Medical Workers Compensation
Resume:
Alexia Watkins
Valrico, FL *3596
**********@***.***
Job Objective: After years of experience, seeking work as a Workers Compensation
Adjuster/Medical/Loss Time within a qualified and stable company.
Highlights of Qualifications:
Experience in managing complex litigated workers’ compensation claims
Knowledge of medical terminology
Ability to handle confidential information
Ability to lead with integrity, honesty and trust
Ability to deliver reliable, unique and leading edge solutions
Excellent written and verbal communication and interpersonal skills
Strong analytical and computer skills
Professional Experience:
Workers Compensation Loss Time Adjuster
2009-2011 Zurich/Worker’s Compensation/Loss Time/Handled litigation files including proper file
documentation and detailed analysis of claims, Responsible for detailed data analysis and trend
identification within the medical and legal community, Managing defense counsel for the handling
of litigated claims.
Job Description:
Processed workers' compensation claims and determined compensation and benefits due on
long-term indemnity claims
Monitored reserve accuracy and filed necessary documentation with state agency
Maintained service initiative and the consistent delivery of quality claims service
Developed and managed workers' compensation claim action plans to resolution, coordinated
return-to-work efforts and approved claim payments
Managed subrogation of claims and negotiated settlements
Communicated claim action/processed with claimant and client
Reviewed, investigated and processed reports within the organization’s multi-state sites.
Recognized and removed barriers to assure high quality claims outcome.
Reviewed injury circumstances to analyze merit and estimate financial impact.
Reviewed investigative reports and other documentary evidence.
Organized and evaluated legal strategic conference calls at critical claim development intervals.
2011-2012 Zurich/Worker's Compensation/Medical Only Adjuster Trainee as secondary worker
compensation medical only adjuster, as needed.
Job Description:
Verified coverage, investigated, managed, and resolved medical only claims, under moderate
supervision, followed and established requirements and procedures, and promptly established
and maintained accurate reserves.
Enhanced injured worker’s understanding of the injury, treatment and satisfaction with care.
Interacted with the physician before and after every visit.
Recognized cases that needed medical management.
Recognized cases requiring surveillance.
Analyzed employee compliance to prescribed therapy.
2012 Nationwide/Trip Insurance Benefit Compensation Adjuster
Job Description:
Processed and handled trip insurance claims including trip cancellation, trip interruption, travel
delay, medical expense, baggage and baggage delay.
Manage Calls, Reports, and Medical Files
Attorney Represented Files
Kept current on state/territory regulations, statutes, case law and issues as well as industry
activity and trends
Contact this candidate