Customer Service Manager

ANTHONY L. FULLER

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

Mira Loma, CA 91752

714-***-**** ***********@*******.***

Professional Summary

Insurance professional with a 21-year track record of success managing

individual and group Workers' Compensation programs for leading insurance

and insurance investigation firms. Key competencies include:

Client Relations & Customer Service Customer Training & Education Programs

Insured / Self-Insured / Captive Claims Management Background

Programs

Account Acquisition & Retention Expertise in Medical Billing /

Strategies Terminology

Employee Hiring & Supervision Claims Advocacy / Reserves

Claim Reviews, Audits & Trend Analysis State Insurance Law Knowledge

Career History & Accomplishments

HORSEMEN INVESTIGATIONS Customer Service Manager Huntington Beach,

CA: 2/2010 to Present

Manage Sales Support staff productivity in order to prevent, identify, and

resolve customer related issues in order to achieve extraordinary customer

service, for this leader in the insurance claims investigation industry.

. Set staff proficiency standards and establish measures for

accountability.

. Monitor and evaluate efficiency of Sales Support functions for

maximum productivity.

. Effectively utilize web-based management system to obtain relevant

data/reports for review and analysis to identify improvement

opportunities.

. Identify and address training needs.

. Conduct new business Review and assigned new losses to the claim

adjusters.

SEABRIGHT INSURANCE Claims Manager Orange, CA: 11/2008 to 12/2009

Recruited by SeaBright to supervise five Workers' Compensation Claim

Adjusters and one Claims Assistant to process workers compensation claims

in accordance with state rules and regulations, account instructions, and

Best Practice guidelines. Additionally assist with the day-to-day

operations of the claims office.

. Review and assign new losses to the claim adjusters.

. Review cases for appropriate reserves.

. Coordinate and participate in quarterly and/or bi-annual claim

reviews.

. Performed supervisory oversight of adjuster assigned workers'

compensation claims.

. Conduct/participate in new business installation meetings.

. Communicate with Underwriter's regarding account performance, issues

and concerns.

MARSH INC. VP - Workers Compensation Consultant Los Angeles, CA: 4/1999

to7/2008

Provided claims advocacy for this global leader in insurance and risk

management. Advised an assigned client base on how to perform effective

claims management for insured, self-insured, and captive insurance

programs.

. Delivered successful workers' comp advocacy on complex claim issues

in accordance with client/broker service agreement.

. Coordinated and conducted productive workers' compensation claim

review meetings with client and Carrier/TPA representatives to ensure

satisfactory progress toward resolution, resulting in reserve

reductions from $5,000 to $300,000.

. Conducted periodic review of loss data to analyze and identify loss

trends and old "high dollar" claims in an effort to determine cost

saving opportunities. Efforts resulted in improved risk controls and

the movement/monitoring of old "high dollar" claims.

. Coordinated and conducted various diagnostic services to assist in

the improvement of client workers' compensation programs

TRAVELERS INSURANCE Unit Manager Brea, CA: 1/1991 to 4/1999

Supervised teams of up to eight Workers' Compensation Claim Adjusters in

accordance with state rules and regulations, account instructions, and Best

Practice guidelines.

. Conducted quarterly and bi-annual claim reviews in accordance with

account instructions.

. Performed supervisory oversight of adjustor assigned workers'

compensation claims at 30, 60, 90 and 180 days.

. Conducted monthly quality assurance reviews of 3-5 randomly selected

claims to ensure regulatory compliance and account instruction

adherence.

. Responsible for hiring, training, and supervision of staff including

two Nurse Case Managers, two Claim Assistants, and up to eight Claims

Adjustors. Training curriculum included Best Practices training, as

well as instructing the entire staff on the company's "Achieving

Extraordinary Customer Relations" (AECR) methodology.

TRAVELERS INSURANCE Claims Adjuster - Workers' Comp Brea, CA: 5/1989

to 1/1991

Under supervisory direction, ensured satisfactory claim resolution via the

investigation of new notices, effective medical management (including

return-to-work), litigation oversight, and the negotiation of settlements

while maintaining a caseload of approximately 150 to 170 cases.

. Provided appropriate and timely medical and indemnity benefits on

accepted claims, as well as issuing timely denials of non-compensable

claims.

. Settled claims within appropriate authority limits or sought

authority from clients as outlined in the account instruction limits;

obtained appropriate authority limits from client, when required.

. Prepared periodic status report summaries in preparation for claim

review meetings with clients and broker representatives.

Education, Certifications & Industry Involvement

BS Degree, Speech Communications, Oregon State University, Corvallis, OR

. Associate of Risk Management (ARM) designation

. Self-Insurance Plans (SIP) certification

. Fire and Casualty broker's license

. Completion of extensive professional in-house sales training

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