Claims Examiner Manager

MV MARIA FERNANDA

VILLEGAS

******************@*****.*** +1-786-***-**** Miami, FL 33178

PROFESSIONAL

SUMMARY

I am a competitive and collaborative claims examiner manager with extensive experience in handling insurance claims for over 4 years, strong analytical skills and the ability to handle complex claims efficiently. I am an expert in driving growth and raising a good team to complete the necessary steps to investigate claims and advocating for fair resolutions. Seeking to leverage expertise to contribute to the success of your company as a claims examiner manager.

SKILLS Caseload Management

Claim Form Analysis

Customer service and support

Relationship Building

Strong analytical and problem-

solving abilities

Excellent communication and

interpersonal skills

Attention to detail and

accuracy

Ability to work independently

and in a team environment

Knowledge of insurance

policies, regulations, and

procedures

Management and

organizational skills

WORK HISTORY Property Claims Examiner Supreme Claim 10/2022 - CURRENT Consultants - Miami, FL

Evaluated insurance policies and analyzed damages to determine coverage.

Directed claims negotiations

Conduct thorough investigations to assess the extent of damage. Evaluate documentation to determine claim validity. Negotiate settlements within authority limits and refer complex claims to senior adjusters or legal counsel when necessary. Ensure compliance with company policies, procedures, and regulatory requirements.

Collaborate with internal departments such as underwriting and legal to address claim-related issues.

Maintain accurate records of claim activities and update claim files regularly.

Claims Examiner 911 Claims - Miami, FL 01/2019 - 05/2021 Assisted senior adjusters in processing insurance claims and resolving inquiries.

Reviewed claim documentation and entered data into the claims management system.

Responded to customer inquiries via phone, email, and in-person meetings.

Coordinated with external vendors and service providers to facilitate claim resolution.

Prepared correspondence and documentation for claim files. Assisted in the preparation of settlement offers and negotiation strategies.

EDUCATION Fermin Toro University, Venezuela 05/2014 Bachelor of Business Administration

LANGUAGES Spanish

Native or Bilingual

English

Professional Working

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