Veronica Hernandez
East Los Angeles
Overview
25
25
years of professional experience
Work History
Claims Examiner II
Interinsurance Exchange Of Southern California
Arcadia, CA
11.2017 - 03.2022
- Handled sensitive information with discretion, ensuring confidentiality of personal and financial details for claimants throughout the claims examination process.
- Utilized analytical skills to evaluate medical bills for accuracy and appropriateness of charges before approving payments as part of the claims process.
- Participated in cross-functional team meetings to address organizational challenges related to claims management and develop solutions collaboratively.
- Reduced claim processing time by implementing efficient workflow strategies and prioritizing tasks effectively.
- Interpreted policy provisions, endorsements, and exclusions to accurately determine coverage for claims.
- Maintained detailed records of all claims activities, ensuring compliance with regulatory requirements and company policies.
- Examined photographs and statements.
- Negotiated settlements with claimants'' attorneys when needed, achieving favorable outcomes for both parties while minimizing costs.
- Conducted thorough investigations of complex claims, gathering relevant documentation and interviewing witnesses when necessary.
- Consulted police and hospital records when needed.
- Assisted in the development of training materials for new Claims Examiners, fostering a supportive learning environment.
- Read over insurance policies to ascertain levels of coverage and determine whether claims would receive approvals or denials.
- Maintained contact with claimants and attorneys to determine treatment status.
Bodily Injury Claims Adjuster
Access General Insurance
Orange, Ca
02.2011 - 10.2017
- Participated in ongoing training programs to stay up-to-date on industry trends, regulatory changes, and best practices for bodily injury claims handling.
- Negotiated terms and handled settlements and adjustments with attorneys, claimants and co-defenders.
- Prepared and presented complex cases to management, in-house legal team and Claims Committee.
- Interviewed policyholders, witnesses and third parties to gather information and details regarding injury event.
Material Damage Claims Adjuster
21st Century Insurance/Farmers Insurance Company
Monrovia, CA
12.1996 - 12.2010
- Developed strong relationships with vendors and service providers, fostering trust and cooperation in the claims process.
- Identified subrogation opportunities through careful analysis of accident details, recovering funds for the company when appropriate.
- Effectively documented all communications related to claims handling for easy reference in future situations or disputes that may arise later on.
- Continuously improved professional expertise by attending training sessions and staying current on industry trends.
- Negotiated fair settlements with claimants by leveraging strong communication skills and industry knowledge.
- Maintained compliance with state regulations and company policies during the claims handling process.
Education
High School Diploma -
Sierra Vista High School
Baldwin Park, CA06.1990
Skills
- Verbal Communication
- Claims Processing
- Claims Evaluation
- Decision-Making
- Insurance policy coverage knowledge
- Accident scene investigations
- Valuation knowledge
- Settlement Negotiation
Languages
Spanish
Native or Bilingual
Timeline
Claims Examiner II
Interinsurance Exchange Of Southern California
11.2017 - 03.2022
Bodily Injury Claims Adjuster
Access General Insurance
02.2011 - 10.2017
Material Damage Claims Adjuster
21st Century Insurance/Farmers Insurance Company
12.1996 - 12.2010
High School Diploma -
Sierra Vista High School