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Skills

  • Supervision
  • Stakeholder collaboration
  • Business operations
  • Time management and prioritization
  • Process improvement
  • Expert testimony in workers' compensation cases
  • Cost-containment strategies
  • Injury assessment and classification
  • Budgets
  • OSHA compliance

Work Experiences

  • Authored internal audit reports that led to the identification of 10 high-risk claims worth approximately $7, contributing to proactive resolution strategies.
  • Oversaw claim negotiations within a $13 budget and assisted in successful litigation for complex issues.
  • Transported Power BI to 6 months customer locations.
  • Achieved high claim closure rates by overseeing complex, multi-party claims involving third-party liability, settlements exceeding $12.
  • Analyzed legal precedents and the latest state regulatory changes to ensure compliance with evolving workers' compensation laws, leading to Innovation Award from Cedar Works for compliance excellence.
  • Achieved proper classification.
  • Achieved favorable outcomes in 44% of cases.
  • Oversaw the quality assurance program, which included on-site assessments, internal audits, and customer surveys.
  • Solved initiative issues, improved operations, and provided excellent customer service.
  • Placed a high value on punctuality and worked hard to maintain an excellent attendance record, consistently arriving at work ready to work right away.

Summaries

  • Proven track record of using excellent negotiating skills to speed up settlements.
  • Achieved 69% of workers returning to modified duty.
  • Within Miscellaneous, senior Workers Compensation Adjuster and outstanding performer in quality assurance and vendor management.
  • Strengths in performance reporting and risk assessment backed up by Miscellaneous training.
  • Adept in injury classification.
  • Hardworking Workers Compensation Adjuster with 7 years of telecommuting experience meeting customer needs.
  • Achieved timely claim settlements.
  • Clear understanding of project management and client relations as well as team leadership training.
  • Built strong relationships to facilitate claims.
  • Overall morale and productivity are boosted by experience in policy development and staff management procedures.

Accomplishments

  • Exhibited excellent rapport-building techniques with employees suffering from workplace injuries, increasing claimant satisfaction ratings by 85%.
  • Actively monitored changes in state workers' compensation laws, adapting policies to ensure the organization remained compliant.
  • Supervised compliance in multi-state workers' compensation claims, ensuring resolution aligned with differing regional regulations and timelines.
  • Effectively communicated claims strategies and resolution plans with external stakeholders, ensuring progressive movement of high-risk claims.
  • Reduced total lost time on employee injuries by implementing a robust return-to-work strategy, decreasing paid-time-off requests by 73%.
  • Implemented a streamlined claims investigation process, resulting in a decrease of 45% in claim review time across a portfolio of 8 cases.
  • Identified trends in workplace injuries by conducting risk analysis, leading to the development of tailored prevention programs in Miscellaneous.
  • Reduced potential legal risks by thoroughly reviewing claims reports and collaborating with the legal team to handle cases legally and ethically.
  • Successfully mediated 8 benefit dispute cases, avoiding litigation and securing favorable settlements for both parties.
  • Worked closely with medical providers and legal professionals to resolve claims, saving the company $11 by negotiating fair settlements.

Affiliations

  • Project Management Institute
  • Freemason
  • National Association of Self-Insured Employers (NASIE)
  • National Association of Insurance Commissioners (NAIC)
  • Society of Human Resource Management (SHRM)
  • International Social Security Association (ISSA) Workers’ Compensation Section
  • Society of Human Resource Management
  • Toastmasters
  • American Compensation Association (ACA)
  • Jaycees

Certifications

  • National Institute for Workers’ Compensation Adjusters (NIWA) - Certification
  • Certified Workers' Compensation Professional (CWCP)
  • Occupational Health Nurse (OHN) Certification
  • Salesforce
  • SHRM Certified Professional (SHRM-CP)
  • SHRM Senior Certified Professional (SHRM-SCP)
  • Associate in Risk Management (ARM)
  • Certified Compensation Professional (CCP)
  • Certified Case Safety Professional (CSP)
  • Google Certified Professional Cloud Architect

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