Beverly Williams

*** ******-**** **, ************, TN 37127

615-***-**** acvsbn@r.postjobfree.com

Office Professional

Administrative Assistance – HR Support – Secretarial Expertise – Claims Expertise – Customer Service

Obtain a position that utilizes communication, interpersonal skills, with a background of service as administrative clerk in the United States Army and consistently recognized for superior performance.

Technical proficiency in MS Word, PowerPoint

Experienced in multi-line telephone systems, scanners, faxes and copiers

Files, screen telephone call, maintain schedules and inventories, and distributes mail.

Extensive work in the field of Workers Compensation Claims Adjudication

Experience Highlights

Administrative Support:

Follow-Up Specialist to assist with the collection of the balance due on workers’ compensation claims for hospitals in Tennessee.

Revenue Specialist to analyze workers’ compensation claims for proper payment per jurisdiction, Preferred Provider Network contracts, and state fee schedules.

Process claims forms, allocation of payments, enter claims data into systems, and interpret coding and medical terminology in relation to diagnosis and procedures with the ultimate goal of claims resolution.

Provide administrative support to senior level officers. Coordinated and managed multiple projects.

Provide Multi-jurisdictional Workers’ Compensation Case Management Review on First Reports of Injury. In cases of indemnity loss, set ultimate cost reserve and propose a plan of action for continued case management and claims resolution. Interact with employers, employees, doctors, and attorneys while reviewing incoming medical bills. Work with Nurse Case Managers to review the treatment plan and discuss recommendation for file resolution.

Reviewed incoming medical bills, handled Texas, Oklahoma, and Louisiana lost time and Medical maintenance claims to conclusion, utilized Case Management, Peer Review, Required Medical Examination, Designated Doctors, and Utilization Review to bring claims to resolution. Initiated payment of indemnity loss and impairment benefits timely.

Office Team. Nashville TN January 2015 -- Present

Enable Comp. Franklin, Tennessee May 2010 – August 2012

Insurance Overload. Dallas, Texas November 2006-August 2009

September 2002 - February 2003

Crawford and Company. Dallas, Texas February 17, 2003 - November 20, 2006

Education

Workers’ Compensation Insurance Adjuster License, Leonard School of Insurance, Dallas, Texas November 1994

Inactive License: Texas and Oklahoma. Handled claims in the following jurisdictions: TX, LA, OK, CO, IL, MO and AR

AA Medical Lab Technician, Franklin School of Science, Philadelphia, Pennsylvania October 1975

Additional Certifications HIPPA

Skills

Proficient in Personal Computers, Operating systems Windows 98 through Windows Professional 7, Enforcer, Citrix Based Operating Systems, and DOS based operating Systems, Lotus, Microsoft Outlook.

Additional Skills

19 years workers’ compensation experience starting as a claims administration assistant then to a licensed insurance adjuster. Follow adjudications policies and procedures to ensure proper payment of claims. Provide prompt customer service to providers, billing departments and other insurance companies regarding claims.