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Skills

  • MS Office
  • CCTV
  • Operational improvement
  • Team building
  • Customer service
  • Security systems
  • Insurance billing
  • Communications
  • Efficient communication with claimants and employers
  • Vendor relationship management

Work Experiences

  • Developed a reputation for punctuality and hard work.
  • Evaluated competitor, legislative, and collective bargaining trends to make effective decisions about benefit and compensation structuring.
  • Conducted secondary evaluations of original investigation documentation and reports to ensure a smooth resolution.
  • Achieved CPA and applied new learnings to expedite claim closures by 6 days on average.
  • Achieved a 41% decrease in employee recovery time.
  • Achieved a 17% reduction in erroneous claims.
  • Achieved 51% accuracy in file documentation.
  • Achieved zero penalties during 2022's state audit.
  • Learned cross-functional collaboration and client relations to help with office needs.
  • Led claim negotiations up to $2 and assisted in the litigation process for failed settlements.

Summaries

  • With a 11-year career assessing properties, determining liabilities, and negotiating settlements, I am an experienced insurance professional.
  • Analytical Senior Workers Compensation Adjuster with strong data-gathering, report-writing, and data-compilation abilities.
  • Student pursuing a Insurance degree who is eager to contribute developed knowledge in the role of Senior Workers Compensation Adjuster.
  • Capable of detangling and bolstering complicated benefit systems.
  • Strong interpersonal, decision-making, and multitasking skills.
  • Category and standard have a proven track record.
  • Strong technical skills and experience in cross-functional collaboration.
  • Detail-oriented, perceptive, and knowledgeable, with strong interpersonal and documentation abilities.
  • Well-versed in new hire orientation, onboarding, and training.
  • Workday and HubSpot experts with exceptional interpersonal skills.

Accomplishments

  • Led cross-functional teams in process optimization programs, which improved overall claim-processing time by 48%.
  • Initiated key procedural reforms that reduced average claim resolution time from 9 weeks to 17 weeks, improving employee satisfaction.
  • Implemented comprehensive accident investigation protocols, leading to a 79% reduction in injury recurrence across marketing.
  • Developed and executed defense strategies for high-value claims, achieving favorable legal outcomes in 43% of cases.
  • Trained new adjusters on in-depth claims analysis techniques, boosting departmental capacity and improving KPI performance by 47% within the first 15 months.
  • Streamlined intake and review processes for new claims, improving caseload capacity by 34% while reducing processing errors.
  • Identified fraudulent claims proactively, resulting in over $10 in savings through denied or adjusted claims in 2018.
  • Managed a multi-state caseload of 2 claims, ensuring compliance with federal and state-specific regulations, reducing late payment penalties by 83%.
  • Negotiated settlements ranging from $6 to $8, leading to cost savings of 85% compared to pre-litigation estimates.
  • Reduced overheads by 83% by designing and implementing claims-handling templates that standardized workflow across 8 teams.

Affiliations

  • Conference Presenter, National Workers' Compensation and Disability Conference (NWCDC)
  • Affiliate, National Council on Compensation Insurance (NCCI)
  • Volunteer, National Commercial Liability Adjuster Network 2019
  • Certification, Chartered Property Casualty Underwriter (CPCU) designation
  • Member, American Risk & Insurance Association (ARIA)
  • Membership, National Association of Insurance Commissioners (NAIC)
  • Member, American Association of State Compensation Insurance Funds (AASCIF)
  • Participant, National Occupational Injury & Disability Conference (NOIDC) 2021
  • Contributing Member, Claims and Litigation Management Alliance (CLM)
  • Member, Public Risk Management Association (PRIMA)

Certifications

  • Microsoft Office Specialist (MOS)
  • Professional Risk Consultant (PRC)
  • Certified Business Analysis Professional (CBAP)
  • Loss Reserving Certification (LRC)
  • Workers Compensation Surveillance Certification (WCSC)
  • Managed Healthcare Professional (MHP)
  • ServSafe
  • Chartered Property Casualty Underwriter (CPCU)
  • Senior Professional in Insurance Management (SPIM)
  • Legal Aspects of Workers' Compensation Certification

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