Candace Rashid

Experienced Workers' Compensation Claims Professional with 10+ years of progressive experience managing complex multi-state claims, ensuring regulatory compliance, leading claim resolution strategies, and supporting operational excellence in fast-paced insurance environments. Proven expertise in workers' compensation investigations, claims administration, litigation management, payment processing, EDI compliance, and client relations. Strong leadership, communication, and organizational skills with a demonstrated ability to mentor teams, improve workflows, maintain quality standards, and manage high-volume caseloads.

Claims Specialist II at CCMSI (2024-01 – Present)

• Managed complex workers' compensation claims while ensuring compliance with company guidelines and state regulations.
• Conducted investigations, evaluated compensability, and determined appropriate claim handling strategies.
• Collaborated with claimants, attorneys, employers, and medical providers to facilitate timely claim resolution.
• Maintained accurate electronic documentation, processed benefit payments, and participated in mediations and file reviews.

Claims Specialist II at PGCS (2023-01 – 2024-01)

• Administered complex workers' compensation claims for a Florida municipality.
• Investigated workplace accidents and analyzed claims exposure to determine compensability.
• Managed communication between claimants, employers, attorneys, and medical providers.
• Maintained EDI compliance according to Florida state requirements.

Claims Adjuster at Insurance Staffing Benchmark (2022-01 – 2023-01)

• Processed workers' compensation claims while ensuring compliance with statutory requirements.
• Reviewed medical records and claim documentation to support accurate adjudication.
• Maintained organized claim files and assisted with complex claims assignments.

Implementation Consultant at Paylocity (2020-01 – 2022-01)

• Managed payroll implementation projects and ensured accurate system configuration.
• Conducted quality assurance reviews and verified payroll balancing procedures.
• Provided client support and managed multiple implementation deadlines.

Claims Adjuster at Sedgwick Claims Management (2015-01 – 2016-01)

• Managed workers' compensation claims in accordance with state statutes and company standards.
• Evaluated claims exposure, processed benefits, and coordinated medical management strategies.

Claims Adjuster at Sedgwick Claims Management (2019-01 – 2020-01)

• Managed workers' compensation claims in accordance with state statutes and company standards.
• Evaluated claims exposure, processed benefits, and coordinated medical management strategies.

Lost Time Claims Adjuster at ESIS / CHUBB (2018-01 – 2019-01)

• Investigated and managed multi-state workers' compensation lost-time claims.
• Reviewed medical and legal documentation and coordinated settlements.

Lost Time Claims Adjuster at AmTrust (2016-01 – 2018-01)

• Managed workers' compensation claims involving investigation and benefit administration.
• Maintained accurate records and ensured compliance with regulatory guidelines.

Associate of Arts Degree – Valencia College (2008)