Claims Representative Specialist

MICHELE “MICKEY” WALKER, CWCP

********@*****.*** Metro Atlanta, GA 678-***-****

https://www.linkedin.com/in/mickey-walker-cwcp-61277414

Workers’ Compensation Expert

Highly capable, minimal supervision required, workers’ compensation professional. A team player who is attentive to detail and able to work in a fast pace environment producing quality and accurate results. Proficient in prioritizing and completing tasks in a timely manner, yet flexible to multitask when necessary. Excellent oral and written communication skills. Possess the ability to lead and supervise others with poised competence in a high pressure environment. Areas of expertise:

Investigation

Litigation Management

Claims Management

Audit Guidelines & Requirements

Loss Run Reports

NCCI Coding

Annual Budgets

Vendor Accountability

Human Resources

RFP Processes

Return to Work Programs

Safety

Training/Presentations

Proficiency in Microsoft Office

Six Sigma Experience

Organization/Prioritizing

Professional Experience

Applied Risk Solutions, LLC (2016 – Present)

Senior Risk Manager / WC Lead

Supervise and manage claims department

Review multiple lines of insurance (EPLI, CGL, Auto, WC) for various incidents

Conduct investigations to determine overall exposure and subrogation potential

Supervise litigated claims

Settle claims for Client’s below deductible

Audit TPA to ensure claims settle for reasonable amount

Conduct bi-annual audit with various TPA’s

Hold weekly calls with clients to review outstanding claims with goals for resolution

Provide direction and resolution of litigated claims handled by carrier

Provide instruction to assist with reduction of insurance premiums on annual basis

Attend mediations and settlements on behalf of clients to ensure cost effective claim resolution

Hummingbird Risk Advisors, LLC (2015 – 2016)

Director of Client Risk Solutions

Supervised Workers’ Compensation and Safety program for multi-state Skilled Nursing Facilities

Developed and implemented Workers’ Compensation and OSHA training

Provided direction regarding Human Resource issues

Conducted bi-annual audit with TPA

Held monthly calls with locations to review every open claim and safety goals

Completed detailed monthly analysis report for each location

Worked Compliance Department to provide Emergency Preparedness Procedures for locations

Certified resident interstate and intrastate travel complied with DOT regulations

Jacobson Group, Alpharetta, GA (2014 – 2015)

Senior Claims Examiner

Dedicated adjuster for major account

Lost time adjuster for Alabama, Georgia, & Florida

Directed all litigation assignments for resolution of claims

Responsible for filing of petitions for various benefits

Processed and paid vendors assigned to assist with resolution of claim issues

Michele “Mickey” Walker, CWCP

********@*****.*** Metro Atlanta, GA 678-***-****

https://www.linkedin.com/in/mickey-walker-cwcp-61277414

City of Atlanta, Atlanta, GA (2006 – 2014)

Workers’ Compensation Administrator

Managed workers’ compensation program for City of Atlanta

Managed workers’ compensation program for OCIP at Hartsfield-Jackson International Airport

Developed and implemented Audit Guidelines

Calculated & prepared annual departmental budgets

Worked in conjunction with Safety & Human Resources

Conducted training and presentations for various departments on Human Resources, Workers’ Compensation, and Safety

Determined authority for litigation and settlements for resolution of files

Rewrote Policies & Procedures for reduction of workers’ compensation costs

Supervised workers’ compensation personnel in multiple departments

AIG, Alpharetta, GA (2004 - 2006)

Senior Claims Examiner

Lost time adjuster for various clients within Massachusetts

Responsible for investigation and determination of compensability of lost time claims

Complied with Managed Care vendor requirements

Designated Massachusetts trainer for new employees

Committee member for “paperless environment” rollout

Spherion, Alpharetta, GA (2000 - 2004)

Claim Manager

Supervised claims administration process with TPA in 34 States

Provided direction and resolution of litigated claims within managed area

Investigated large loss and death claims

Conducted quarterly audits for central hub locations

Conducted bi-annual audits for smaller hub locations

Developed and implemented procedural outline for medical facilities

Insured posting compliance with various jurisdictions

Developed and implemented bonus program which reduced claim costs in 18month period

Implemented territory wide Return to Work Program

Provided training and presentations for various departments on Human Resources, Workers’ Compensation, and Safety

Additional Experience

RSKCo - Senior Claims Representative; Tucker, GA

St. Paul Fire & Marine Insurance Company – Senior Claims Specialist; Tucker, GA

Education

Georgia State University, Atlanta, GA

Licenses

Adjuster

Georgia, Florida, Indiana, Alabama, Louisiana

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