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Click here or scroll down to respond to this candidateCandidate's Name , JR.Columbus, OH PHONE NUMBER AVAILABLE EMAIL AVAILABLELinkedIn: LINKEDIN LINK AVAILABLESUMMARY:Experienced professional with expertise in Workers Compensation Claim Management, Investigation, and Resolution. Skilled in evaluating coverage and liability, providing exceptional customer service, and managing inquiries from various stakeholders. Proficient in FMLA, ADA, and the Pregnant Workers Fairness Act. Adept at operating personal computers, utilizing Microsoft Office Suite, and analyzing complex data. Strong problem-solving abilities, exceptional communication skills, the ability to handle sensitive inquiries, leadership skills, will take initiative, time management skills, critical thinking skills and can adapt to the work environment.WORK EXPERIENCESales Representative March 2022 to PresentZipfizzIntroduces new and existing customers to Zipfizz product.Offer samples and answer questions about ZipfizzKeep Zipfizz display clean and orderlySetup display table in various Costco locationsLOA CoordinatorSedgwick March 2024 May 2024Establishes FLMA; tracks and codes documentation in accordance with internal workflow processesAnalyzes FLMA and other paid leave claims to determine eligibility, certification, payment calculations, payments and/or adjustments in compliance with client paid leave plans, policies and state and federal regulationsCommunicates decisions and on-going expectations with claimants and clientsMake timely case decisions based on service expectations as established by the clientHuman Capital Management Analyst May 2023 January 2024OHIO Department of Transportation, Columbus, OHTrack, process, monitor, and review Workers Compensation claims for ODOT employees.Scan and process OBWC and Industrial Commission mail into Origami computer system.Perform updates and edits on claims as needed.Respond to questions and concerns from ODOT field offices, and handle miscellaneous duties as required.Real Estates SalespersonColdwell Banker January 2022 January 2023Scheduled Appointments and showingsAnswered phone calls and emails about housingPrepared offers and counteroffers on housingWatched real estate market for clients housing needsUnemployment Specialist September 2022 - Dec 2022 Surge Staffing, Columbus, OHProvide excellent customer service by establishing a rapport with the Offices and the state unemployment agencies; Receive and prioritize claims, questionnaires, determinations, and other unemployment related data.Analyze individual case information by reviewing data accessed through the company database, from the investigative telephone calls or document images, to determine if the facts warrant a response; Using the details regarding an employee's separation provided by branch offices, interpret and apply state laws and regulations in response to unemployment documents.Respond to an office or state agency with all pertinent details within the time frame allowed by the state or departmental procedures.Initiate timely telephone calls, faxes, or emails to the branch offices to obtain, document or pass along needed information.Verify and analyze employee information stored in the company database prior to calling theOffice to ensure that each call is focused and complete and the office's satisfaction is achieved.Workers Compensation Specialist March 2021 - September 2022Surge Staffing, Columbus, OHAssisted field offices with resolving incidents and claims of injury.Prepared files for industrial commission hearings, and administered drug testing programs.Monitor and review changes in legislation both at Federal and State level and make c angels as needed to ensure the compliance of the company.Wage Service Specialist February 2015 - April 2019State of OHIO Bureau of Workers Compensation, Columbus, OH.Determined wages to be paid to workers injured on their job by gathering wage information by fax, phone, and email.Responded to inquiries from interested parties such as the injured workers, employers, legal representatives, and employers' legal representatives within a 24-hour time frame.Formulated all wage calculations within 5 days per employer mandates.Medical Claims Specialist Apr 1993 - February 2015State of OHIO Bureau of Workers Compensation, Columbus, OHDecided 80% percent worker's compensation claims assigned within 14 days of receipt by gathering information by fax, phone, email, and regular mail as required.Responded to inquiries from interested parties such as injured workers, employers, medical providers, Managed Care Organizations (MCO's) and attorneys within a 24 to 48-hour time frame.Updated claim information such as demographic, injury and other information as needed within a 24hour time frame.Administered all assigned worker compensation claims assigned within the legal limit of workers compensation law (21 -day minimum with a 28-day maximum).MILITARY:US MARINE CORPS, Honorable DischargeEDUCATIONMASTER'S DEGREE, Human Resources ManagementKeller School of ManagementMASTER'S DEGREE, Public AdministrationKeller School of ManagementBACHELOR'S DEGREE, Technical ManagementConcentration: Health Care ManagementDeVry UniversityLICENSESOhio Insurance Salesperson Life, Health and Accident |
