Customer Service Workers Compensation

LOUIS C. DRUMMOND, JR.

Columbus, OH 614-***-**** **************@*****.***

LinkedIn: linkedin.com/in/louisdrummondinsurance

SUMMARY:

Experienced professional with expertise in Workers Compensation Claim Management, Investigation, and Resolution. Skilled in evaluating coverage and liability, providing exceptional customer service, and managing inquiries from various stakeholders. Proficient in FMLA, ADA, and the Pregnant Workers Fairness Act. Adept at operating personal computers, utilizing Microsoft Office Suite, and analyzing complex data. Strong problem-solving abilities, exceptional communication skills, the ability to handle sensitive inquiries, leadership skills, will take initiative, time management skills, critical thinking skills and can adapt to the work environment.

WORK EXPERIENCE

Sales Representative March 2022 to Present

Zipfizz

Introduces new and existing customers to Zipfizz product.

Offer samples and answer questions about Zipfizz

Keep Zipfizz display clean and orderly

Setup display table in various Costco locations

LOA Coordinator

Sedgwick March 2024 – May 2024

Establishes FLMA; tracks and codes documentation in accordance with internal workflow processes

Analyzes FLMA and other paid leave claims to determine eligibility, certification, payment calculations, payments and/or adjustments in compliance with client paid leave plans, policies and state and federal regulations

Communicates decisions and on-going expectations with claimants and clients

Make timely case decisions based on service expectations as established by the client

Human Capital Management Analyst May 2023 – January 2024

OHIO Department of Transportation, Columbus, OH

Track, process, monitor, and review Workers Compensation claims for ODOT employees.

Scan and process OBWC and Industrial Commission mail into Origami computer system.

Perform updates and edits on claims as needed.

Respond to questions and concerns from ODOT field offices, and handle miscellaneous duties as required.

Real Estates Salesperson

Coldwell Banker January 2022 – January 2023

Scheduled Appointments and showings

Answered phone calls and emails about housing

Prepared offers and counteroffers on housing

Watched real estate market for clients housing needs

Unemployment Specialist September 2022 - Dec 2022 Surge Staffing, Columbus, OH

Provide excellent customer service by establishing a rapport with the Offices and the state unemployment agencies; Receive and prioritize claims, questionnaires, determinations, and other unemployment related data.

Analyze individual case information by reviewing data accessed through the company database, from the investigative telephone calls or document images, to determine if the facts warrant a response; Using the details regarding an employee's separation provided by branch offices, interpret and apply state laws and regulations in response to unemployment documents.

Respond to an office or state agency with all pertinent details within the time frame allowed by the state or departmental procedures.

Initiate timely telephone calls, faxes, or emails to the branch offices to obtain, document or pass along needed information.

Verify and analyze employee information stored in the company database prior to calling the

Office to ensure that each call is focused and complete and the office's satisfaction is achieved.

Workers Compensation Specialist March 2021 - September 2022

Surge Staffing, Columbus, OH

Assisted field offices with resolving incidents and claims of injury.

Prepared files for industrial commission hearings, and administered drug testing programs.

Monitor and review changes in legislation both at Federal and State level and make c angels as needed to ensure the compliance of the company.

Wage Service Specialist February 2015 - April 2019

State of OHIO Bureau of Worker’s Compensation, Columbus, OH.

Determined wages to be paid to workers injured on their job by gathering wage information by fax, phone, and email.

Responded to inquiries from interested parties such as the injured workers, employers, legal representatives, and employers' legal representatives within a 24-hour time frame.

Formulated all wage calculations within 5 days per employer mandates.

Medical Claims Specialist Apr 1993 - February 2015

State of OHIO Bureau of Worker’s Compensation, Columbus, OH

Decided 80% percent worker's compensation claims assigned within 14 days of receipt by gathering information by fax, phone, email, and regular mail as required.

Responded to inquiries from interested parties such as injured workers, employers, medical providers, Managed Care Organizations (MCO's) and attorneys within a 24 to 48-hour time frame.

Updated claim information such as demographic, injury and other information as needed within a 24hour time frame.

Administered all assigned worker compensation claims assigned within the legal limit of workers compensation law (21 -day minimum with a 28-day maximum).

MILITARY:

US MARINE CORPS, Honorable Discharge

EDUCATION

MASTER'S DEGREE, Human Resources Management

Keller School of Management

MASTER'S DEGREE, Public Administration

Keller School of Management

BACHELOR'S DEGREE, Technical Management

Concentration: Health Care Management

DeVry University

LICENSES

Ohio Insurance Salesperson Life, Health and Accident

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