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Skills

  • Customer service
  • Employee relations consultation
  • Compliance with North Carolina standards
  • Case management
  • Medical treatment authorization
  • Standard equipment
  • Budgeting for workers' compensation claims
  • Settlement Negotiation
  • Case strategy development
  • Team building

Work Experiences

  • Authored comprehensive guidelines on case management procedures that were implemented across multiple divisions.
  • Achieved cost savings of $15.
  • Looked into and assessed property damage, as well as reviewing property damage estimates.
  • Collaborated with legal departments.
  • Approved medical treatment settlements.
  • Examined claim forms and other records to determine insurance coverage.
  • Collaborated with legal departments to provide detailed case documentation, ensuring flawless hearing preparation.
  • Boosted client retention by 31%.
  • Identified insurance coverage limitations with a thorough examination of claims documentation and related records.
  • Collaborated with HR departments across metric.

Summaries

  • Oversee 11 cases per month with care.
  • Proven track record of using excellent negotiating skills to speed up settlements.
  • Client-focused case manager specializing in liaising between injured workers and supervisors to ensure smooth transitions into modified duty frameworks with a 68% success rate.
  • Analytical professional experienced in creating comprehensive return-to-work plans, assisting injured workers in reintegrating and achieving reduced extended disability rates.
  • Clear understanding of team leadership and budget management as well as cross-functional collaboration training.
  • Assisted injured workers in reintegrating.
  • Empathy, dependability, and enthusiasm for customer satisfaction.
  • Listening to customers, meeting productivity goals, and staying current on company offerings are all skills she possesses.
  • Advised management on risk factors.
  • Accomplished negotiator.

Accomplishments

  • Implemented a proactive approach to adjuster training, leading to a reduction in claim processing errors by 53%.
  • Re-engineered the case management system to improve documentation accuracy and reduce processing errors by 72%.
  • Managed a portfolio involving 17 high-profile workers' compensation claims, resulting in a 56% success rate in settlements.
  • Built strategic partnerships with rehabilitation services, improving the success rate of return-to-work programs by 20%.
  • Collaborated with underwriting teams to provide claim history analyses, impacting future insurance premium reductions.
  • Achieved a 75% reduction in legal expenses by effectively managing litigation expenses and avoiding unnecessary lawsuits.
  • Used Microsoft Excel to develop inventory tracking spreadsheets.
  • Successfully managed a caseload of 9 claims per month, with a resolution rate of 55% within legally mandated timelines.
  • Created and monitored workers’ compensation dashboards, providing real-time insights that improved decision-making across 10 departments.
  • Collaborated with third-party vendors, improving service quality and ensuring compliance with workers’ compensation guidelines.

Affiliations

  • Member, International Association of Rehabilitation Professionals (IARP)
  • Association for Computing Machinery
  • Jaycees
  • Affiliated Member, National Association of Occupational Health Professionals (NAOHP)
  • Continuing Education, American Board of Work Compensation Professionals (ABWCP), 2022
  • Freemason
  • Participant, Workers’ Compensation Research Institute (WCRI) Forums
  • Graduate, Legal Aspects of Workers’ Compensation, Lakeside Partners, 2020
  • Member, American Society of Workers' Compensation Professionals (ASWCP)
  • Rotary International

Certifications

  • Workers' Compensation Legal Specialist Certification by standard (if required)
  • Certified Fraud Examiner (CFE) – Workers' Compensation Fraud
  • Certified Business Analysis Professional (CBAP)
  • Case Management Administrator Certification (CMAC)
  • Certified Case Manager (CCM) by the Commission for Case Manager Certification (CCMC)
  • Certified Life Care Planner (CLCP)
  • Associate in Risk Management–Workers Compensation (ARM-WC)
  • Risk Management for Workers’ Compensation (RMWC) by the American Institute for Chartered Property Casualty Underwriters
  • Certified Managed Care Professional (CMCP)
  • Certified Public Accountant

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