Hearing Representative, Workers Comp Liens, Litigation Specialist

Jessica Yaeger

Defense Workers Compensation Professional

Cell: 562-***-****

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

www.linkedin.com/in/jessica-yaeger

Highly motivated, results focused individual with 7 years of experience in Defense Workers Compensation Industry Manage heavy caseloads of 40 files with up to 250 liens, while maintaining accuracy, quality of work, quick closures, current lien matrix, status updates to client, and low-cost file workup Utilize assertive negotiation skills resolving high dollar outstanding liens with overall averages of 82% savings to clients resulting in over $3.5 million dollars in savings

Aggressive litigation strategies including MPN, reasonableness of charges/treatment, admissibility of evidence, substantial medical evidence, Official Medical Fee-Schedule, IMR, IBR, and Utilization Review

PROFESSIONAL EXPERIENCE

Work Comp Resolutions – Anaheim Hills, CA

Hearing Representative - October 31, 2015 – Present Worked independently to provide premier Lien Negotiations in house and Expert Lien Litigation at all WCAB locations for various TPA’s and Insurance Carriers.

• Managed heavy case load of up to 40 Lien files from set-up to closure.

• Designed case status reports, hearing reports, and closing reports to keep clients updated on file status

• Prepare Exhibits and move forward with Lien Conferences and Lien Trials, if cost effective, including Pre-Trial Conference Statement and Trial Briefs

• Average closures of 7-10 files per month, settled liens at 18% average

• Prepare estimated litigation budgets & present “cost-benefit” analysis of settlement versus litigation

• Average monthly billing goals exceeded

• Participate in client document retrieval at physical locations

• Prepare pleadings: Dismissal of Lien/Party, Motion to Quash, Dismissal of Adjudication, Declaration of Readiness to Proceed (DOR,) objections, co-defendant contribution, etc.

• E-Filed with File Net, EAMS, document retrieval

• Good reputation at all WCAB locations

Health Care Resource Group (HCRG) – Buena Park, CA Lien Negotiator Supervisor June 1, 2010 – October 30, 2015 Joined as Lien Negotiator, quickly recognized as top performer having exceptional organization, time management, multi-tasking abilities, highest quality of service and leadership. Promoted to Supervisor July 2011 Trained and led a team of up to 6 Negotiators while maintaining a case load of up to 100 active liens and complex lien files.

• Created and maintained Negotiator Reference Manual with cheat sheets, client guidelines, examples, “how-to’s,” proper lien handling steps for each type of services, and which increased employee confidence and standardized performance

• Educated team of negotiation strategies and arguments resulting in over 2.5 million in savings to our clientele

• Acted as representative for lien matters on behalf clients like Sedgwick, ESIS, Zurich Insurance, Everest, Gallagher Bassett, and Enstar in compliance with all client guidelines

• Negotiate with lien claimants to reduce the amount of debt the insurance company must pay. Goal was reductions of 70% or less SKILLS

• Management / Strong Leadership

• Expert Lien Negotiation; Obtain

Accurate Lien Balances to prevent file

re-open, Thorough investigation and

proper analysis of all claims docs

• Litigation: Pre-Trial Conference

Statement, Hearing Reports, Stip and

Orders, Trials, Preparation of Court

Files, service of records

• Great understanding of case law, labor

codes, regulations, SB863, SB1160,

fraudulent providers, and research

• Resourceful problem solver with proven

ability to bring quick resolution to

challenging situations as well as build

lasting relationship with co-workers and

clients

• Provide monthly Status Reports and

expected closure dates

• Ability to adapt to any and ALL client

guidelines on lien handling procedures

HIGHLIGHTS

• Earned promotion following superior

performance and demonstrated ability

to quickly learn and master job duties

• Received annual performance

evaluations where expectations were

exceeded in my job positions of both

Lien Negotiator and Lien Supervisor

(HCRG)

• Flexible and willing to challenge lien

resolution processes and procedures to

ensure the best possible outcomes.

• Provides cost-effective analysis on

“tough” liens to ensure client

satisfaction

• Received “Glass Half Full Award” 2013

and “Carpe Diem (Seize the day)” 2014

by my peers at HCRG

• Take Nothing Findings at every Lien

Trial that went forward on the record,

otherwise settlements made at a trial

level were resolved $50 - $100

regardless of lien balance

EDUCATION

INSURANCE EDUCATION ASSOCIATION

• The Institutes: Workers' Compensation

Claims Administration Certificate

(WCCA)

WHITTIER ADULT SCHOOL BUSINESS

SKILLS CENTER, Whittier, CA

• Medical Office and Medical Billing

Courses

Contact this candidate