Human Resources Insurance
Resume:
Robert Murillo
Los Angeles, California 90012
**********@***.***
State Certified Senior Claims Examiner
Senior Claims Analyst Gallagher Bassett (Jan. 12 - present)
Administrate and adjudicate claims for California Casualty Indemnity Corporation and other smaller clients. 186 to 168 claims,
closed large number of claims, asbestos claims, large loss claims, some life pension and 100% claims – defense strategies with
defense attorneys. Reserves on all files was $29 million. New and Further claim filings, subrosa, new claim set up SB863
defenses. File review with client and reinsurance. A reasonable program and overall slowly successful file acquisition from
GAB Robins to Gallagher Bassett post file migration and update to Gallagher Bassett coding and best practices.
Senior Claims Analyst Select Staffing (May 11 – Jan.12)
Administrate and adjudicate in the Risk Management Department for the 7 th largest company in the United States.
Administrating claims for mainly California, inputting data, thorough backgrounds, on-site investigation, recorded statements,
and reviewing legal documents for California claims, approving settlements, and claims strategy, closure tactics in one of the
most aggressive safety/risk programs in California.
Claims Examiner II Tristar Risk Management (July 10 – May 11)
Administrate and adjudicate for City of Los Angeles Sworn Officer Department. Case load of over 200 claims for alpha split.
Monthly settlement request, closures, and movement of files. Weekly meetings with legal department, to direct file towards
resolution.
Claims Examiner II Sempra Energy subsidiary. SoCal Gas (Nov. 09 – July 10)
Administrate and adjudicate for unionized employees for the largest natural gas distributor in the United States. Settlements,
Diary Review, 24 hour responses, proactive, reserve analysis. Investigations, Legal Analysis, and in addition to all claim
functions, worked with time-keeper to integrate payments of sick benefits as administrated LTD plans, OSHA.
Claims Analyst LADWP (limited assignment) (Jan. 09 – Nov. 09)
Administrate and adjudicate claims for municipal, self insured, water works. Settled claims, meet with injured worker, on-site
doctors, and department for return to work situations. Settlement worksheets on all settlements, litigation preparation, closure
projects, and assisted other claims examiner where needed.
Senior Claims Examiner (III)/Claims Administrator (Mar. 06 - Nov. 07)
Insurance Overload (temp)
Zurich - administrated for largest (by volume) account for a media payroll company, warehouse, and other manufacturing plant.
90% litigated claim for a Tier III claims, some near catastrophic claims, settled claims, maintained monthly closures, maintained
diary, 3 point contact on new claims, issued bi-weekly checks, medical contact. client meetings, quarterly reviews, and legal
management, AOE/COE investigations .Other assignment was for administrative, file review, support Human Resources at
venues, and concert halls for House of (prior to the buyout by Live Nation). Provided settlement recommendations, payroll
information, ADA support, and centralization of Hob administration. Worked on providing w/c handbook for new Dallas venue,
authorized Return to WorkGrant$ within the State of Ohio, direct carrier to provide optimal case resolution. Review general
liability, and NCCI analysis, report analysis, HR training.
Senior Claims Examiner Cambridge Solutions Incorporated (Aug. 04 – Mar .06)
Administration and adjudication of large loss California Insurance Guarantee Association claims in the average of 180. Present
Large Loss reports monthly to client, maintained a steady month claims closing of 7per month, diary up to date, and mailed read
documented and responded to promptly. Settlement negotiations, C&R/Stipulations, Claims strategy, Litigation Management,
Timely bill payment, Maintain meticulous documentation on all correspondences and review of files. Maintain excellent client
relations.
Claims Examiner Broadspire (Aug. 03 – Aug. 04)
Administration and analysis of all aspects of claim adjudication for CIGA files, (i.e. insolvent Cal Comp, Legion and Superior
National). Present Large Loss reports on monthly basis to client. Reserve Changes, PD and TD payments, Legal defense
resolutions and settlements via C&R or Stipulations for various types of claims – Asbestosis, continuous trauma for professional
athletes, and other common and uncommon industrial injuries.
Claims Examiner Claim Net (temp) (Mar. 03 – Aug. 03)
Administration of mini disability claims for SCIF – L. A. Basin. Payment of TTD and medical review and analysis of claims
within the first four months of disability. Alpha split, handled the St – U alpha during an California State insurance anomaly
where SCIF had more than 50% of the market.
Insurance Educational Association - WCCA.
Self-Insurance Administration Certificate, i-VOS, Lightspeed, Portal, State Fund Applications, Training for MCSE.
Contact this candidate