Edny Veronica Jara

Chicago, IL *****

224-***-****, adumvd@r.postjobfree.com

Employee Development Xactimate Bilingual

Team Support Work Independently MS Office

Career Summary

CCMSI, Chicago, IL 2021-2022

Multi Lines Claims Adjuster

Investigate, evaluate and adjuster multi line claims in accordance with established claim handling standards and laws.

Follow city and state ordinances in order to determine liability on auto, property, and bodily injury claims against the city of Chicago.

Establish reserves/ and or provide reserve recommendations within established reserves.

Authorize and make payments of multi-line claims in accordance with CCMSI claim procedures.

Negotiate settlements

Assist in the selection, referral and supervision of designated multi- line claims files sent to outside vendors.

Review maintain personal diary.

Review medical, legal and miscellaneous invoices to determine if reasonable and related to the ongoing liability claims. Negotiate any disputed bills for resolution.

Use tort immunity whenever applicable on a case by case basis.

Manage emails, voicemails and incoming claims on a daily basis.

Allstate Insurance, Northbrook, IL 2020 to 2021

Claims Adjuster OA

Investigate and determine coverage of loss onsite and adjusts all elements of Property Loss claims of moderate- high severity.

Handle moderate-severe complexity claims assigned under little supervision

Investigate and evaluate onsite to resolve complex coverage and damage issues to include preparing complete estimates of repair for the covered damages.

Explain coverage of loss, assists policyholders with itemization of damages, emergency repairs and additional living arrangement.

Works with and may coordinate a number of vendor services such as contractors, emergency repair, cleaning service and various replacement services.

Identify suspicious losses. Recommend referral to SIU where appropriate and may assist SIU in their investigation and settling of the claim.

American Independent Insurance, Des Plains, IL 2018- 2020

Property Damage Claims Adjuster

Deliver exceptional and courteous customer service

Investigate, evaluate, and negotiate liability claims to ensure a positive customer experience

Accurately document claims information

Work collaboratively with a team in a fast-paced environment

Determine applicable coverage’s in claims involving a single claimant and determines applicable coverage limits in claims involving multiple claimants

Take recorded statements from claimants, insured’s, witnesses, etc. and prepares summaries

Review investigation notes and determine claim value, coverage and liability for claims

Review and analyze policies, claim facts and applicable law in order to make coverage determination

Evaluate claims to determine potential liability, establish loss and expense reserves, formulate resolution plans and proposals

Make recommendations and establish action plans for the disposition of reported claims

Provide written and verbal reports to management

Perform assigned accountabilities in accordance with established departmental guidelines to include evaluations, authority levels, claim guidelines

Utilize computer software for the completion of assigned accountabilities

American Freedom Insurance, Mount Prospect, IL 2018

Claims Handler

Initiate new auto claims by searching and entering new data into our shared database, initiate first point of contact with insured and claimant, ensure completion of assigned files for management review.

Initiate facts of loss statements from both insured and claimant as well as investigate any inconsistencies within the reporting process.

Manage multiple tasks independently with little to no supervision and work independently to finish daily workloads.

Effectively communicate with fellow team mates and leadership on files statuses, while providing positive feedback during training sessions of new associates.

Receive and respond to attorney leans regarding opened claims.

Ensure completion of time sensitive assignment given by management and fellow coworkers with a fast and timely resolution.

Recommend denials on claims for approval by applying knowledge of the claim process, policies and procedures after reviewing the file.

Translate transcripts from Spanish to English on a daily basis as well as provide detailed claim procedures to clients.

Allstate Insurance, Northbrook, IL 2012 to 2017

GHRN Trainer/Call center supervisor/ Damages Claims Specialist

Trained new customer service representatives how to use the GHRN software and taught various mapping skills in order to service the customer in a quick and efficient manner.

Responsible for handling wholesale and retail claims initiating first contact with customer and providers finding creative solutions

Recorded proper and up to date documentation within shared software of claims handled which provided an efficient communication system between team members

Led and directed providing feedback resulting in fast and effective service

Assisted auditing claims by approving/denying supplements requested by our providers by adequately following up and properly mapping their request

Follow ups with clients, created incident reports in accordance with company requirements

Provided high quality customer service to difficult clients in harm’s way with medical issues, or stranded resolving their issues by collaborating with service providers

Skills

Bilingual in Spanish and English.

Education

Northeastern University, Chicago IL In progress

Bachelor of Arts in Finance

Triton College, River Grove, IL

Associate in applied science Human Resource Management

International Academy of Design and Technology, Chicago, IL

Bachelor of Arts in Merchandising Management

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