Claims Manager Adjuster
Resume:
Crystal Henderson
**** *. ****** *** ******, CO *0015
adn26b@r.postjobfree.com
Background –
I have 21 years of multi-jurisdictional Workers’ Compensation experience as an Adjuster, Team Lead, Claims Supervisor and Claims Manager.
Experience –
Intact Insurance - Englewood, Colorado – Workers’ Compensation Claims Manager
2015 to Present
Successfully manages a team of seven adjusters and assists with the daily management and training of three supervisors.
Oversight of TPA (third party administrator) to ensure claim handling compliance with best practices and state guidelines.
Responsible for auditing claim files quarterly throughout the Workers’ Compensation line of business to ensure compliance with internal best practices and state guidelines to avoid penalties and sanctions.
Develop training, coaching and feedback plans and proactively manage performance of team members to ensure compliance with expectations.
Reduce leakage through proactive investigations, litigation management and subrogation referrals.
Assist with initial 3 point contact, obtain medical information to ensure treatment is appropriate and related, determine work capabilities, investigate red flags, obtain legal opinions, determine subrogation potential, and determine compensability on new Workers’ Compensation claims.
Assist with facilitating a return to work between the employer and the injured worker.
Coordinate and participate in claim reviews with employers, brokers, third party administrators and adjusters.
Develop proactive succession/development plans and complete ongoing assessments of team members to develop next steps in career path.
Responsible for onboarding and training new employees.
Travelers Insurance - Englewood, Colorado – Workers’ Compensation Claims Supervisor
2010 to 2015
Successfully managed a team of 12 adjusters who were responsible for handling claims under investigation, lost time claims, litigated claims, and catastrophic claims.
Completed daily file audits to ensure compliance with internal guidelines and state expectations.
Participated in customer meetings and claim reviews.
Responsible for training, coaching and development of new employees and existing employees.
Travelers Insurance - Englewood, Colorado – Workers’ Compensation Senior Claim Adjuster/Team Lead
2005 to 2010
Successfully managed a caseload of 150+ lost time, litigated and catastrophic claims.
Accountable for the development and execution of complex resolution and settlement strategies involving the careful coordination of medical, disability, and litigation resources.
Assisted employers and injured workers with all facets of medical and disability management, as well as coordination of return to work.
Presented claim strategy and settlement proposals, to internal and external parties including agents, brokers, customers, claimants, attorneys, internal management, and home office.
Participated in claim reviews with customers, agents/brokers, attorney’s, and internal business partners to develop strategies to resolve issues and move claims to closure.
Responsible for training and development of new employees and developed a mentorship program for existing employees.
Assisted Supervisor with claim reviews and development of training.
Travelers Insurance - Englewood, Colorado – Workers’ Compensation Claims Adjuster
1999 – 2005
Successfully managed a caseload of 180 medical only claims and questionable claims.
Completed 3 point initial contacts with all parties to develop the facts of loss, obtained medical records and witness statements and discussed claims with defense counsel to assist with the determination of compensability.
Participated in claim reviews with customers, agents/brokers, attorney’s, and internal business partners to develop strategies to resolve issues and move claims to closure.
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