Workers Compensation Claims Adjuster
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Results-oriented professional with a proven history of success in fast-paced environments. Skilled in managing competing priorities, fostering strong relationships, and driving collaborative solutions. Recognized for exceptional communication, keen attention to detail, and a proactive approach to problem-solving. Committed to continuous learning and consistently delivering high-quality outcomes with integrity and precision.
Claims Assistant/Medical Only Workers Compensation Claims Adjuster
AMTrust North America-Boca Raton
September 2021-April 2025
Coordinated medical appointments scheduling to ensure timely case progression and compliance with adjuster requirements.
Ensured seamless execution of settlement payments by accurately managing financial data with RMIS(Risk Management Information System).
Provided administrative oversight of Pay Diaries for designated Lost Time adjuster, contributing to accurate and efficient claim processing.
Facilitated information exchange between clients, vendors and internal departments to drive efficient workflow and informed decision-making.
Conducted thorough investigations of reported losses to assess cause, extent of damage and eligibility for compensation.
Applied analytical judgment to evaluate claims, set reserves and initiate appropriate payment actions.
Maintained effective and empathetic communication with claimants, clients, vendors, and internal teams to support seamless claims processing and resolution.
Claims Assistant/Workers Compensation Claims Adjuster
Seminole Tribe of Florida-Hollywood, FL
September 2015-August 2021
Prepared incident documentation through Perspective software to support efficient claims processing and timely assignment to adjusters.
Maintained and updated the Incident Detail Report Log using Excel to ensure accurate tracking and documentation of workplace incidents.
Administered check issuance and control procedures, maintaining secure handling and timely delivery of financial documents.
Managed claim setup procedures in RMIS (Allegro and Enterprise), contributing to streamlined operations and prompt adjuster assignment.
Oversaw mail operations, including receipt, sorting and dispatch, to support efficient communication and workflow across the unit.
Managed incoming calls and voicemail retrieval for the unit, ensuring prompt and accurate transfer to appropriate adjusters.
Oversaw the creation and reconciliation of the monthly Check Register Report, facilitating informed financial oversight and cross-departmental alignment.
Administered claims in alignment with regulatory requirements, company policies, and procedural standards to ensure accurate and timely case handling.
Engaged with diverse sources, including clients, claimants and internal teams to obtain accurate data and support timely decision making.
Conducted thorough evaluations of loss claims to determine causation, scope and compensability supporting accurate and timely claim resolution.
Administered indemnity payments as needed, verifying documentation and payment accuracy to support proper case handling.
Evaluated assigned claims to establish appropriate financial reserves and authorize timely, policy-compliant payments.
Recorded all investigative and administrative steps in alignment with regulatory standards to support claim outcomes.
Maintained comprehensive documentation of claims actions to uphold file integrity and facilitate informed decision making. Delivered professional and empathetic communication to claimants and clients, enhancing trust and ensuring clarity throughout the claim process.
MBTI, Associates Degree, Secretarial Sciences
