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Click here or scroll down to respond to this candidate Candidate's Name
Street Address
PHONE NUMBER AVAILABLE EMAIL AVAILABLE
PROFESSIONAL EXPERIENCE
Lost Time Adjuster 10/2019 - Present
Corvel Corporation White March, MD
Initiate indemnity payments in a timely manner and maintain diary for ongoing payments as required.
Make timely and proper completion of State filings of all required forms.
Promptly approve medical bills for payments.
Promptly investigate and determine validity and compensability of the claim.
Provide customer service to clients including claim reviews.
Prepare hearing preps for defense counsel.
Control and manage medical issues.
Control and manage litigation claims.
Administer and resolve claims in a timely manner in accordance with company guidelines and legal
statures.
Medical Only Claims Specialist 01/2019 - 10/2019
Corvel Corporation IOS Staffing White Marsh, MD
Investigate claims as reported and determine injured worker s eligibility for
Workers compensation benefits.
Administered indemnity and medical benefits for workers compensation claims.
Maintained positive relationships, created high level of satisfaction with our clients.
Managed the progression of the claims process thru collaboration with physician, nurses
attorneys and other parties as needed.
Workers Compensation Administrator 10/2015 07/2018
Platinum HR Management - Brooklyn, NY
Examined and evaluated claims for payment for various workers compensation
benefits under health, dental, life, disability or other insurance programs.
Approved the adjuster with information for denial of claims as appropriate, initiate payment
action and request adjustment to funds reserves as needed and settlement dollars.
Made contacts (4 point contact) with client, adjuster, employee and provider.
Responsible for claims review with carrier adjuster regarding open cases.
Setup and manage the individual claims reviews with clients and regional team members.
Reviewed the out of work and work restriction reports and make all necessary changes that are
applicable.
Updated OSHA logs making sure all injury reports are entered accurately.
Submitted new claims to correct insurance carriers.
Claims Representative 04/2013 - 10/2015
Gallagher Bassett Services - Manhattan, NY
Handled the investigation of medical only claims for NY, NJ and PA jurisdictions.
Evaluate, investigate and confirmed compensability of medical only injury claims with store
managers, risk managers, claimants and physicians.
Schedule medical appointments with recommended referrals to specialist and set up
transportation.
Established and monitor claim reserves for review and approval of medical bill payments.
Responsible for time sensitive claim management until resolution of claims with adherence to
client specifications.
Medical Only Adjuster 3/2009 - 04/2013
Gallagher Bassett Services - Columbia, MD
Handled the investigation of medical only claims for MD, VA and DC jurisdictions.
Exercised proper judgment and decision making to analyze the claims exposure and to determine
the proper course of action.
Handled claims consistent with our clients and corporate policies, procedures and Best Practices
and also in accordance with statutory, regulatory and ethical requirements.
Responsible for paying internal and external bills.
Technical Assistant 1/2008 - 3/2009
Gallagher Bassett Services - Columbia, MD
Provided assistance to the branch/area manager and assisted supervisors in the overall branch
workflow process.
Created documents using word processing software including letters, memos, forms, reports, and
certificates of insurance.
Handled routine administrative work including dictation, data entry, mail processing, and routing
incoming calls.
Administrative Assistant / Bookkeeper 4/2004 - 1/2007
Intuitive Business Concepts - Columbia, MD
Provided administrative project support to four partners and sixteen computer technicians.
Coordinated travel arrangements including, making airline and hotel reservations and prepared
itineraries.
Set up management meetings, conference calls, and special events.
Maintained office supplies. Assembled training packages.
Processed monthly expense reports based on supporting documents.
Prepared payroll for twenty employees. Handled all new employee orientation, including
providing guidance on benefit plans and documents.
Prepared correspondence, including offer and rejection letters.
Prepared month end reports for clients.
Utilized Quicken database to organize and maintain company confidential personnel and client
records.
Leasing Consultant 4/2002 4/2004
Garrison Forest Apartments - Owings Mills, MD
Established rapport with potential tenants to explain lease guidelines and apartments features.
Leased apartments to future residents and achieved necessary sales and move-in goals.
Prepared move-in packages and conducted move-in orientations.
Assisted in completing applications and all required forms.
Conducted tours of apartments. Collected deposits and fees.
Patient Representative A/R A/P 4/2001 4/2002
McBee Associates - Columbia, MD
Reviewed account receivables and payables for various clients.
Assisted in training new employees.
Acted as liaison between patient and billing office to ensure patient satisfaction.
Followed up on claims to resolve issues and secure payments.
Posted cash to accounts and disbursed payments.
Coordinated manual billing of co-payments, rental equipment, and late charges.
EDUCATION AND PROFESSIONAL DEVELOPMENT
New York State Independent Adjuster License
For Motor Vehicle No-Fault & Workers Compensation and Health Service.
2013-2020
Howard Community College, Columbia, MD
Business Management
2003-2005
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