career objective                              

seasoned, resourceful workers compensation claims adjuster eager to contribute strong investigative, analytical, and communication skills toward supporting the employer in optimizing revenue and operational performance

profile                                                

ø  offer numerous years of progressive experience managing workers compensation claims, with extensive knowledge of the texas, oklahoma, colorado, michigan, kansas, louisiana, and arkansas jurisdictions

ø  facilitate a client-focused, service-oriented environment vital to maximizing customer satisfaction and retention; serve as primary client contact

ø  manage the comprehensive claims process from initial review through ultimate resolution; diligently investigate claims to determine eligibility, coverage, and compensability

ø  partner with internal and external legal counsel, other departments, and interdisciplinary specialists to most effectively manage claims; prevent fraud through identifying suspicious claims

ø  establish and maintain accurate reserves for all cases, attend quarterly claims reviews and benefit review conferences, negotiate settlements to mitigate cost and exposure, structure payment arrangements, and set up attorney fees

ø  document all relevant information  and ensure timely filing with appropriate governing bodies

ø  dynamic communication, presentation, negotiation, and relationship management skills; proactive team player equally effective in independent and collaborative environments

ø  recognized for excellent performance and granted numerous internal promotions

ø  sharp technical proficiencies including insurance software programs and microsoft office (word, excel, powerpoint, access, outlook)

professional experience                

fara insurance                                                                                                               2010 c present

claims investigator

 

liberty mutual insurance co.                                                                                          1988 c 2010

claims case manager iii (2007 c 2010)

claims case manager i / ii (1999 c 2001)

case manager associate (1998 c 1999)

office assistant (1988 c 1997)

education                                           

san jacinto college, pasadena, tx                                                                                insert date

insert degree / major 

 

~ professional licenses ~

insurance license c texas and oklahoma