Mary Hall

Sr Resolution Manager

North Venice, FL 34275

ad2lpg@r.postjobfree.com

+1-941-***-****

I have handled all types of work comp claims. Minor to catastrophic. I am very knowledgeable on the litigation piece. Very proactive with moving claims to resolution. Authorized to work in the US for any employer

Work Experience

Senior Resolution Manager

Gallagher Bassett Services - North Venice, FL

January 2016 to Present

Areas of practice include the handling of workers' compensation claims in multiple jurisdictions for commercial small business & Risk Management Accounts.

• Performs a combination of duties in accordance with departmental guidelines.

• Interprets more complex or unusual policy coverages and determines if coverages apply to claims submitted, escalating issues as needed.

• Set activities, reserves and authorizes payments within the scope of authority. Ensures issuance of disbursements while managing loss costs and expenses.

• Coordinates and performs investigations and evaluates claims and suits through contact with insureds, claimants, business partners, witnesses and experts.

• Proactive light duty return to work. Seeks early resolution opportunities, Identifies files that have potential fraud with referral to SIU.

• Utilizes negotiation skills to develop complex settlement packages.

• Identifies claims with third party recovery potential and coordinates with subrogation/salvage unit.

• Partners with attorneys, account representatives, agents, underwriters, doctors, nurse case managers and insureds to develop a focused strategy for timely and cost effective resolution of more complex claims.

• Analyzes claims activities. Prepares and presents reports for management, to include special projects and presentations.

• Responsible for input of data that accurately reflects claim circumstances and other information important to business outcomes.

• Provides guidance and assistance to other claims staff and functional areas.

• Keeps current on state/territory regulations and issues as well as industry activity and trends. Accomplishments: National Adjuster Recognition Award four (4) years in a row, recognized as "exceeding account expectations." CNA Cornerstone Award recipient Workers Compensation Specialist

CNA Insurance Company - Nashville, TN

September 1993 to December 2015

Investigate,evaluate,negotiate workers compensation claims for large risk management accounts Workers Compensation Specialist

Aetna Insurance Company - Nashville, TN

January 1981 to August 1993

Evaluate, investigate, negotiate all aspects of workers compensation claims in accordance with the jurisdictional guidelines in multiple states

Education

High School Diploma. Some College in Business

Father Ryan High School - Nashville, TN

September 1972 to June 1975

Skills

• Excel, Microsoft Office, Outlook (10+ years)

• Leadership

• Administrative experience

• Medical billing

• Communication skills

• Organizational skills

• Workers' Compensation

• Human Resources Management

• Expense Management

• Employee Orientation

• Excellent handling of WC claims (10+ years)

Certifications and Licenses

Licensed in multiple states

September 1996 to Present

Licensed to handle work comp in the following states; TN, LA, NC, SC, GA, AL, MS, FL, KY, IN Professional In Human Resources

Additional Information

• Seasoned professional with over 25 years experience investigating, evaluating, negotiating workers compensation claims from inception to closure. Licensed in multiple jurisdictions including, but not limited to the following states; TN, FL, AL, AR, LA, MS, VA, IN, OK, KY, NC, SC, GA.

• Provides excellent customer service in a fast paced, demanding environment handling various commercial accounts, risk management accounts that involve strict adherence to multiple special handling instructions.

• Proficient in Microsoft Office, including Outlook, Excel.

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