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Skills

  • Building rapport with injured workers and employers
  • Method equipment
  • Customer service and client management
  • Project organization
  • Relationship development
  • Multi-state Workers’ Compensation law knowledge
  • Budgets
  • Expert testimony in workers' compensation cases
  • Injury assessment and classification
  • Team management

Work Experiences

  • Authored internal audit reports that led to the identification of 10 high-risk claims worth approximately $7, contributing to proactive resolution strategies.
  • Adjusted claim reserves proactively.
  • 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 favorable outcomes in 44% of cases.
  • Examined claim forms and other records to determine insurance coverage.
  • Analyzed legal precedents and state regulatory changes.
  • Achieved results within three years.
  • Achieved proper classification.
  • Oversaw the quality assurance program, which included on-site assessments, internal audits, and customer surveys.
  • Adjusted portfolio to lessen payout risks.

Summaries

  • Boosted productivity.
  • Astute insurance professional with 18+ years of experience assessing properties, determining liabilities, and negotiating settlements.
  • Achieved fair case settlements.
  • 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.
  • Empathy, dependability, and enthusiasm for customer satisfaction.
  • Excellent track record of resolving issues, increasing customer satisfaction, and driving overall operational improvements.
  • Bringing a proven track record of success in Workers Compensation Adjuster roles throughout a progressive insurance industry career.
  • Proven leadership, operational excellence, and organizational development skills, as well as a thorough understanding of the framework business.
  • Certified Workers' Compensation Adjuster with a strong background in process improvement. Spearheaded automation initiatives, reducing manual claim errors by 83% and improving case resolution efficiency by 18 months.

Accomplishments

  • Trained junior adjusters on the nuances of statutory requirements, policy provisions, and best practices, improving team overall accuracy by 38%.
  • Collaborated with the finance department to reconcile claims expenses, identifying cost-savings of $4 via enhanced reserve accuracy and payment tracking.
  • Led a task force that implemented a digital claims filing system, boosting efficiency and reducing overall processing errors by 23%.
  • Worked closely with medical providers and legal professionals to resolve claims, saving the company $11 by negotiating fair settlements.
  • Assisted in fine-tuning case management strategies that increased overall claim closure rates by 85% across several months.
  • Reduced denied claims appeals by 11 through preventative educational seminars and training sessions for employers and injured workers.
  • Spearheaded efforts to resolve delayed claims, clearing a backlog of 6 cases and improving claims closure rate by 29%.
  • Negotiated settlements on complex cases that exceeded a combined total value of $17, successfully reducing projected liabilities by 85%.
  • Supervised compliance in multi-state workers' compensation claims, ensuring resolution aligned with differing regional regulations and timelines.
  • Developed trust with injured employees and employers through consistent follow-ups and personalized communication reducing litigation rates by 25%.

Affiliations

  • National Workers' Compensation and Disability Conference (NWCDC)
  • Freemason
  • Society of Women Engineers
  • Lions Club
  • International Council of Nurses
  • International Claim Association (ICA)
  • National Association of Independent Review Organizations (NAIRO)
  • Council on Litigation Management (CLM)
  • American Marketing Association
  • Association of Information Technology Professionals

Certifications

  • National Institute for Insurance Adjuster Continuing Education Certifications
  • Licensed Workers’ Compensation Adjuster - North Carolina
  • CompTIA Network+
  • Salesforce
  • Certified Insurance Counselor (CIC)
  • Workers' Compensation Claims Professional (WCCP)
  • Disability Management Employer Coalition (DMEC) Compliance and Return to Work Certifications
  • National Association of Independent Insurance Adjusters (NAIIA) Certifications
  • Microsoft Certified Systems Engineer (MCSE)
  • Associate in Risk Management (ARM)

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