Customer Service Management

Gini Summers

Workers Compensation & Risk Management Professional Seeking New Opportunity

**********@*****.***

Summary

15+ years of progressive responsibility leading to roles in management and team leadership experience in

complex rigorous areas of: marketing and sales, business development, claims examination, Workers

Compensation, Group Rating, Wellness, Vocational Rehabilitation, Independent Medical Examinations, FMLA,

Disability, Fitness for Duty, Analytical/Medical file review services, Risk Analysis, and Customer Service.

Specialties: Workers Compensation, Benefits, Insurance, Risk Management, Ancillary Sales, Independent

Medical Examinations, FMLA, Disability. Fitness for Duty Examinations, Customer Service,

Experience

Account Executive at AdvoCare Group/ Benefits 1 Group

December 2012 - June 2013 (7 months)

The AdvoCare Group is a family of companies specializing in Workers’ Compensation, Vocational

Rehabilitation, Third Party Administration (TPA) functions, Litigation Support, Group Health, Wellness and

related services and includes:

# AdvoCare Medical Management (MCO)

# Benefits 1 Group (TPA)

# VoCare Services (Vocational Rehabilitation and Litigation Support)

1 recommendation available upon request

Midwest Regional Manager at Support Claim Services

June 2012 - October 2012 (5 months)

Provided efficient medical cost containment services in the areas of Workers Compensation, Liability and

Automobile claims

Provide senior management presentations on IME and bill review services

Generate new business through existing and new client relationships.

Maximize savings for clients while providing quality evaluations and professional services within a HIPAA

compliant, paperless environment

5 recommendations available upon request

Business Development Manager at Gateway Management Services

March 2010 - October 2011 (1 year 8 months)

Developed plans and procedures necessary to gain and retain clientele.

Page1

Created and coordinated senior management presentations regarding Independent Medical Examination

(IME) Scheduling services for Third Party Administrators (TPA). Employer and Legal Counsel for workers

compensation and disability claims.

Reviewed and developed synopsis of medical records for physician review.

6 recommendations available upon request

Claims Examiner III, Self Insured at CompManagement, Inc. a Sedgwick CMS Company

May 2007 - March 2010 (2 years 11 months)

Senior Adjustor, Analyzed and processed complex or technically difficult claims by investigating and

gathering information to determine the exposure on the claim

Managed claims through well-developed action plans to an appropriate and timely resolution.

Oversaw Workers’ Compensation, Settlement, Risk assessment, Claims management.

Led client meetings and claims reviews.

3 recommendations available upon request

Account Representative at Gateway Management Services

July 2002 - May 2007 (4 years 11 months)

Scheduled Employer Specialized Independent Medical Examinations (IME) for Workers Compensation and

Disability claims.

Analyzed medical, and Physician/ Independent Examiner Reports for accuracy and completion.

Developed physician letters/medical synopsis for examination and addendums; claimant correspondence.

Coordinated Doctor selection, Provider recruitment, Managed Care Specialist, and Customer Service for

Pro-active IME case management.

1 recommendation available upon request

Senior Claims Examiner Self Insured at GatesMcDonald a Nationwide Insurance Company

May 2000 - July 2002 (2 years 3 months)

Self-Insured and Dedicated Account Claims Examiner for Employer TPA.

Reviewed claims for treatment and billing authorization, Calculated reserves, compensation and settlements.

Prepared accounts for litigation and audits, medical review and IME utilization

Senior Clinical Review Specialist; MCO ADR Coordinator; Trainer at Harrington ProHealth

CompCare (MCO)

March 1997 - May 2000 (3 years 3 months)

Ohio MCO Alternative Dispute Resolution (ADR) Coordinator and Corporate Trainer.

Senior Clinical Review Specialist for Ohio Managed Care Organization.

Team lead for 5 other specialists responsible for ADR efforts.

Specialist in the areas of Degree Of Disability Management (DoDM) and Lump Sum Settlement (LSS) .

Trained new hires in the areas of treatment and authorized treatment plans.

Liaison between Managed Care Organizations (MCO), doctors, employers and TPA.

Coordinated Health Partnership Program (HPP) and Provider training with clients.

Examiner, State Fund, Handicap reimbursement coordinator at Cantlon Associates

Page2

1993 - 1997 (4 years)

State Fund and Public Employer workers compensation examiner, Handicap reimbursement coordinator

Skills & Expertise

Workers Compensation

Compensation

FMLA

Employee Benefits

Risk Management

Negotiation

Customer Service

Claims Management

Account Management

Problem Solving

New Business Development

Insurance

Healthcare

Microsoft Office

Auditing

Public Speaking

Risk Assessment

Analysis

Accident Investigation

Deferred Compensation

Claim

Benefits Administration

Claim Investigation

Financial Risk

Accident

Business Development

Recruiting

Liability

Management

Policy

Sales

Investigation

Health Insurance

Human Resources

Training

Managed Care

Process Improvement

Medicare

Property & Casualty Insurance

Leadership

Legal Liability

Disability Insurance

Brokers

Page3

Commercial Lines

Excess

HIPAA

Casualty

Professional Liability

Strategy

Underwriting

Education

Akron Institute

Medical Administration, Medical Assisting, 1987 - 1988

The University of Akron

Business, 1982 - 1984

Hudson High School

Interests

Business Development, Marketing, Sales, Ondependent Medical Evaluations, FMLA, Workers Compensation,

Cost Containment, Management training, Sales

Page4

Gini Summers

Workers Compensation & Risk Management Professional Seeking New Opportunity

**********@*****.***

16 people have recommended Gini

"It's my pleasure to recommend Gini Summers to prospective employers. Having worked with Gini on the

operations side of the workers compensation industry as well as in client service and sales, Gini historically

generates excellent results and forges solid relationships with her clients. She is very knowledgeable in the

workers compensation area and would be an asset to any organization."

Sherm Caldwell, was Gini's client

"Gini was our workers compensation adminstrator and her skills and ability helped reduce our overall costs.

Gini was very responsive with our account and always upheld the highest integrity and professionalism.

Based on her past performance I would recommend Gini highly."

Rick Tarantelli SPHR, was Gini's client

"I worked with Gina and she is a hard working individual. She knows workers compensation and all of its ins

and outs I would highly recommend her .She would be an asset to any company she works for."

Jeri Morris-Long, Workers Compensation Examiner III, SedgwickCMS, worked directly with Gini at

Support Claim Services

"Gini is a true workers compensation professional.I enjoyed working with her at Support Claim Services and

look forward to our continued working relationship."

Michael Moss SPHR, CEO, American International Talent Acquisition Inc., was a consultant or

contractor to Gini at Support Claim Services

"Gini Summers is a talented professional whose knowledge of Workers' Compensation and its associated

Disabiilty issues is vast. In working with Gini, and for GIni, I can attest to her honesty, integrity and hard

work. She is a tremendously passionate professional whom I would highly recommend to others."

Linda Derringer, was Gini's client

"Gini is a very talented individual. She is always professional, friendly and capable. I have worked with Gini

for many years and have always received excellant service results. I highly recommend her to always come

through when hired for a service."

Melinda Murray, was Gini's client

Page5

"I had the distinct pleasure to work with Gini, as Business Development Manager of an Ohio based

consulting firm, during my employment with a workers' compensation third party administrator. I found

Gini's expertise in her field second to none. She is meticulous in the strategic process she follows and is a

master in anticipating both medical and legal issues inherent in the workers' compensation field. Gini

maintains an extraordinary rapport with medical, insurance and legal industry contacts. What makes Gini

invaluable to clients is her ability to establish direction, problem solve and bring clarification to a myriad of

issues. I would highly recommend Gini's talent and enthusiasm!"

Anne Kopf, was Gini's client

"I have had the opportunity to work with Gini on a number of occasions and I always come away with the

feeling that she is extremely knowedgeable, an expert in communications and highly professional. It is always

a pleaure to work with Gini."

Lisa Patterson, was Gini's client

"I cannot say enough about Gini's talents and performance. Her broad experience is a tremendous asset. Also,

Gini is an excellent team player and supports the efforts of everyone when involved in a project."

Brian Tarian, Attorney, Roetzel & Andress, was with another company when working with Gini at

Gateway Management Services

"I have known Gini Summers for years both as a service provider and as a peer. Gini is very knowledgeable

and active in the industry. She is a great resource often sharing new ideas and information. She is diligent and

dedicated in all aspects of her profession. Her consistent, pleasant demeanor make her a pleasure to work

with. I recommend her to anyone looking to partner with someone of her work ethic and integrity."

Jim Anderson, Partner, Infoquest, Ltd., was a consultant or contractor to Gini at Gateway Management

Services

"I have worked with Ginni as a client in the past. Ginni is very personable and is always willing to go the

extra mile for her clients. She has been very supportive of my work and I have enjoyed working with her. I

hope to continue to work with her in the future. Judith L. Murphy, AIC, FCLS"

Judith Murphy, was Gini's client

"I highly recommend Gini as a colleague in business, given her outstanding professionalism and knowledge

in her field. She has a command over the aspects and challenges in occupational disability claim management

and has always conducted herself very ethically and professionally. She is senstive to cost containment and is

very fair when approaching situations to achieve a win-win outcome for all parties involved. She is an

excellent team player and her approach to her business moves her profession forward."

Mark Querry, Psychologist, Behavioral Science Specialists, LLC, was with another company when

working with Gini at Gateway Management Services

Page6

"Gini 's extensive knowledge of the Workers' Compensation arena and enthusiasm result in a very effective

skill set."

Kelly Powers, was Gini's client

"Gini is always willing to go the extra mile, help others as needed, and does her work in a professional

manner that reflects well on the company and Gini. Her growth and drive to be the best has proven her

commitment to her career."

Rodney Threatt, Operation Manager, Sedgwick CMS, worked with Gini at CompManagement, Inc. A

Sedgwick CMS Company

"I have known Gini for many years, in her role in the independent medical examination industry and as a

claims examiner. I always chose Gini as my main point of contact in setting up exams with her company. I

could depend on her to follow through and provide reports in a timely manner. We were both colleagues at

Sedgwick. Gini is always upbeat and very personable. She brought a lot of enthusiasm to her job as a claims

examiner. Gini is a dedicated, hard worker."

Mary Pat Work, Claims Examiner III, Sedgwick CMS, worked with Gini at Sedgwick CMS

"Gini was always very timely to my inquiries and any problems I had. She made sure I was happy with the

work I had hired her company to do. Gini was very personable, and truly knew what good customer service

meant."

Jackie Spring, was Gini's client

Contact Gini on LinkedIn

Page7

Contact this candidate