Susan M. LoRusso

Cell 716-***-****

abi0fq@r.postjobfree.com

SUMMARY OF QUALIFICATIONS:

Licensed Workers Compensation representative with years of experience and a comprehensive

understanding of applicable laws, insurance principles, investigations and methods of effectively

returning personnel to work. Goal oriented, team player possessing communication, negotiations,

organization, time management, problem solving, cost reduction and customer services.

PROFESSIONAL EXPERIENCE:

ACE/ESIS 2005 to 2010

Communicated with the State Compensation Board, law offices, insured and claimants to secure the

necessary information to process claims and bring them to closure.

Investigate and settle worker’s compensation claims regarding compensability and benefit entitlement.

Conduct full investigations with claimants, insured’s witnesses, physicians and attorneys.

Manage and resolve inventory settling claims promptly and within best practice guidelines.

Work with the Special Investigations Unit to pursue insurance fraud and report to the State Attorney

General.

Communicated with vendors and negotiated pricing for durable medical equipment, independent

medical exams and Medicare set asides

Determine exposure, established adequate reserves and made timely adjustments as required.

Sedgwick CMS/GM-Delphi-Buffalo, NY 1996-2002

Workers’ Compensation Manager

Plant Liaison between New York and Michigan: trained Michigan claim representatives New York

State Laws.

Returned employees to work as expeditiously as possible by effectively working with case managers,

plant medical physicians, union representatives, and plant management.

Assisted in implementing special investigations unit, people not at work and return to work programs.

Audit Reserves on Workers Compensation

OTHER EMPLOYMENT:

Merchants Mutual Insurance & One Beacon Insurance 1993-2005

Workers Compensation claims, Disability and No-Fault Adjuster.

First Choice Proofreader

Proof read Independent Medical Exams

EDUCATION:

College: Medaille, Erie Community College

Paralegal: Tort Law, Legal Research, Investigations, Real Estate, Family Law, Estates and Trusts.

Business Courses: Business Organization and Management, Accounting, Business Law, Computer

Systems.

OTHER TRAINING:

Medical terminology, Managed Care, Insurance Fraud, Diagnostic Care.

Computers Systems: Juris, Apollo, Microsoft outlook, Vista, Microsoft word, Excel, Access

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