INSURANCE CLAIMS

EMPLOYMENT

Senior Claims Adjuster - Review medical, dental, vision, and time loss claims, and assist in training new personnel. Handle all claims for two major client companies and ensure that each claim is legitimate and in line with standard medical practices. Have developed close working relations with policyholder reps and frequently answer questions of individual employees. Maintain an excellent record in loss control and in identifying discrepancies that frequently lead to denial of claims or reductions in amount paid. Among the staff of 45, one of two to be named on the “high production” plaque six consecutive quarters.

Branch Manager—As branch manager review and assign each claim and supervise a staff of 10. Recognized within the company as the best training branch and typically receive employees who have had difficulty at other branches. Highly successful in turning them into effective claims people. Among eight regional offices, consistently maintain the highest production per person, and for the last four years the office has been among the three lowest in cost per claim.

Claims Examiner - Assigned claims with serious injuries and handled cases through settlement or litigation. Examined all facts and details of a case and determined liability and the worth of each claim. Set the reserves, obtained recorded statements, police reports, and medical reports, and negotiated with individual claimants or their attorneys. Consistently assigned the most difficult cases, which often involved deaths or paralysis. For cases being prepared for trial, introduced the case to the attorney and made recommendations for defense strategies. Right up to trial day continued to negotiate with claimant attorneys and usually settled cases to the satisfaction of both parties.