WORKER COMPENSATION ADJUSTER
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Multi-state adjuster in handling over 15 states bodily injury; workers compensation; and general liability claims. Implementation of key business programs meeting management goal to lower costs and reduction of incidents.
Claims Examiner II - Safeway/Sedgwick - Pleasanton, California
(2018-01)
Handled 150 claims from beginning to closure ensuing a 100 percent closure rate, meeting company requirements regarding three-point contact, and avoiding penalties. Over 50 percent of settlements completed without assistance from counsel. Settlement authority $100,000 and reserve authority of $200,000. Mentor the team on technical issues, selection of doctors/attorneys within MPN and the Qme process, and how to settle a claim. Keep litigation costs at manageable at for the client.
Worker Compensation; Safety Specialist - Sherwood Food Distributors - Detroit, Michigan
(2014-01 - 2017-12)
Completed root cause analysis using statistics to ensure compliance with OSHA rules and regulations for 8 different states. Completed safety training and conducted all accident investigations. Implemented Return to Work Program. Taught employees and management the proper procedures to report a claim, and how to locate medical treatment for injuries. Negotiated contracts with medical providers. Handled 150 claims from 8 different states including California.
Claims Specialist - Department of Veteran Affairs - Detroit, Michigan
(2009-01 - 2014-12)
Ensured veterans received benefits pertaining to disability, pension, medical treatment, and vocational rehabilitation. Reviewed medical records, tax records, lay statements and personnel file before issuing a decision. Explained to veterans their rights and responsibilities during the appeal process.
Senior Claims Examiner - Farmers Insurance - Pleasanton, California
(2007-01 - 2008-12)
Handled up to 150 claims with a caseload 55 percent litigated. Reserve and settlement authority up to $75,000.
Senior Claims Examiner - Kaiser Permanente - Oakland, California
(2002-01 - 2007-12)
Handled up to 175 claims with reserves of $33,000,000; settling over 50 percent of claims within guidelines provider by the employer. Ensured compliance with state rules regarding catastrophic claims. Prepared settlement worksheets outlining expenses: permanent disability, medical treatment lost wages, and vocational rehabilitation. Set up a program pertaining to utilization review for over 100 medical providers.
Bachelor - Business Administration - Temple University