Customer Service Management

Sherri L. Jones

**** ***** ****** **

Grove City, OH 43123

Home: 614-***-****

Email: abhuox@r.postjobfree.com

Strong organizational and people's skills with over 20 years experience of aggressive Workers' Compensation

claim management in both the Self-insured and State fund areas. Ability to manage Employers’

Unemployment Benefits program. Have previously managed 17 direct reports from clerical positions to

Board Certified Attorneys.

EXPERIENCE

Gates McDonald and Co. Hearing Rep Supervisor Sept 05 - May 2010

Managed a service team of 17 associates. Prepared and maintained weekly schedule for attendance of 321

Industrial Commission hearings for the 16 districts all over the State of Ohio. Attended in-person and

telephone conference Unemployment Hearings presenting the employer’s position/document to preserve their

best interest. Monitored and acted upon time sensitive materials pertaining to Unemployment issues. Audited

work activities to ensure customer requirements were being met based on service plans and State regulations.

Handled customer service issues for both internal and external customers. Conducted mid-year and annual

reviews, interviewed for new hires, hired and trained new hires, maintained salary administration and other

Human Resources duties. Approved expense reports, managed business expenses with department annual

budget. Prepared monthly reports to Upper Management with statics on department results.

Gates McDonald and Co. W/C Claims Supervisor March 2003 – Sept 2005

Managed W/C Claim service team that administered claims for Ohio Self-Insured employers. Audited claims

of the Claims Examiners to ensure claims were processed according to the Bureau of Workers’

Compensations rules and regulations. Monitored for timely filing of paperwork, approved reserve

adjustments, and lump sum settlements. Audited wage calculations and payment of benefits to ensure

benefits were paid timely and properly. Conducted pre-audits of Employers’ claim files prior to the Bureau of

Workers’ Compensation state audit for compliance. Provided ongoing training to staff to ensure we remained

current with the Ohio rules and regulations of claims administration.

Gates McDonald and Co. W/C Hearing Rep August 2000 - March 2003

Provided hearing representation of State fund and Self-insured employers before the Industrial Commission

of Ohio on litigated Workers' Compensation issues. Provided follow-up hearing letters suggesting necessary

steps to ensure appropriate steps for further claim defense. Remained familiar with the Bureau of Workers'

Compensation and Industrial Commission rules and regulation, as well as current case law to provide

appropriate representation. Served as an Account Executive for several small State funded employers

overseeing problems, as well as renewal issues and fee negotiations.

Sedgwick Claims Management Claims Examiner II December 1998-August 2000

Maintained cost containment and claims management for Ohio Self-insured Workers' Compensation claims.

Processed necessary paperwork to establish new claims filed with the Bureau of Workers' Compensation.

Made appropriate medical and lost time benefits payments. Reviewed orders, motions and other

documentation to determine the plan of action. Filed appeals, motions and objections to ensure the claim is

managed effectively. Ensured all paperwork was filed timely to comply with Ohio rules and regulations.

Maintained claim reserves based on claim activity. Report claims to excess insurance carriers based on their

criteria,

Compensation Consultants, Inc Team Manager May 1997 - December 1998

Supervised 7 employees assigned to my team of 23 Ohio Self-insured clients. Reviewed all new claims for

compensability and assigned to appropriate adjuster for claim handling. Provided monthly quality control on

claims under my teams’ assignment. Prepared and attended pre-audits and state audits. Conducted claim

review and client visits. Prepared special client reports. Handled unresolved issue with clients. Stayed

actively involved in claims that had unusual circumstances.

Helmsman Claims Management W/C Claims Examiner II June 1995 - May 1997

Maintained cost containment for Ohio Self-insured Workers' Compensation clients. Filed necessary

paperwork to ensure proper management: i.e. appeals, motions. Scheduled medical exams and file reviews to

defend litigated issues. Attended hearings at the Industrial Commission to represent our clients on litigated

issues. Provided follow-up hearing letters to clients and claims adjuster making suggestions on plans of action

to further defend the case. Maintained first pay logs, hearing reports, client service logs and travel expense

reports.

Gates McDonald W/C Hearing Representative March 1993 - June 1995

Gates McDonald W/C Claims Representative May 1988 - March 1987

CCI Co. W/C Medical Examiner April 1987- May 1988

Gates McDonald W/C Medical Examiner August 1985 - April 1987

EDUCATION

Graduated. Westland High School. Galloway, Ohio.

Some college studies. Columbus State Community College.

REFERENCES

Available upon request.

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