Guadalupe Luna
Tucson
Summary
Dynamic Property Field Adjuster with extensive experience at Travelers Insurance, excelling in claims evaluation and fraud detection. Proven ability to manage multiple projects while delivering exceptional customer service. Skilled in policy investigations and complex problem-solving, ensuring accurate assessments and timely resolutions for policyholders.
Overview
12
12
years of professional experience
Work History
Property Field Adjuster
Travelers Insurance
Tucson
10.2024 - Current
- Evaluated property damage claims for accuracy and completeness.
- Conducted on-site inspections to assess damages and gather evidence.
- Collaborated with policyholders to discuss claim details and expectations.
- Utilized claim management software to track and document claim progress.
- Communicated with contractors to obtain repair estimates and timelines.
- Managed multiple projects simultaneously while meeting strict deadlines.
- Determined if a structural engineer is needed to assess structural integrity of buildings damaged by natural disasters or other catastrophes.
- Monitored progress on repairs made by contractors hired by insureds for verification purposes.
Property Claims Adjuster
Farmers Insurance Exchange
Dallas
11.2023 - 10.2024
- Assessed damage to properties.
- Documented and communicated claim activity to clients.
- Scheduled appointments with third-party vendors.
- Conducted secondary evaluations of original investigations, documentation, and reports to facilitate smooth resolutions.
- Coordinated emergency repair, cleaning companies, and contractors to optimize customer claim handling.
- Reviewed policies to determine appropriate levels of coverage, and assist with approval or denial decisions.
- Explained loss coverage, assisted policyholders with itemizing damages, and coordinated alternative living arrangements.
Electronic Manufacturer
Virtex
Plano
03.2023 - 11.2023
- Identified root causes of service failures and implemented appropriate remediation measures to prevent future issues.
- Evaluated problematic conditions to resolve issues and optimize service levels.
- Collaborated with warehouse and other entities to coordinate physical movement of products between internal sites.
- Analyzed client orders and deadlines with available driving personnel to plan and execute assignments.
- Analyzed client orders and available personnel to plan and execute within client needs and expectations.
- Checked items into computer system, printed labels and directed to storage locations.
Pip Insurance Adjuster
Kemper
Lake Mary
01.2022 - 01.2023
- Input claim data and guide insureds throughout the claim process.
- Obtain accurate information, dissect the policy to assure that the regulations and guidelines are being followed accordingly.
- Based payment or denials of medical claims upon well-established criteria for claims processing.
- Documented file notes clearly and concisely in GuideWire.
- Tracked differences between plans to correctly determine eligibility and assess claims against benefits and data entry requirements.
- Sent clinical request and missing information letters to obtain incomplete information.
- Stayed current on HIPAA regulations, benefits claims processing, medical terminology and other procedures.
- Accurately processed large volume of medical claims every shift.
- Investigated potentially fraudulent claims with focus on thoroughness, quality and cost control.
Case Specialist / Chat Agent
Signet Jewelers
Fairlawn
01.2018 - 01.2023
- Resolve escalated situations that will be reasonable and satisfying to both the customer and company.
- Maintained digital and physical records of files and managed timely updates.
- Conducted secondary evaluations of original investigations documentation and reports to facilitate smooth resolutions.
- Analyzed information gathered by investigations and reported findings and recommendations.
- Delivered exceptional customer service to clients by communicating information and actively listening to concerns.
Warehouse Associate
Amazon
Coppell
01.2014 - 01.2015
- Fulfilling the logistics behind receiving, processing, and storing inventory
- Assist as problem solver to correct inventory issues
- Lead up to 9 workers independently while management was away.
Education
Lewisville High School
05.2013
Skills
- Order Picking
- Assembly and production
- Material Handling
- Warehouse Operations
- Complex Problem-Solving
- Logistics
- Licensed Insurance Agent
- Negotiation
- Excellent time management skills
- Tech-Savvy
- Analytical-minded
- Claims Evaluation
- Property Damage Assessment
- Decision-Making
- Policy investigations
- Claims Processing
- Fraud identification
- Expense Control
- Coverage Determination
- Inventory and Supply Logistics
- De-Escalation Techniques
- Customer Service
- Fraud detection
Timeline
Property Field Adjuster
Travelers Insurance
10.2024 - Current
Property Claims Adjuster
Farmers Insurance Exchange
11.2023 - 10.2024
Electronic Manufacturer
Virtex
03.2023 - 11.2023
Pip Insurance Adjuster
Kemper
01.2022 - 01.2023
Case Specialist / Chat Agent
Signet Jewelers
01.2018 - 01.2023
Warehouse Associate
Amazon
01.2014 - 01.2015
Lewisville High School
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