Customer Service Management
Resume:
Sylvia Medina
Stafford, TX ****7
OBJECTIVE:
To be afforded the opportunity to utilize my knowledge and skills while contributing to your organization’s success.
LICENSE:
Texas Worker’s Compensation Adjuster: Type 03 License KNOWLEDGE & SKILLS:
Knowledge of Texas Workers' Compensation old law and new law knowledge of insurance industry procedures, computer literate effective communication skills telephone etiquette people oriented team player quick learner and bilingual.
EMPLOYMENT HISTORY:
December, 2015 – May, 2016, TriStar Risk Management, Houston, Texas Sr. Claims Examiner
● Investigated worker’s compensation claims according to Texas Law and Statutes for the
● City of Houston and appropriate handling of claims according to client instructions. August, 2014 – December, 2015, AS&G Claims, Houston, Texas Sr. Claims Adjuster
● Medical Management handling of old and new law claims.
● Utilizing appropriate cost management techniques to reduce overall cost of claims.
● Prepare state filings when warranted.
● Manage reserves adequately throughout the life of the claim
● Providing good customer service to incoming and outgoing calls September, 2005 – June, 2014 Texas Mutual Insurance Company, Houston, Texas Workers' Compensation Claims Specialist II
● Investigated worker’s compensation claims according to Texas Law and Statutes.
● Ensured regulatory compliance and proper claims handling.
● Examined claim forms, police, hospital medical records and other documents to ascertain compensability appropriately
● Contacts made with Policy Holder, Injured Employee, Witnesses and any other appropriate parties to determine compensability.
● Administered income benefits to injured worker appropriately.
● Managed reserves adequately throughout the life of the claim.
● Utilized appropriate cost management techniques to reduce overall costs of claims.
● Prepared monthly claim status reports to policyholders.
● Prepared state filings when warranted Investigated claims to determine 3rd party potential or contribution. Continued contacts with Policyholders and Insured Worker’s throughout life of file. EDUCATION:
Willowridge High School
Missouri City, Texas
Diploma: May, 1983
Bradford School of Business
Houston, Texas
Certificate of completion, December 1983
REFERENCES:
Available upon request
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