Legal Assistant Data Entry
Resume:
CLAUDIA CHAVEZ
*** ******** ***. *******, ** ****0
adt197@r.postjobfree.com
Objective:
Talented, dependable and experienced workers’ comp legal assistant seeking an opportunity to continue my career in the legal industry, customer service or office management. I am seeking employment with a company where I can use my experience and skills to grow and expand within the company.
Law Offices Of Christopher Congleton, Santa Ana, CA June 2017-June 2020
Hearing Representative/Legal Assistant
• Duties include but not limited to, open workers’ compensation claims, amend applications, file/serve documents, E-file and file reviews.
• Answer correspondence, review medical reports, fax/e-mail documents, relay settlement offers, and negotiate settlements.
• Assist applicants with their workers’ comp case, answer questions, explain the process and set expectations, explain documents, call insurance carrier to follow up on applicants’ benefits, check status of claims, agree to AME's, send out orders to subpoena records.
• Prepare notes and exhibit sheets for the attorney to attend hearings at the workers’ comp appeals board, file petitions, familiar with declarations of readiness to proceed and motions.
• Responsible for the office calendar with setting up court hearings, applicants and doctors deposition. Scheduling interpreters and court reporters when needed.
• Worker’s Comp court appearances with injured workers. Made appearances for the following type of hearings, Status Conference, Expedited Hearings, Priority Conference, Mandatory Settlement Conference, Walk-Throughs and Lien Negotiations. HCRG, Buena Park, CA
April 2016-Nov. 2016
Lien Negotiator
• Evaluated the services provided. Ensured alignment with claim, body parts and appropriateness of service based on appropriate legislation and evidence based guidelines.
• Evaluated the services provided with emphasis on duplication and over utilization.
• Evaluated provider-profiling information and delineate patterns, formulate strategies to address those patterns.
• Evaluated payment history to determine timeliness of payment and objections.
• Consulted with the medical department and use their evaluations on whether billing and coding mythology utilized by claimant meet all legal and technical requirements. 2
• Evaluated appropriateness and correctness of each CPT Code, unbundling of CPT Codes, overpricing of CPT Codes, adherence to coding clinic requirements and federal and state standards delineated by Medicare, Midi-Cal, large managed care organizations an community standards.
• Consulted with our in-house medical team to determine whether services provided meet ACOEM evidence based guidelines, appropriateness and reasonable criteria.
• Utilized the evaluation data and findings to formulate our basis or negotiation. A.C. Specialized Legal Services, Santa Ana, CA
Feb. 2010-April 2016
Supervisor/Legal Assistant
• Duties include but not limited to, assisting applicants with their workers’ comp case, answer questions, explain the process and set expectations, explain documents, call insurance carrier to follow up on applicants’ benefits, check status of claims, agree to AME's, send out orders to subpoena records.
• Prepare notes and exhibit sheets for the attorney to attend hearings at the workers’ comp appeals board, file petitions, familiar with declarations of readiness to proceed and motions.
• Answer correspondence, review medical reports, fax/e-mail documents, relay settlement offers, and negotiate settlements.
• Open workers’ compensation claims, amend applications, file and serve documents and file reviews.
• Supervise a staff of 20 people.
Law Offices of Winters and Banks, Santa Ana, CA
Dec. 2008-Jan. 2010
Legal Assistant
• Schedule Client and Doctor's depositions.
• Assist receptionist, administrative and clerical staff as needed for coverage.
• In charge of sending all Objections to Utilization Review, Denial of Medical Treatment to all parties, amending as necessary, mailing out with Proof of Service.
• Handle intakes for all new Spanish speaking applicants, in charge of obtaining locations to be served for applicant records, and sending out work orders to copy services.
• In charge of managing applicants’ wages and ensuring clients are being paid the correct amount for Temporary Disability.
• Operate office equipment such as fax machines, copiers, data base management, adobe, word processing, scanners, filing in numerical order and other applications Skills:
Bilingual English/Spanish – Fluent written and verbal, Type 45+ WPM, Proficient with Microsoft Word, Excel, Adobe, Experience in Data Entry, Provide excellent customer service, Thrive well under pressure
References Available Upon Request
Contact this candidate