Erica P. Lugo

**** *********** **

Brandon, FL **510

813-***-****

ad2u34@r.postjobfree.com

Skills

Microsoft Office, ARMS, AS400, Guidewire, ECS

Experience

Bodily Injury Adjuster/EH2 12/2017 08/2020

The General Tampa, FL

Evaluated and investigated policy coverage, liability and damages in a timely manner following a set of general claim and statutory guidelines.

Assisted internal and external customers with problems or questions regarding claims by phone or through written correspondence while providing a high level of customer service.

Established initial reserves for all potential exposures and adjust as appropriate throughout the claim.

Investigated and evaluated claims using a lowest ultimate cost strategy.

Established and maintained an appropriate diary of open claims following company guidelines.

Conducted thorough investigations which can include obtaining necessary documents and forms from claimants and insureds; conduct recorded statements.

Attended mediations, roundtables and other settlement conferences as needed.

Negotiated timely and appropriate settlements with claimants, insureds and attorneys; issued proper payments.

Processed correspondence related to assigned claims.

Recognized recovery opportunities regarding subrogation and salvage.

Evaluated and settled bodily injury claims within designated authority.

Worked with plaintiff and defense attorneys as appropriate.

Prepare reports for management to correspond with guidelines regarding time demands and potential excess exposures.

Handled 3rd party property damage.

Set up and monitored rentals.

BI/PD Area Manager 05/2017 10/2017

State Farm/Bintech Winter Haven, FL

Bintech/State Farm compliance courses, licensing, and training was completed for new hires.

Monitored claim intake and diary handling for the four teams managed a team of 39 representatives including 3 supervisors.

Monthly Touch points held

Set in place individual metrics for the representative.

Liaison between Management team and client management.

Monitored and responded to deficiencies in workflow or quality.

Set in place Rental handling guidelines.

Coached, mentored and developed the staff by preparing and administering performance feedback and one on one attention.

Conducted file audits and supervisor team audits to ensure accurate claim handling.

Approved and administered counseling forms Monitored representatives' diaries periodically to ensure all files are being handled in a timely manner.

Conducted interviews for potential new hires.

Managed phone reports provided by State Farm Kept abreast of training issues and electronic claim resources as needed.

BI/PD Supervisor 03/2017 05/2017

State Farm/Bintech Winter Haven, FL

Bintech/State Farm compliance courses, licensing, and training was completed with new hires.

Monitored claim intake and diary handling.

Managed a team of 9 reps.

Delegated files in order to reach the metrics.

Monitored representatives’ diaries periodically to ensure all files are being handled in a timely manner.

Trained and Developed representatives.

Managed phone reports provided by State Farm.

Worked in partnership with all clients both internal and external, Claims Processors, Trainers, and Supervisors.

Kept abreast of training issues and electronic claim resources as needed.

Daily use of various electronic resources for claim handling. Bodily Injury Adjuster 02/2016 03/2017

State Farm/Bintech Winter Haven, FL

Consistently delivered remarkable customer experience through assisting and handling claims involving injuries.

Within approved limits, applied claims settlement procedures to process claims, initiate claim payment process and close files assigned.

Worked in partnership with all clients both internal and external, Claims Processors, Trainers, and Supervisors.

Worked with attorneys and paralegals in coordination of settlement as well as providers, subro holders and others involved in the claim.

Exceeded metric expectations monthly.

Secured releases and issued payments in compliance with state standards and statute.

Kept abreast of training issues and electronic claim resources as needed.

Daily use of various electronic resources for claim handling. Non-Attorney Represented Bodily Injury Adjuster 11/2015 02/2016 Direct General Auto Insurance Tampa, FL

Reviewing policies, claim forms and managing all external communications with the non-attorney represented customer and medical providers to determine injuries and determining / establishing reserve requirements under State Laws.

Responsible for early identification and resolution of settlement opportunities.

Investigations include interviewing all involved parties, collecting/ evaluating documentation and securing evidence.

Analyzing obtained documentation and evidence, evaluating coverage, determining liability, extent of damages and associated compensation.

Documenting records, updates status notes, results of external information gathering and relevant medical reports and opinions.

Maintaining accurate claims and investigative reports, recordkeeping and the handling of all administrative responsibilities associated with the processing and payment of claims. Property Damage Adjuster 10/2013 11/2015

Direct General Auto Insurance Tampa, FL

Staying current on claim settlement process, process and procedures ensuring strict adherence of all company policies and practices and state regulations and statues.

Review Auto policies, Review policy documents, and other forms to ensure there is coverage for the loss.

Ongoing investigation and constant communication with all involved parties in loss.

Maintained upkeep of files and ensured the claim is noted appropriately.

Efficiently managed diary.

Managed incoming appraisals, new mail and Letter of Representation.

Managed claim payments and ensured right amount is paid according to company guidelines.

Handled Preservation of Evidence for the Florida PD department.

Assisted with training new hires.

Claims Customer Service Supervisor 10/2012 10/2013 Direct General Auto Insurance Tampa, FL

Direct General Supervise a Team of 7 representatives.

Monitored daily reports such as Not Ready Times, Call Intake, Manned Time, Abandon Rate, Break/Lunch schedules.

Trained team on verifying PIP coverage's, PIP Exhaustion, PIP EOB's, and PIP Benefits Letter of Experience Project: I have a team of 3 representatives that I delegated the project to and I monitored the outgoing letters.

Handled escalated supervisor calls.

Created phone metrics for department.

Education and Training

Southern New Hampshire University Present Hooksett, NH Keiser University 2017 Lakeland, FL

Osceola High School 2003 Osceola, FL

Languages

Fluent in English and Spanish

Skills

Excellent management skills, customer service, and workflow management

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