WORKERS' COMPENSATION SENIOR ADJUSTER FLOATER/SUPERVISOR DEVELOPMENT - CorVel Corporation
(2026-02)
- Provide desk coverage for adjusters during absences, ensuring uninterrupted claim progression and compliance with internal and regulatory guidelines.
- Prepare comprehensive claim review summaries and present cases during claim reviews and strategy meetings.
- Manage full indemnity claim handling functions, including payments, litigation oversight, investigations, and system updates.
- Issue payments and checks timely while maintaining accuracy in all documentation and data fields.
- Investigate new and ongoing claims to ensure proper reserve management and claim strategy execution.
- Maintain and update system notes, POAs, and required claim documentation to ensure audit readiness and compliance standards.
- Support supervisors and adjusters by assisting with backlog reduction, documentation updates, and data integrity improvements.
- Manage Tail Claim Triage assignments by conducting thorough file reviews, updating all claim components, issuing payments, and transitioning files to designated adjusters once fully reviewed.
- Ensure all files are returned in equal or better condition than received, maintaining quality and performance standards.
- Consistently meet or exceed performance scorecard metrics, including QA standards (85%+ average over last three quarters).
- Maintain strong compliance performance with no missed PFBs and adherence to CPS fines and P&L expectations.
- Demonstrate leadership readiness by thriving in fast-paced, changing environments while delivering superior customer service and responsiveness.
WORKERS' COMPENSATION LOST TIME CLAIMS SPECIALIST - CorVel Corporation
(2024-08)
- Receives claim, confirms policy coverage and acknowledgement of the claim.
- Determines validity and compensability of the claim by investigating and gathering information regarding the claim and files necessary documentation with state agencies.
- Establishes reserves and authorizes payments within reserving authority limits.
- Develops and manages well documented action plans with the case manager and outcomes manager to reduce overall cost of the claim.
- Coordinates early return-to-work efforts with the appropriate parties.
- Manages subrogation and litigation of claim as it applies.
- Manages potential claim recoveries of all types.
- REPORT claims to the excess carrier when applicable.
- Communicates claim status with the customer and claimant.
- Adheres to client and carrier guidelines and participates in claims review as needed.
- Develops and maintains professional customer relationships.
- Complies with rules and regulations of applicable state.
- Additional projects and duties as assigned
WORKERS' COMPENSATION LOST TIME CLAIMS ADJUSTER - FLORIDA LEAGUE OF CITIES
(2020-02 - 2023-03)
Diligently assess newly assigned claims within 48 hours of assignment. Determines the extent of coverage for insured individuals. Confirms coverage with receipt of first notice of injury and assist with establishing the setup of the file. Information is secured from the members, claimants, witnesses, investigating authorities, medical personnel, attorneys, and experts. Facilitate recorded statements when needed. Review and confirm facts and other necessary information to document the file as part of the overall investigation of each claim.
Requests Special Investigation
Unit assistance when warranted if fraudulent activity is suspected. Maintain diary for follow-up on files, determination of damages and additional investigations. Evaluate and conclude office managed claims within designated monetary authority. Conduct settlement negotiations via telephone and written correspondence when required. Possesses a $50,000 level of financial authority to settle independently. Oversee the assigned duties of clerical staff, nurse case managers and field case managers assigned to the files.
WORKERS' COMPENSATION CLAIMS CUSTOMER SERVICE REPRESENTATIVE - FLORIDA LEAGUE OF CITIES
(2019-06 - 2020-02)
- Queried ISO Services on all new claims and advised claims personnel of prior injury claims.
- Processed claims information into the claims system.
- Maintained diary system for all claim activities as assigned by the adjuster.
- Established and maintained customer relationships through courteous and efficient services of customer requests.
- Compiled information and correspondence for assigned files.
- Corrected and entered EDI data.
- Entered payments for internally approved invoices or charges.
- Processed and mailed employee information packets.
WORKERS' COMPENSATION CLAIMS CLERK - FLORIDA LEAGUE OF CITIES
(2018-09 - 2019-06)
- Provided excellent customer service to external and internal customers.
- Answered inbound claims intake calls.
- Spoke with members to gather pertinent information to set up claims for the injured workers.
- Answered other inbound calls and either assisted or forwarded to the appropriate person and/or department.
- Sorted and filed emailed correspondence.
- Received, sorted, and filed paper mail appropriately.
- Reviewed outgoing check batches, verified check count, and prepared checks for mail.
Business owner - ASHANTIS, and Company
(2017-01)
As the owner and sole eyelash extension technician, successfully created, solely operated, and launched a line of eyelash extensions. Artfully, create and implement advertising products, host a wide range of promotional events, and offer consultation services to other beauty technicians.
Community Liason Assistant - lusterall - Bartow, FL
(2009-03 - 2013-08)
- Prepared documents for HIV and AIDS Awareness seminars and events.
- Distributed sexually transmitted disease prevention literature and products at community festivals and other events.
- Worked diligently within the community to heighten awareness of sexually transmitted diseases.
- Also performed normal office performed, such as answering phone calls and managing daily tasks.
