I possess over 30 years experience in the insurance industry. Over the years, I have proven to be not only an effective team member but also a motivating mentor and trainer. Throughout my career, I have had to analyze data, make recommendations, and consult with various stakeholders, including clients and all levels of staff and management on issues. I am skilled at working in a profession that is based in customer service and handling difficult situations.
I possess strong interpersonal, organizational and problem-solving skills. I have worked remotely for the past several years and have continued to display an excellent work ethic, the ability to work independently, and to be a self-motivator. Although my experience is in California workers compensation, I am a quick learner and will adapt easily to new policies and procedures and am willing to earn any needed certification that the position requires.
Managed and resolved claims to ensure timely and effective outcomes. Conducted thorough investigations to ascertain claim benefits
and guide stakeholders through resolution process. Provided expert evaluations to determine most advantageous course of action,
combining strong analytical skills with detail-oriented approach.
βͺ Offered leadership and direction in development of innovative solutions that meet needs of all parties involved.
βͺ Negotiated and settled claims effectively by demonstrating strong ability to resolve disputes and achieve favorable results.
βͺ Facilitated clear and articulate client communications, ensuring mutual understanding and satisfaction in claim resolutions.
βͺ Streamlined claims management processes, resulting in improved efficiency and stakeholder guidance.
βͺ Oversaw handling of San Francisco Municipal claims to maintain portfolio of 125 claims with focus on clear communication and
strategic problem-solving.
Managed portfolio of 150 lost time and litigated workers’ compensation claims with focus on resolving complex cases efficiently.
Developed and implemented strategic solutions and provided clear guidance to stakeholders, while ensuring thorough investigation and
accurate determination of benefits. Maintained clear and effective communication with clients to facilitate understanding and resolution
of claims. Exercised strong analytical skills to evaluate and minimize exposure for determining optimal course of action.
βͺ Closed 100% of new losses each month by maintaining exceptional levels of case resolution and client satisfaction.
βͺ Applied organized approach to claims management, leading to streamlined processes and reduced resolution times.
Managed workers’ compensation claims, ensuring investigation and accurate determination of benefits. Implemented strategic solutions,
effectively serving as liaison between company and major clients to facilitate understanding and resolution of claims. Evaluated case
exposure to determine optimal courses of action, while providing expert guidance to all stakeholders. Prepared comprehensive
management process reports to track and improve claims handling procedures.βͺ Demonstrated exceptional independence and effectiveness in managing claims without supervision.
βͺ Increased efficiency and client satisfaction by streamlining claims evaluation and resolution processes.
βͺ Fostered strong relationships with clients and stakeholders through clear and articulate communication.
βͺ Contributed to development of best practices in claims management, setting standards for excellence within team.
Oversaw daily operations of workers’ compensation claims unit, ensuring adherence to legal and regulatory guidelines. Conducted
comprehensive monthly audits to evaluate examiner performance and maintain high standards of claims management. Guided claim
resolutions to optimize process efficiency and effectiveness.
βͺ Enhanced team knowledge and skills by developing and delivering training on California workers’ compensation procedures.
βͺ Minimized risk and expediting case closures by assessing claim exposure to devise strategic action plans.
βͺ Streamlined claims review process, resulting in expedited resolution and increased examiner productivity.
βͺ Fostered collaborative team environment that emphasized skill development and professional growth.
Managed complex claims and spearheaded issue resolution to minimize client risk and exposure. Conducted thorough investigations to
ascertain workers’ compensation benefits eligibility, ensuring adherence to legal and policy requirements. Developed and refined
management process reports to optimize operational efficiency. Acted as key liaison between company and major clients to foster strong
relationships and maintain open lines of communication.
βͺ Enhanced team performance and knowledge base by providing expert guidance and mentorship to junior examiners.
βͺ Recognized by company president for outstanding management of a principal account, resulting in a special commendation.
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