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Claims Adjuster Customer Service

Location:
Hollywood, FL, 33024
Salary:
75000
Posted:
August 22, 2023

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Resume:

PEDRO A. CABANA Cell#: 954-***-****

Subrogation - Adjuster 820 NW 68th Terrace,

E-mail: ady4tv@r.postjobfree.com Hollywood, FL 33024

C areer Objective: To offer a top level of subrogation services by identifying the responsible party, finding out if recovery exists based on rules and State regulations. A self-started candidate identifies legal Liability and pursues, negotiates, and settles subrogation collection seeking to enhance productiveness, minimize losses, and improve the overall effectiveness recovery of the organization. Career Summary:

With over 20 years of Claims Adjudication experience, incumbent holds a proven history of exceeding outstanding results on Subrogation collections, planning and scheduling work needed to be in control of an office, process claims, and conduct its investigations. Skills:

Passion to help others, excellent interpersonal problem solver, conceptual critical thinker who analyze, modify, and implements a faster and more accurate procedure to save time on process prioritizing clients’ needs; skills which include:

Planning experienced / Detail Oriented Account Acquisition & Retention Strong organizational skills Effective on relationship-building practices Decision maker Takes care of Industry reputation

High analytical skills Sensitive on financial confidentiality Simplify data Tenacious negotiator

Communication virtuoso on verbal and writing skills Expert level on(Word/Excel/Outlook/PW PNT) Etiquette fluent bilingual (English/Spanish) Easily adapt into new software’s systems Achievements:

Increase Subrogation recovery from $400K per month to $ 2M per month in a team level at United Automobile Insurance Company.

Increase Subrogation recovery in 300% from the date I started at Universal Property and Casualty Insurance.

Proudly achieve a $6 Million Credit loss Reduction from a $10 Million Losses on the first year of service (2008 to 2009), and $ 1 million of credit reductions per year thereafter at Associated Grocers.

Licensing

ACA - Accredited Claims Adjuster (FL 6-20 All-Lines Adjuster) (Certificate of Completion) Polk State Corporate College 11/15/2013

Excellent Quality Customer Service training (Certificate of Completion) Continental Connection 09/20/2007

E XPERIENCE

United Automobile Insurance Co. Miami Gardens, Florida 33309 Subrogation Adjuster February 13, 2023 to Present

E ssential Functions and Responsibilities

Understands policy and endorsements to verify coverage.

Investigate all claims in search on possible third-party negligence that would lead to subro.

Contact and interview insured, claimants, witness.

Collect and study Police reports

Create demand Letters using auto damage scope of repairs, photos, and proof of payment

Contact adverse carriers using ISO, present demand packages, and negotiate settlements based on liability chances to prevail and recommend litigation when settlement satisfaction is not reach.

Maintains diary and spreadsheet to manage claim queue.

Determine what state-specific subrogation rules or case law applies to a claim, apply that knowledge to the negotiations.

Work independently with limited supervision.

Manage a queue of approximated of 280-300 claims.

Communicate claim status with insureds

Participate in occasional claim reviews with customers providing status updates. Develops & maintains professional customer relationships

Resolve/ brought money to the company within a 30 days period of presenting demand.

Knowledgeable running GuideWire, Atlas, Xactimate, ISO, TLO, BUYCRASH, LEXISNEXIS, ACCURINT Universal Property and Casualty Insurance Fort Lauderdale, Florida 33309 Subrogation Adjuster Oct 05, 2016 to Feb 10, 2023

E ssential Functions and Responsibilities

All the functions listed above + (PLUS)

Collect and study Police, Fire, and Engineer’s reports

Schedule join inspections

Look for defective products and recalls

Aware of Florida Statutes that will lean scale in favor of case in place.

Attend mediations as Corporate rep.

Work with counsel to quicker resolve files on litigation Progressive Insurance Fort Lauderdale, Florida 33309 Claims Adjuster Feb 24, 2014 to Sept 30, 2016

E ssential Functions and Responsibilities

Look for all coverages that will apply in the best interest of insured prior initial contact.

Meticulously clear all possible red flags that may affect coverage leading to possible fraud.

Obtain verbal authorization or via mail from attorney prior contacting the represented.

Gather pertinent data from insured, claimants, & witnesses’ record interviews.

Review scene of the accident using g-maps and interviewing parties at the same time.

Arrange third party towing services and its billing to pick up vehicle for repairs.

Arrange date, time, and inspection location between estimator and body shop.

Arrange auto rental between the affected party and the rental provider

Follow up with affected party advising estimated completion date of repairs and perform post follow up call to ensure repair satisfaction.

Make 3 way call with banks and owners to find out payoff amounts and obtain letter of guarantee.

Collect title, salvage documents, and power of attorneys to finalize total loss process.

Order police reports, contact police departments, and obtain hospital records as required.

Ran specific programs to trace drivers and vehicles in the event of hit and runs, uncollected information from the police report, false tags, phantom vehicles (non-existing VIN).

Examine photographs of vehicle damages to verify point of impact, determine if it is a total loss, if repairable, if the magnitude of such collision will lead to injuries reported.

Based on investigations, determined liability and contact all parties to inform the same.

Issue payout checks to appropriate parties (coll, comp, rental, property damage, etc…) Associated Grocers of Florida Pompano Beach, Florida 33069 Claims Adjudicator Feb 11, 2002 to Dec 01, 2013

E ssential Functions and Responsibilities

Evaluate claim authenticity, investigate and collect information to exercise proper judgment.

Negotiates settlement with designated authorities.

Manages the litigation process; ensures timely and cost effective claims resolution.

Trained crew members in a monthly basis to improve reviews, researches, and process.

Control and reconcile inventory on monthly basis to all customers.

Facilitate and distribute reports on weekly and monthly basis to all personnel.

Calculate and record payroll.

Provided administrative support to management.

Create and maintain files in compliance with company guidelines and state regulations.

Attends and cooperates on Food Show Conventions. E ducation & Licensing

Business Administration (Under - Graduated)

Broward Community College Current

Real Estate License for Sale Associate (Graduated) Gold Coast 08/27/2014

Instrument Pilot (Graduated)

Broward Community College 12/14/2006

Private Pilot (Graduated)

Delta Connection Academy (FAA Approved) 08/14/2006

Private Pilot (Graduated)

Broward Community College 05/04/2006

High School (Graduated)

Cooper City High School 01/14/2002

R ecommendation Letter:

Upon Request



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