Carlos Alfaro
Ruther Glen
Summary
Experienced insurance professional with 17 year career determining liabilities managing claim files and negotiating settlements. Detail-oriented, observant and knowledgeable with excellent interpersonal and documentation skills. Efficiently handle high case volumes with accuracy and care.
I've handle commercial, ride share, as well as personal claims from multiple sta
tes. Licensed for most U.S. states.
Overview
20
20
years of professional experience
Work History
Claims Examiner
Allcat Claims Service
San Antonio
02.2023 - Current
- Worked as Third Party Adjuster for various accounts and their own systems, including Tesla, Lemonade and Farm Bureau.
- Reviewed insurance claims for accuracy and compliance with company policies.
- Analyzed documentation to determine eligibility for claims processing.
- Collaborated with team members to resolve complex claim issues efficiently.
- Assessed and interpreted policy coverage in relation to submitted claims.
- Managed workloads efficiently by prioritizing tasks based on urgency or importance.
- Examined claims investigated by independent adjusters.
- Negotiated settlement terms with claimants within authorized limits.
- Provided excellent customer service, resolving claimant concerns and queries promptly.
- Discussed current cases and issues in claim committee meetings.
- Reviewed police reports, medical treatment records, medical bills and physical property damage to determine extent of liability.
Claims Adjuster
GEICO
Fredericksburg
02.2008 - Current
- Reviewed, evaluated and adjusted claims to promote fair and prompt settlement.
- Negotiated and settled claims according to information presented through reports, research and data verification.
- Recommended settlement offers and negotiated payment arrangements.
- Investigated questionable claims to determine payment authorization.
- Obtained necessary information to complete proper evaluation of injury claims.
- Reviewed data to verify validity of claims and determine case management actions.
- Coordinated benefits while applying applicable deductibles, co-insurance and out-of-pocket costs.
- Completed required investigations on referred files within established timeframes.
- Identified and obtained evidence to ascertain claim value.
- Drafted statement of loss to summarize damages, payments and underlying policy coverage.
- Identified and collected evidence and determined value to specific claim to properly assess conditions.
- Gathered information from various third parties to determine claim acceptability.
- Handle commercial claims from various states across the country, following the applicable rules and regulations of each state.
Graphic Designer
Newtown Printing
Fredericksburg
09.2006 - 01.2008
- Generated digital image files for use in digital and traditional printing.
- Developed, designed, laid out and produced variety of technical illustrations for brochures, banners and signs.
- Selected colors and themes while adding functionality to create new designs.
Education
Associate of Arts - Graphic Design
Art Institute of Washington
Rosslyn, VA12.2003
Some College (No Degree) - General Studies
Virginia Tech
Blacksburg, VASkills
- Property claims
- Interviewing techniques
- Medical terminology specialist
- Claims file management processes
- Oral and Written Communication
- Microsoft Office
- Teamwork and Collaboration
- Multitasking and Prioritization
- Calm and Professional Under Pressure
- Verbal and Written Communication
- Computer Skills
- Spanish Translation
Timeline
Claims Examiner
Allcat Claims Service
02.2023 - Current
Claims Adjuster
GEICO
02.2008 - Current
Graphic Designer
Newtown Printing
09.2006 - 01.2008
Associate of Arts - Graphic Design
Art Institute of Washington
Some College (No Degree) - General Studies
Virginia Tech