Medical Management

Janine

M. Ianniciello

** **** ****** ( Saugus, MA 01906 ( 781-***-**** (

******.***********@*******.***

JOB OBJECTIVE

To establish myself as a committed professional in the Insurance Industry

by obtaining a position with a company that will utilize my strong

medical/legal background, effective analytical, communication and

organizational skills.

QUALIFICATIONS

. Twenty years experience as a workers' compensation claims adjuster.

. Efficient, detailed-oriented and skilled at time management.

. Strong written and verbal communication skills.

. Proficient in Pyramid Claims System, Microsoft Works/Word, Excel,

and Windows XP

PROFESSIONAL EXPERIENCE

2008 - 2009 Boston Medical Evaluations

Director of Medical Partner Management

. Recruited and credentialed physicians of all specialties on a

nationwide basis to join our network of physicians that perform

independent medical evaluations.

. Recommended appropriate medical specialist for independent medical

exams.

. Liaison between medical providers and clients to ensure that

Independent Medical Evaluations and Medical Record Reviews issues

were addressed appropriately and timely.

. Prepared monthly schedules for 25 physicians in 16 various

locations.

. Coordinated educational symposiums

2006 - 2008 Sun Life Financial, Wellesley Hills MA

Senior (LTD) Benefits Analyst

. Receive claims acknowledged receipt of claim in accordance with

ERISA Standards.

. Reviewed policy to determine coverage.

. Thoroughly investigate claim to determine compensability by contact

with employer, employee and medical providers.

. Work closely with settlement and appeals unit to resolve claims in

the most cost effective manner.

1994 - 2006 Curtin, Murphy & O'Reilly, P.C., Boston, MA

Senior Workers' Compensation Claims Administrator

. Effectively managed the inventory of over 300 Massachusetts and New

Hampshire workers compensation claims.

. Supervised self-insured department.

. Assisted associates in operations, procedures, skill development,

account management and troubleshooting difficult claims.

. Quarterly claim reviews with self-insured clients and defense

council.

1992 - 1994 The Lawrence Group, Waltham, MA

Workers' Compensation Claims Adjuster

1988 - 1992 Wausau Insurance Company, Burlington, MA

Workers' compensation claims Representative III

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