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Customer Service Human Resources

Location:
Louisville, Kentucky, 40243, United States
Posted:
March 21, 2011

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J. ******* ******

*** ******* ***** . **********, ** 40243

502-***-****. *******.******@*****.***

Seeking to apply more than ten years' expertise in insurance claims,

customer service, and human resources in a career position that utilizes

strong interpersonal-relations,

conflict-resolution, and organizational skills.

QUALIFICATION SUMMARY

. ORGANIZATION: Utilized Microsoft Outlook and company diary systems to

efficiently complete tasks on a daily basis. Consistently maintained 0%

overdue on weekly reports and case diaries.

. MULTI-TASKING: Resolved customer concerns, completed correspondence,

managed in-coming phone calls, and interviewed employees, employers, and

medical providers in fast-paced environment.

. CONFIDENTIALITY: Maintained confidentiality with sensitive issues

regarding medical conditions, employee compensation, and disciplinary

actions.

. FAIRNESS: Practiced the Golden Rule of treating others with respect;

utilized active listening and clear communication (oral and written) with

employees and clients.

. DUAL FOCUS: Successfully balanced client needs (case resolution, budget

issues, setting priorities) with business objectives (case closure,

revenue, Best Practice Standards).

. TEAM ORIENTATION: Partnered with clients, their employees, and co-

workers.

RELEVANT SKILLS AND EXPERIENCE

Customer Service & Interpersonal Skills

. Conducted on-site visits, educating clients on services and claims

process resolution.

. Skilled at developing rapport with individuals in challenging and

stressful situations.

. Coached clients utilizing active-listening skills while maintaining

confidentiality.

Workers Compensation

. Managed 350-client claims caseload, including pneumoconiosis and hearing-

loss claims. Utilized defense counsel to coordinate medical fee disputes

on post-award cases.

. Evaluated new and existing cases for total exposure and developed action

plans to bring cases to closure, collaborating with case managers and

utilization review nurses.

. Successfully settled several post-award cases that saved in excess of 50%

of total exposure under the KAHCF program.

. Interviewed employers and employees to determine claims compensability.

Managed active caseload (200+) while maintaining an excellent closure

ratio.

. Managed medical, disability, and litigation expenses for cost-

containment.

. Identified cases for subrogation and structured settlement potential, and

directed defense attorney negotiation in securing claim resolution.

Human Resources & Safety

. Coached employees in filing complex state forms with insurance carriers.

Investigated status of payments on outstanding medical bills.

. Provided ongoing interview skill-building training to colleagues.

. Ensured stores maintained OSHA logs and filed annual Department of Labor

Reports.

. Assisted co-workers with questions on 401(k) plans enrollment, election,

and distribution.

J. ******* ****** Page 2

EMPLOYMENT HISTORY

Material Handler Louisville, KY

FedEx Express 2010 - present

. Loading and unloading inbound and outbound aircraft

. Completed ASPIRE management training program

Workers Compensation Patient Claims Coordinator Louisville, KY

Progressive Medical & Rehabilitation 2008 - 2010

. Interviewed patients for completion of intake paperwork (work comp/PIP)

. Obtained pre-certification for medical procedures

. Processed billing for x-ray and MRI scans

Workers Compensation Examiner / Sr. Adjuster Louisville, KY

GAB Robins, North America 2006 - 2008

. Reviewed cases and set appropriate reserves

. Provided detailed analysis of medical and legal exposure

. Developed action plans to posture cases for settlement or closure

Sr. Adjuster / Litigation Specialist Louisville, KY

The Frank Gates Service Company 2001 - 2006

. Reviewed new assignments; provided direction and handling recommendations

to co-workers

. Evaluated litigated cases, provided a written synopsis, and extended

settlement authority to defense counsel

. Managed high exposure cases with reserves up to $3 million

. Learned process and procedures for new jurisdictions while taking on a

new book of business

EDUCATION AND TRAINING

Master of Arts, Human Services - Executive Leadership

Lynchburg, VA

Liberty University GPA: 3.85 (anticipated May, 2011)

2011

Master of Science, Management

Louisville, KY

Indiana Wesleyan University GPA: 3.83

2010

Bachelor of Science, Business Administration

Louisville, KY

University of Louisville

1993

. Human Resources Co-op, Rally's Hamburgers - 3 semesters

LICENSES AND CERTIFICATIONS

. Kentucky Adjusters License (multi-state handling experience includes: KY,

NC, SC, TN, GA, IN, IL, MN, WI); WCLA

. Strength Deployment Inventory (SDI) Qualified Facilitator

ACTIVITIES

Commissioner, City of Woodland Hills

2008 - present

Louisville Triple Crown of Running & Kentucky Derby Mini-Marathon

2006 - 2008

Care Ministry Volunteer & Team Leader, Southeast Christian Church

2005 - 2007



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