Summary
Overview
Work History
Education
Skills
Languages
References
Timeline
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Edward Martinez

Tucson

Summary

Results-driven Insurance Claims Specialist with a proven track record in claims analysis and fraud detection. Expertise in regulatory compliance and negotiation, delivering exceptional outcomes for clients and organizations. Strong problem-solving skills enhance customer service and operational efficiency. Maintains current knowledge of insurance laws and policies to effectively manage complex claims.

Overview

10
10
years of professional experience

Work History

Insurance Claims Specialist

A1 Hail Repair
Tucson
03.2021 - 02.2025
  • Reviewed insurance claims for accuracy and completeness.
  • Processed claims using specialized software tools efficiently.
  • Communicated with clients to gather necessary claim information.
  • Collaborated with repair teams on damage assessments and estimates.
  • Advised clients on claim status and next steps regularly.
  • Maintained detailed records of all claims and communications.
  • Assisted customers in filing new insurance claims and provided status updates on existing ones.
  • Maintained detailed records of all claim activities including correspondence, decisions, payments.
  • Inspected property damage for assessment of repair costs.
  • Collected payments, processed receipts and informed policyholders of outstanding balances.
  • Corresponded with insured or agent to obtain information or inform of account status or changes.
  • Called insurance companies to ascertain pertinent information regarding policies and payment benefits for patients.

General Manager

Too Hot Motors
Tucson
02.2015 - 03.2021
  • Oversaw daily operations ensuring efficient workflow and high-quality service.
  • Managed team performance through regular training and development sessions.
  • Implemented new inventory management systems to streamline supply chain processes.
  • Fostered a positive work environment promoting teamwork and employee satisfaction.
  • Established strong relationships with vendors to negotiate favorable terms and conditions.
  • Resolved customer complaints quickly while maintaining high quality standards of service delivery.
  • Trained employees on duties, policies and procedures.
  • Established and maintained effective communication with staff members to ensure efficient operations.
  • Built and maintained loyal, long-term customer relationships through effective account management.
  • Delivered exceptional client experiences through hands-on leadership of associates and managers.
  • Provided guidance and support to subordinate managers in order to foster an atmosphere of cooperation throughout the organization.
  • Identified areas of improvement in current business practices and collaborated with other departments to develop action plans for implementation.
  • Delegated work to staff, setting priorities and goals.

Education

High School Diploma -

Pima Community College
Tucson, AZ
08-1998

Skills

  • Claims processing and loss assessment
  • Insurance policy management
  • Data entry and record management
  • Customer communication

Languages

Spanish
Professional
English
Professional

References

References available upon request.

Timeline

Insurance Claims Specialist

A1 Hail Repair
03.2021 - 02.2025

General Manager

Too Hot Motors
02.2015 - 03.2021

High School Diploma -

Pima Community College

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Edward Martinez