Insurance Medical

SABRINA DE FARES **** Noble Avenue #**P

Bronx, NY 10460

(H) 718-***-**** (C)347-***-****

PROFESSIONAL EXPERIENCE

YORK RISK SERVICES GROUP 2010-Present

Claims Examiner- Worker's Comp Dept.

. Conduct & Complete Multi-State 3 point contact (claimant, insured &

Providers) within 24 hours

. File all necessary Workers Compensation Board Forms

. Prep files for litigations

. Determine initial reserves for new medical and loss time claims to

ensure that all bills & wages were paid.

. Determine the need to refer Case Management to ensure claimant's needs

are met

. Review & issue payments of awards from the Worker's Compensation Board

. Prepare 30 day status reports and claims reviews

. Review & process mail (Board decisions, attorney's correspondence &

authorization requests)

. Manage 100+ PPD files.

HEREFORD INSURANCE COMPANY, NEW YORK 2005-2009

Senior Worker's Compensation Adjuster

. Reviewed & processed mail (Board decisions, attorney's correspondence &

authorization requests)

. Filed NYS Worker's Compensation Board forms

. Completed three point contact (claimant, insured & provider) within 48

hours

. Reviewed medical bills for payment & causal relationship within 20 days

of receipt

. Issued bi-weekly payments to claimants

. Prepared files for hearings

. Filed notices of liens in third-party actions

. Settled cases through Section 32 process

. Negotiated settlement of outstanding medical bills

. Reviewed & issued payments of awards from the Worker's Compensation

Board

. Requested appeals and adjusted reserves

. Assigned cases for IME, Investigations and Case Management

. Prepared 90 day status reports on claims over $50,000

. Maintained 1:1 closing ratio and daily diary of pending cases

AON RISK SERVICES, New York 2002-2004

Associate Production Specialist

. Provided Operation & Premium Transaction for all lines of business

. Defined Class of Business & Coverage Types

. Processed New Business, Endorsements, Renewals, Cancellations Audits,

Premium Allocations, Third Party, Tax & Fees, Direct & Agency Premiums

. Applied Surplus tax lines for non admitted carriers

. Reconciled client discrepancies of policies & premiums

. Assisted account managers, syndicators, relationship managers, client

specialist, brokers in handling all accounting needs

SKILLS

Microsoft Windows (Excel, Word), AS400, Claims Connect, Lotus Notes, Esco

DESIGNATIONS & LICENSES

Intro to Property & Liability Insurance Principals, INS 21-Property &

Liability Insurance, INS 23- Commercial Insurance, NY,ME, DE, CT, NH,

Independent Casualty Adjuster Licenses.

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