Legal Assistant Account Specialist

Shari Brown

*******@*****.***

Workers Comp Claims Professional

Seasoned, dependable, loyal, diligent, passionate, and innovative Workers’ Compensation Adjuster; with 20+ years of experience. Specifically, California and Georgia.

Of Note

Extensive background in handling claims from inception to an equitable resolution.

Enthusiast of advance learning and technology changes. Sound work ethics and professionalism; excellent team player and communication skills; both oral and written. CEU’s, current.

Education & Certifications

University of La Verne – La Verne, CA

BS- Public Administration

Pasadena City College- Pasadena, CA

Legal Assistant Certification

Certifications:

CWCP- Certified Workers Compensation Professional

Accident, Health and Life - Georgia

o#750794

WCCA California – course work completed

Accident, Health and Life - California

oLicense# 4068016

Qualified Resident Agent

Professional Experience

Workers Compensation Adjuster

Sedgwick CMS (Temporary Assignment)

COUNTY OF LOS ANGELES SHERRIFF’S AND PROBATION DEPARTMENT ACCOUNTS

June 2021- Present

Analyze and manage claims by investigating and gathering information to determine the exposure on the claim

Manage claims through well-developed action plans for a timely and appropriate resolution

Assess liability and resolve claims

Settle claims with designated authority

Calculate and assign reserves to claims

Manage reserve adequacy throughout claim process

Calculate and pay benefits as approved

Manage litigation process and ensure cost effective claim resolution

Coordinate vendor referrals for additional investigation and/or litigation management

Effectively utilize strategic vendor partnerships to reduce overall cost of claims for our clients.

Maintain professional client relationship

Manages claim recoveries including subrogation

Ensures claim files are properly documented and claims coding is correct.

Lien Only Adjuster – Workers Compensation

CALIFORNIA INSURANCE GUARANTEE ASSOCIATION (CIGA)

June 2016- February 2021

As per Insurance Regulation code 1063(i)(2):

Use CIGA defenses

Which includes utilizing CIGA defenses, timely provision of benefits, benefit accuracy, lien settlement strategies, litigation management, reserving accuracy, lien management, and to stay current on action plan.

Plan of Action Management

Interact with various vendors and defense counsel to ensure fair and equitable resolution and file closure.

Workers Compensation Claims Examiner

ICW Group Insurance Companies (Temporary Assignment)

June 2015 – June 2016

Applied workers comp technical knowledge and customer relation skills to the daily workload to ensure fair and prompt management of cases.

Performed self-audit on workers compensation claims to ensure compliance to claims service procedures.

Evaluated accident/injury investigations for compensability and recommended resolutions.

Sr. Workers Compensation Claims Adjuster

GEORGIA ADMINISTRATIVE SERVICES, (TPA) STATE OF GEORGIA

March 2010 – March 2015

Work with counsel to manage litigated claims outcome

Serve as liaison between lawyers, medical providers, employers and employees

Investigated and managed workers’ compensation claims

Assist clients with their risk procedures

Negotiate settlements

Understand, interpret, and comply with workers’ compensation laws, rules, and procedures

Maintain professional client relationships; resolve client issues

Coordinate medical treatment

Workers Compensation Claims Specialist

SUMMIT CLAIMS CENTER, (A LIBERTY MUTUAL COMPANY)

July 2007- September 2009

Work with counsel to manage claims outcome.

Ensured compliance, compensation policies and procedures.

Managed employee injury cases.

Participated in mediations and settlement negotiations.

Analyzed inquiries and complaints and assisted in resolving all complaints.

Maintained workers compensation claims and related activities.

Related Work Experience

Workers Comp Adjuster

AIG CLAIMS — Alpharetta, GA

12/2002 – 1/12/06

Workers Comp Adjuster

THE CLAIMS SOLUTIONS – ATLANTA, GA

(Staffing/Recruitment Agency) 1999 - 2002

Claims Account Specialist – Workers Compensation

CAMBRIDGE (RELIANCE) INSURANCE SERVICES – ATLANTA, CA

Triage Coordinator – Workers Compensation

HANOVER INSURANCE COMPANY — Atlanta, GA

Workers Comp Paralegal,

SWIFT, CURRIE, MCGEE & HIERS — Atlanta, GA

Workers Comp Adjuster,

Liberty Mutual Insurance Company – Glendale CA – 1997 - 1999

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