data conversions, testing and documentation.
• Analytical and problem solving skills, including a demonstrated ability to assess and solve issues, reasoning and intuitiveness
Sr. Medical Claims Analyst 2003-2011
• Analyze claims to determine company’s liability,
• Make approval and denial decisions and negotiate settlements.
• Interview claimants and investigate questionable issues
• Successfully engaged in multiple initiatives simultaneously.
• Work independently to define concepts.
Bodily Injury Adjuster 2011-Present
• Provide optimum service to policyholders, negotiate fair settlements and
• Identified fraudulent claims.
• Critically evaluate information, gathering from multiple sources to reconcile conflicts.
• Proactively communicate and collaborate with external and internal customers to analyze information needs and deliver to completion.
• Ensure compliance of all state regulatory requirements associated with the handling of claims
EDUCATION
Associates Degree in Computer Business Programming – University of New Mexico, Albuquerque, NM
Associates in Claims (AIC) – Insurance Educational Association
TECHNICAL SKILLS
Microsoft word Microsoft Power Point
Microsoft excel Web Ex
Microsoft outlook Acrobat
Colossus Certified
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