KATHERINE CRUZ CALERO
San Juan
Summary
Dedicated legal and insurance professional with over nine years of experience in claims management, legal research, and dispute resolution. Currently in my third year of law school at the Pontifical Catholic University of Puerto Rico, with a strong foundation in civil law, administrative law, and insurance regulations. Proven ability to analyze complex cases, manage appeals and grievances, and lead teams effectively. Seeking an opportunity to apply my legal expertise, analytical skills, and leadership abilities in a federal government role.
Overview
12
12
years of professional experience
Work History
Subrogation (Grievance & Appeals, Coordination of Benefits)
Humana Insurance
09.2018 - Current
- Manage subrogation claims to recover medical costs from third-party liability cases
- Handle grievance and appeals cases, ensuring compliance with regulatory requirements and effective dispute resolution
- Conduct Coordination of Benefits (COB) to determine primary and secondary coverage, optimizing health insurance benefits
- Communicate with clients, insurance providers, and internal departments to facilitate claim processing and case resolution
Paralegal / Team Leader
Sanders Phillips Grossman, LLC
01.2014 - 09.2018
- Assist in medical product liability cases, including pharmaceuticals and implants
- Conduct client intake and consultations via phone and email
- Work closely with plaintiffs, including incarcerated individuals and persons with mental disabilities
- Lead a team handling legal documentation, case management, and research for mass tort litigation
Host Supervisor
East Asian Bistro
01.2013 - 01.2014
- Supervised and trained staff to provide exceptional customer service
- Managed reservations, table assignments, and overall floor coordination
- Handled and resolved customer complaints to ensure a positive dining experience
Education
Juris Doctor (J.D.) - Third Year
Pontifical Catholic University of Puerto Rico – School of Law
Ponce, PR05-2026
Master’s Degree - Criminal Justice
Interamerican University of Puerto Rico – Metropolitan Campus
San Juan, PR01.2015
Bachelor’s Degree - Criminal Justice
Interamerican University of Puerto Rico – Metropolitan Campus
San Juan, PR01.2012
Skills
- Legal Research
- Case Analysis
- Claims Management
- Insurance Law
- Team Coordination
- Problem-Solving
- Dispute Resolution
- Case analysis
Languages
Spanish
Native language
English
Proficient
C2
Timeline
Subrogation (Grievance & Appeals, Coordination of Benefits)
Humana Insurance
09.2018 - Current
Paralegal / Team Leader
Sanders Phillips Grossman, LLC
01.2014 - 09.2018
Host Supervisor
East Asian Bistro
01.2013 - 01.2014
Master’s Degree - Criminal Justice
Interamerican University of Puerto Rico – Metropolitan Campus
Bachelor’s Degree - Criminal Justice
Interamerican University of Puerto Rico – Metropolitan Campus
Juris Doctor (J.D.) - Third Year
Pontifical Catholic University of Puerto Rico – School of Law
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