Medical Management

MICHAEL DREW

*** ****** ** ( Aurora, IL ***** ( Cell 331-***-**** (

abh2mw@r.postjobfree.com

SENIOR CLAIMS SPECIALIST

Pioneered re-establishment of the University of Illinois's Workers'

Compensation Claims Office.

Expertly analyzed, investigated, negotiated, planned, organized, and

settled workers' compensation claims within various jurisdictions.

Optimized claims and safety management platforms through introduction of

enhanced processes, procedures, systems, programs, and tools.

Built and led talented teams of claims specialists focused on surpassing

performance quality objectives.

Directed accident investigation classes for supervisors and managers

Handled claims in the jurisdictions of Minnesota, Michigan, Missouri,

Nebraska, Kentucky, Illinois, Iowa, Indiana, Florida, Colorado, Louisiana

Areas of Expertise include:

Workers Compensation > Liability > Auto Liability > General Liability, Cost

Containment ( Medical Management Investigations ( Litigation Procedures

( Negotiations Settlements ( Corporate / Property Risk Management (

Electronic Claims Files ( Documentation ( Client Relations / Services

Medical Terminology ( Audits ( Policies / Procedures Development (

Regulatory Compliance ( Medical Treatment Options Work Return Processes (

Insured / Self-Insured Accounts ( Wrap-Up Programs ( Reporting ( Benefits /

Insurance Mediation ( Account / Case Management ( Staff Supervision (

Marketing ( Training ( Scheduling

PROFESSIONAL EXPERIENCE

VARIOUS STAFFING AGENCIES, Chicago, Illinois ( 2006-Present

Senior Workers' Comp Adjuster: Deliver expert claims management services

within multiple jurisdictions nationwide to organizations such as Sears,

Tokio Marine Insurance, and Claims One (TPA). Conduct investigations,

analysis of medical reports / documentation, and claim litigation

management to determine validity prior to trial.

Ensured effective completion of claims processing cycle, including MO,

lost time, and litigation cases.

Successfully negotiated settlements.

Analyzed loss runs to analyze problem areas

ISLE OF CAPRI CASINO, Biloxi, Mississippi ( 2005-2006

Corporate Claims Adjuster: Provided the overall review, analysis,

preparation, and reporting of claims / electronic files focused on ensuring

top accuracy for this organization spanning throughout multiple states.

Performed claims adjustment and investigation of workers' compensation,

general liability, auto, staff, property, and crime cases.

Facilitated establishment and enforcement of risk management policies /

programs, working collaboratively with specialists in the areas of

corporate and property risk management as well as 3rd party administrators.

Pioneered creation of "Risk Managers Denial Program" launched corporate-

wide.

Oversee Third Party Administrators for their handling of WC and GL, Auto

Liability claims, and conducted quarterly claim reviews.

Provide loss data to Risk Mgrs to focus on areas of safety

PROFESSIONAL STAFFING, Chicago, Illinois (2001-2005:

Drove the analysis, negotiation, and settlement of workers' compensation

claims. Administered case evaluation to determine validity, scrutinized

medical reports / documentation to conclude length and type of service, and

managed litigation for claims scheduled to go to trial.

Maintained superior levels of productivity and operational quality.

FREMONT COMPENSATION / CAMBRIDGE, Chicago, Illinois ? 1999-2001

Senior Workers' Compensation Examiner: Managed compensation claims and risk

accounts in Illinois, Indiana, and Missouri. Provided case administration,

monitored medical treatments, liaised with injured workers to document /

report progress, supported litigated cases, negotiated settlements, and

pursued subrogation. Directed litigation

Chicago TRANSIT AUTHORITY, Chicago, Illinois ? 04/98-12/99

Senior Workers' Compensation Coordinator. Responsible for the

investigation, negotiation and settlement of Worker's Compensation

claims. Maintained assigned cases and processed medical payments. Monitored

injured employee's medical treatment as well as maintained contact with

injured workers for RTW. Established reserves and adjusted them according

to the activity of the claims. Directed and work with attorneys on

litigated cases. Conducted onsite investigations.

PROFESSIONAL STAFFING, Chicago, Illinois ? 01/95-4/98

Workers' Compensation Claims Representative

Drove the analysis, negotiation, and settlement of workers' compensation

claims. Administered case evaluation to determine validity, scrutinized

medical reports / documentation to conclude length and type of service, and

managed litigation for claims scheduled to go to trial.

Maintained superior levels of productivity and operational quality

G.K. HARRIS LTD. / PREMIER, Chicago, Illinois ? 08/91 - 01/95

Senior Claims Consultant - Worker's Compensation Adjuster.

Responsible for handling responses to RFP and accounts, as well as

handling client programs. Responsibilities also included the planning and

developing of Premier. Handling temporary assignments at the client

locations. Re-established Worker's Compensation claims office for the

University of Illinois at Chicago, which is self-insured. Supervised and

trained clerical staff handled claims and instructed supervisors on

accident investigation

Argonaut Insurance Chicago, IL 04/87-07/91

Senior Account Specialist

Maintained and adjusted Worker's Compensation claims for accounts in

Illinois, Michigan and Nebraska. Maintained cost on all losses as well as

proper reserves. Periodically performed scheduled claim reviews with

account and agent. Maintained diary on all cases, audited all legal bills

and directed investigations and legal council on cases, audited all legal

bills and directed investigations and legal council on cases in litigation

to negotiation settlements and or assist council in negotiations. As an

Account Manager my duties included assisting the account with the services

provided by Argonaut. Mediated any problems that developed with the

services and assist in their conclusions. Scheduled and oversaw all claims

review for the account. As a Marketing Representative, I attended semi-

annual meetings with agents in the state of Michigan to discuss current

accounts as well as to illustrate new programs developed by Argonaut to

better service the account's needs.

Previous Employment:

May 85 - April 87 Workers' Comp Analyst with Temporary Claims

Recruiters - Chicago

Feb 81 - April 85 Account Executive with Self Insurer Services - Chicago

Aug 78 - Feb 80 Workers' Comp Claims Adjuster with Liberty Mutual -

Chicago

EDUCATION

Bachelor of Arts in Philosophy / Political Science ( Lewis University,

Lockport, Illinois

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