Post Job Free

Resume

Sign in

Customer Service Supervisor

Location:
United States
Posted:
October 22, 2014

Contact this candidate

Resume:

Tera King-Gillespie

***** ****** ** *****

Tenino, WA 98589 US

Day Phone: 360-***-**** - Ext:

Mobile: 360-***-**** - Ext:

Email: acggur@r.postjobfree.com

Availability:

Job Type: Permanent

Work Schedule: Full-Time

Work Experience:

WA State Department of Social & Health Services

PO Box 45882

Olympia, WA 98502 United States

12/2010 - 06/2014

Salary: 3,918.00 USD Per Month

Hours per week: 40

Program Specialist 3

Duties, Accomplishments and Related Skills:

Manages a case load of 100-120 Worker's Compensation claims, industrial injury and occupational illness claims. Special projects: LEAN. Employer representative to cohesively work with LIN for compensation and medical benefits to employees. Collects data, conducts research and investigates fact finding and medical evidence to ensure legal orders issued by LNI are according to RCW's, WAC's and department policies. Specialized experience include state institutions, juvenile facilities and offices statewide for DSHS. Plans and carry out all aspects of the claims review and developments, resolves conflicts that arise, interprets WAC and RCW to stakeholders. Handles complex and controversial claims to include but not limited to injury & psychological, recommending decisions to include light duty or transitional return to work job analysis and light duty job descriptions. Provides excellent customer service by assessing needs and provide information for assistance to resolve problems to satisfy customer expectation. Set personal goals, initiative, effort and commitment to completing assignments in a timely manners. Works with minimal supervision. Communicates information in an organized manner with best practices and LEAN. Flexible to change and new information, adapting work behavior methods taking into consideration of FMLA, S/L and LWOP for claims processing. While observing the Americans with Disabilities Act; Collective Bargaining agreements in relation to industrial injuries; Occupational safety and health reporting requirements and the assault benefit statute. Administer state wide transitional return to work program working with employees, supervisors, facility administrators, medical and the Department of Labor and Industries to identify transitional return to work opportunities. Conduct and document the analysis for the essential functions of a position in collaboration with the supervisor to work directly with medical providers and vocational counselors on determining the physical requirements of a position, arrange for workstation evaluation when needed and prepare job modification application when LNI criteria is met for LNI to purchase specialized equipment needed for return to work. Review time and attendance for accuracy in submitting Loss of Earning and to apply for Stay at Work (SAW) reimbursements through LNI for the facilities I cover, currently Region 5 Headquarters and Region 4 DDD/Fircrest, Communicate verbally and in writing with workers their supervisors. Explain the employee's rights, responsibilities and expectations when injured on the job. Maintain data analysis from management, institutions, programs and regional offices. Provide Visual Management for weekly transparency. Provide monitoring and oversight for quarterly industrial insurance payments, the annual Right to Know payments, and risk classifications assigned to DSHS by LNI. Work with Reasonable Accommodations by reviewing case histories, identifying resources to assist with an accommodation. As the claims consultant I assist HR staff, managers and appointing authority, and the employee. Processing SAW (Stay-at-Work) requests to LNI for DSHS reimbursements, collecting documentation and completing packets to ensure it meets the criteria of 66 days or 10,000.00 for return to work reimbursement. User of multiple computer programs to include HRMS, Risk Master, Outlook, Excel, BI, BATS.

Walmart Vision Center

100 Wallace Kneeland Blvd.

Shelton, WA 98584 United States

04/2010 - 11/2010

Salary: 1,350.00 USD Per Month

Hours per week: 38

Optician Apprentice

Duties, Accomplishments and Related Skills:

Provided excellent customer service by acknowledging the customer, identifying customer needs, assisting with purchasing decisions, location merchandise, resolving customer issues and concerns, and promoting products and services, while maintaining a safe shopping environment. Maintain merchandise presentation in the optical area. Maintained the optical area in accordance with company policies and procedures by properly handling insurance claims and product returns, zoning the displays, identifying loss prevention. Operates equipment such as cash registers and related tools, to process customer purchases using appropriate procedures for different payment types and items sold. Servicing customers by measuring, adjusting and repairing frames and lenses, completing eye wear/contact lens orders, requesting, reviewing the processing insurance, collecting payments for doctor services and performing and recording results of optometric pre-tests under the direct supervision of the vision center manager.

Supervisor: Raven Knight 253-***-****)

Okay to contact this Supervisor: Yes

Vandorm Real Estate

1530 Black Lake Blvd SW Ste. F

Olympia, WA 98504 United States

03/2006 - 08/2009

Hours per week: 32

Realtor

Duties, Accomplishments and Related Skills:

Interpreting WA ST law regarding real property and multiple listing rules and regulations, attend county meeting/open forum for boundary lines. Show property and identify easements along property line, marketing, continuing education and licensing. Market & advertise listings, consult buyers and sellers regarding real estate transactions, negotiate commissions, negotiate post inspection transaction, follow up seller responsibility inspection to include but not limited to septic pumper s report, water tests if on well, forced air vent cleaning and maintenance, maintaining all records and reports for timeliness of closing for seller and buyer and to attend closing escrow as the need to strategically evacuate and assume possession of property is critical for buyers and sellers, provide net proceeds report for sellers and ensure vendor amounts reported correctly if to pay out on sellers report. Member of Thurston County Assoc. Of Realtors and MLS and National Realtors Assoc. Computer use NW MLS and Outlook, Excel and Internet.

Supervisor: Self 360-***-****)

Okay to contact this Supervisor: Yes

Washington State Department of Transportation

15700 Dayton Ave. North

Seattle, WA 98533 United States

01/2005 - 08/2005

Salary: 3,727.00 USD Per Month

Hours per week: 40

Safety Officer/Safety Officer Asst.

Duties, Accomplishments and Related Skills:

Duties: Split between SO1 and Safety Officer Assist. Employer representative for employee claims case load of approximately 200 cases. Monitors claim validity of industrial injury and occupational illness claims. Temporary position in Olympia which included, HR and workers compensation. Communicates information in an organized manner with best practices. Flexible to change and new information, adapting work behavior methods taking into consideration of FMLA, S/L and LWOP for claims processing. While observing the Americans with Disabilities Act; Collective Bargaining agreements in relation to industrial injuries; Provided excellent customer services in assessing needs and providing information to resolve problems. Decision making skills based on objective medical evidence. Set s personal goals and displayed high level of initiative to resolve claims. Provided written and oral communications with correct grammar usage and spelling. Responsible and receptive to phone calls and on call accidents. Flexible and open to change with new information of facts and methodology. Occupational safety and health reporting requirement. Plans and carry out all aspects of the claims review and developments, resolves conflicts that arise, interprets WAC's and RCW's to all stakeholders. Handles complex and controversial claims to include but not limited to industrial a injury, occupational illness & psychological, recommending decisions to include light duty or transitional return to work. On call radio and phone conducting and coordinating investigation for vehicle and equipment accidents, conducting and coordination and personal injury investigations for proper corrective or preventative actions; recommends options and solutions to management for preventing accidents and injuries; Managing and administer the claims management program under Title 51. Staffing and coordinating statewide (team effort with HR/OEO return to work committee) for modified duties and OSHA reporting. respond in a timely manner to all aspects of the claim to include protests and appeals; conducted ergonomic workstation evaluations and recommendations, first aid instructor & provided safety and health education, administered and coordinated surveillance program, month end and year end reports for OSHA, composed several technical publications for the NWR Safety Bulletin, provided consultation to Safety Program Manager and attended Pre-Con meetings. Attended the Governor's Safety Conference in Seattle for Safety and Health. Computer programs, Outlook email, calendars, TRAINS, Excel and INTERNET.

Supervisor: Bob Lentz 206-***-****)

Okay to contact this Supervisor: Yes

Washington State Department of Transportation

15700 Dayton Ave. N

Seattle, WA 98533 United States

11/2001 - 08/2004

Salary: 3,727.00 USD Per Month

Hours per week: 40

Safety Officer

Duties, Accomplishments and Related Skills:

Employer representative for employee claims case load of approximately 200-250 cases. Monitors claim validity of industrial injury and occupational illness claims. Temporary position in Olympia which included, HR and workers compensation. Communicates information in an organized manner with best practices. Flexible to change and new information, adapting work behavior methods taking into consideration of FMLA, S/L and LWOP for claims processing. While observing the Americans with Disabilities Act; Collective Bargaining agreements in relation to industrial injuries; Provided excellent customer services in assessing needs and providing information to resolve problems. Made decisions based on objective medical evidence and or preponderance of medical. Set s personal goals initiative to resolve claims. Provided written and oral communications with correct grammar usage and spelling, courteous and polite, responsible and receptive to phone calls. Flexible and open to change with new information of facts and methodology. Provided Occupational safety and health reporting. Plans and carrys out all aspects of the claims review and developments, resolves conflicts that arise, interprets WAC's and RCW's to all stakeholders. Handles complex and controversial claims to include but not limited to industrial a injury, occupational illness & psychological, recommending decisions to include light duty or transitional return to work. I was a Peer Trauma Support Coordinator and team member, scheduling & conducting meetings, investigates employee WSDOT traffic accident and trauma support for fatalities. Conducting and coordinating committee review for vehicle and equipment accidents, conducting and coordinating personal injury and occupational illness claims by investigating for proper corrective or preventative actions, making recommendations to management. Administers the Worker's Compensation program under Title 51. I worked closely with all stakeholders. Decision making based on facts and objective medical. Acts on protests and appeals to department orders; conducted ergonomic workstation evaluations and provided recommendations, first aid instructor, certified flagger/instructor, provided safety awareness, administered medical surveillance program, provided month end and year end reports for OSHA. Composed a number of articles for the NWR Safety Bulletin. Attended Pre-Con meetings. Flexibility and open to change to new information and or work methodologies. Computer programs: Outlook email, TRAINS, Excel, INTERNET.

Supervisor: Sam Swenson 360-***-****)

Okay to contact this Supervisor: Yes

Washington State Department of Labor and Industries

7273 Linderson Way

Olympia, WA 98501 United States

07/1998 - 11/2001

Salary: 3,637.00 USD Per Month

Hours per week: 40

Worker's Compensation Adjudicator 3

Duties, Accomplishments and Related Skills:

Adjudicate and managed a case load of 200-250 of the most complex industrial injury claims and occupational illness claims in accordance with Title 51. Applying RCW, WAC's and department policy. I provided excellent customer service by assessing customer needs and providing information to resolve their problems or concerns. I make decisions based on fact, objective medical or preponderance of medical being committed to action in a timely fashion based on available information. Issue timely legal orders regarding benefits and issued TPD and PPD orders for permanent and partial disability. Make determinations for vocational services, and make appropriate referrals, authorize or deny plan modifications, plan development and funding, monitor progress and take ongoing action. Make a decision if time loss compensation is payable, establish initial rate of compensation and issue a wage order. Respond to liens or other reductions in time loss compensation benefits according to statute. Resolve and communicate decisions made in response to protests. Address board and court orders and reopening applications. Flexible and adapt to new information and methodology. Compose medical examinations assignments and investigation assignments, legal orders and letters. Projects included: Increase in appropriate claim closures and Reduction in protests and appeals by 31%. Provide direct customer service with clear and concise manner and correspond appropriately with workers, employers, doctors, and attorneys. Respond courteously to inquiries and interpret rules and regulations explaining the claim adjudication process. Lead: mentor, give guidance and counsel to lower level adjudicators on adjudicative issues. Refer cases to pension and process fatal claims. Extensive use of computer programs LINIIS, Outlook email & calendars, Imaging, HC screens, MIPS and Internet. Internal safety member for emergencies and working with on-site State Patrol for building security as well as unexpected emergencies.

Supervisor: Deb Kirpes 360-***-****)

Okay to contact this Supervisor: Yes

Washington State Department of Labor and Industries

7273 Linderson Way

Olympia, WA 98501 United States

07/1997 - 07/1998

Salary: 2,992.00 USD Per Month

Hours per week: 40

Worker's Compensation Adjudicator 2

Duties, Accomplishments and Related Skills:

Adjudicates and manages a case load of 250-300 complex industrial insurance injury claims and occupational illness claims in accordance with the industrial insurance laws under Title 51, department policy, procedure and case law. Interpret facts and apply the law in determining claim validity and ongoing adjudicative action, meeting timeliness expectations. Make determinations for vocational services, make appropriate referrals, monitor progress and take ongoing claim actions. Determine time loss rate and compensation, issue a wage order and make appropriate payment. Respond to liens or other reductions in time-loss compensation benefits according to statute. Resolve and communicate decisions made in response to protests, address board and court orders and applications to reopen prior claims. Compose medical examination assignments and investigation assignments, legal orders, and letters. Provide excellent customer service assessing the customer needs and providing information. Correspond with workers, employers, doctors, and attorneys in a courteous manner explaining processes. Interpret WAC's and RCW's and department's policy to customers in response to questions or concerns. As senior WCA2, I took initiative and provided guidance and counsel to newer level 2's and level 1 adjudicative staff on adjudicative issues. Referred fatal claims to level 3, possible pension cases and catastrophic cases, complex psychiatric cases. Acts as supervisor in absence of supervisor and level 3's. Flexible and open to new information and methodologies. Extensive use of computer programs, LINIIS, MIPS, Imaging, Outlook email, calendars and HC screens and INTERNET.

Supervisor: Sara Spiering 360-***-****)

Okay to contact this Supervisor: Yes

WA State Dept of Labor and Industries/Crime Victims Program

15700 Dayton Ave N

Seattle, WA 98533 United States

07/1996 - 07/1997

Salary: 3,310.00 USD Per Month

Hours per week: 40

Worker's Compensation Adjudicator 3

Duties, Accomplishments and Related Skills:

I applied for and accepted this temporary appointment to WCA 3 for the experience and expand my knowledge in other areas of LNI. I adjudicated & managed a case load of State-Federally funded Crime Victim Compensation Claims. Review police reports and interprets facts and applies RCW's, WAC's and department policy in determining claim validity, issue wage order and time loss benefits, determine medical and vocational services based on maximum caps allowed for services, identify 3rd party insurers. Compose medical examinations & request investigations for claim validity and complex repressed memory claims. Flexible and open to case law regarding repressed memory and crime victim claims. Exercise judgment in processing payment for payor of last resort. High level of psychiatric claims, and domestic violence. Make determination for reopening claims and issue appropriate order based on documentation. High level of customer service professional and confidential. Provided written communications to all stakeholders and documents the file. Issued all legal orders pertaining to the claim. Extensive use of computer programs, LINIIS, MIPS, Imaging, Outlook email, calendars, BPS.

Supervisor: Cletus Nnanabu Op Mgr. as the supervisor has retired.. 360-***-****)

Okay to contact this Supervisor: Yes

Washington State Department of Labor and Industries

7273 Linderson Way

Olympia, WA 98501 United States

01/1995 - 06/1996

Salary: 2,992.00 USD Per Year

Hours per week: 40

Worker's Compensation Adjudicator 2

Duties, Accomplishments and Related Skills:

Adjudicates and manage a case load of approximately 500 industrial injury and occupational illness claims in accordance with the industrial insurance laws under Title 51, policy, procedure and case law. Interpret facts and apply the law in determining claim validity and ongoing adjudicative action, meeting timeliness expectations. Make determinations for wage orders, time loss and the need for vocational services, make appropriate referrals, monitor progress and take ongoing actions. Respond to liens or other reductions in time-loss compensation benefits according to statute. Resolve and communicate decisions made in response to protests. Address board and court orders & applications to reopen prior claims. Compose medical examination assignments & investigation assignments, legal orders, & letters. Close claims appropriately. Provide direct customer service clearly and concisely, talk and correspond with workers, employers, doctors, & attorneys. Provided excellent customer service assessing customer inquiries regarding claims and to resolve questions or concerns by all stakeholders. Provided written letters and legal orders in an organized fashion with correct punctuation. Lead: Gave guidance & counsel to newer level 2's & WCA 1's on adjudicative issues. Referred fatal claims to level 3, possible pension cases & catastrophic cases, complex psychiatric cases. Paid TPD and PPD. Acts as supervisor in absence of sup. & WCA 3's. Extensive computer use. LINIIS, MIPS, BPS, Outlook, HC screens, Imaging and INTERNET.

Supervisor: Sally Kopp 360-***-****)

Okay to contact this Supervisor: Yes

Washington State Department of Labor and Industries

7273 Linderson Way

Olympia, WA 98501 United States

07/1994 - 12/1994

Salary: 2,412.00 USD Per Month

Hours per week: 40

Worker's Compensation Adjudicator 1

Duties, Accomplishments and Related Skills:

Review and adjudicates a case load of 300-400 industrial insurance injury and occupational illness claims under Title 51, level ones process the initial claims at the lowest level. However, we were short staffed and I worked WCA 2 cases for 6 months under the direction of a WCA 3 to provide necessary claim coverage. Temporary supervised when all WCA's were out of office, staff included the clerk, typist and Customer Service Specialist. Managed non compensable claims and time loss claims under the WCA 2, issued wage orders, authorized and denied treatment, review and authorize voc plans and authorize the funding and meds. Use of extensive computer programs, LINIIS, MIPS, Outlook, HC screens, Imaging and INTERNET.

Supervisor: Miryna Bell 360-***-****)

Okay to contact this Supervisor: Yes

Washington State Department of Labor and

Industries

7273 Linderson Way

Olympia, WA 98501 United States

04/1993 - 06/1994

Salary: 1,998.00 USD Per Month

Hours per week: 40

Customer Service Specialist 1 & 2

Duties, Accomplishments and Related Skills:

Duties included but not limited to: pay time loss benefits under direction of claims managers, worked correspondence to include return mail, respond to written inquires from attorney, workers, and doctors for medical documentation of injury or occupational disease claims to determine, medical panels, vocational counselor's phone calls, authorize diagnostic tests, dictate medical exams written by the WCA, review claim files, issued overpayment. I worked pilot project for imaging documents, and used the following computer screens LINIIS, MIPS, Outlook HC screens, Imaging and INTERNET. Used microfiche view at that time to review claim files.

Supervisor: Alan Siegal 360-***-****)

Okay to contact this Supervisor: Yes

Washington State Department of Labor and Industries

Black Lake Blvd to

7273 Linderson Way

Olympia, WA 98502 United States

02/1990 - 03/1993

Salary: 1,998.00 USD Per Month

Hours per week: 40

Medical Treatment Adjudicator

Duties, Accomplishments and Related Skills:

Medical Information Payment Systems: (MIPS) Accounts payable for industrial insurance claims for injury and occupational disease, inpatient, diagnostic services, time loss for medical exams only, travel, load codes and make appropriate adjustments for bill payment. Processed inpatient bills in excess of $250,000. a day. Contact employers, providers, claimants and correspond in writing, phone calls. Made recommendations to Asst. Director/Janet Morris for restructuring Medical Benefit Systems. Worked on a 1 year long project and post check for Total Claims Management and Quality Initiative projects that included Best Practices. Another project I worked on was the Request for Proposal (RFP) for Utilization Review. Computer use in LINIIS, MIPS, Outlook, Imaging.

Supervisor: Chuck Cummings 360-***-****)

Okay to contact this Supervisor: Yes

Washington State Department of Labor and Industries

GA Building 4th floor- Capital Campus

Olympia, WA 98501 United States

10/1988 - 12/1989

Hours per week: 40

Clk 2, Clk Typist 2 and Clerk Typist 3

Duties, Accomplishments and Related Skills:

I started for LNI as a Clerk 2 full time in Claims Administration in the claims unit. I answered phones, processed the claims unit mail, and returned calls to internal and external customers at the direction of the claims managers and unit supervisor. I promoted to CT2 for Regional Operations manager, Winnie Nichols. I processed the dictaphone, typing, I did the tracking of 4 unit's legislative inquiries and responses for timely processing, tracked overtime work for claims unit supervisors and processed specific information according to supervisor direction. I set up and completed a tour through the Washington State Department of Corrections Facility in Shelton for staff with claim related injuries for inmates currently serving sentence. Promoted (position reallocated)t o CT3 while working for Winnie Nichols and then transferred to the Agency Director's office under Joe Dear. I worked the switchboard for executive management and tracked direct replies, processed mail and served as the first line of meeting for the director. I attended a 3 day retreat with executive managers for claims and participated with input from line staff to managers. The supervisor has passed away.

Supervisor: Winnie Nichols Operation Mgr Joe Dear (Director's Office) 360-***-****)

Okay to contact this Supervisor: Yes

Education:

Tacoma Baptist High School Tacoma, WA United States

High School or equivalent 06/1978

Major: General

Relevant Coursework, Licenses and Certifications:

General major and requirement of 120 scripture verses for Graduation.

Job Related Training:

Washington State Department of Labor and Industries

06-1990 MTA 300 hrs (Medical Treatment Adjudicator)

12-02-1994 WCA 718 hrs (Worker's Compensation Adjudication)

03-31-1994 WCA 20 hrs Medical Terminology

07-11-1996 WCA -40 hrs Advanced round table

05-05-1999 WCA- 80 hrs Worker's Compensation add'l training, includes

includes: Crime Victims and PTSD

Washington State Department of Transportation

Safety Officer - Critical Incidents 13 hrs 5/17/2002

Language Skills:

Language Spoken Written Read

English Advanced Advanced Advanced

Affiliations:

Washington State Department of Labor and Industries - Claims Training

References:

Name Employer Title Phone Email

Janet Morris Washington State Department of Labor and Industries Regional Administrator 253-***-****

Sam Swenson Washington State Department of Transportation Safety Manager-now retired 360-***-****

John Clayton Washington State Department of Social and Health Services Juvenile Justice and Rehab Administrator 360-***-****

Pani Saleh Washington State Department of Transportation Engineer Supervisor 206-***-****

Erick P. Thomas Washington State Patrol Sgt. 253-***-**** Indicates professional reference

Additional Information:

Certificate of completion.



Contact this candidate