Summary
Experienced workers compensation claims examiner skilled in claims management, adjudication, and negotiation. Proven ability to resolve claims efficiently, ensure regulatory compliance, and analyze data to improve outcomes. Strong communicator focused on client service and results.
Experience
- Managed a caseload of 200+ claims annually, achieving a 92% resolution rate within service expectations.
- Negotiated settlements totaling $400,000, reducing company liability by 18%.
- Analyzed and processed complex claims, identifying trends and improving closure rates by 12%.
- Ensured regulatory compliance and accurate documentation for all claims, passing all state audits.
- Adjudicated claims within client requirements, maintaining a 98% accuracy rate.
- Administered workers compensation benefits for injured employees, reducing benefit processing time by 20%.
- Arranged medical examinations and rated permanent disability for 50+ cases.
Education
Courses
- Professional Claims Certification, Insurance Institute of America