Workers Compensation Adjuster
Resume:
ANDREA BEVERLY
**** ********** *****, *******, ********* 70460
504-***-****, *************.******@*****.***
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SUMMARY OF QUALIFICATIONS
Highly qualified with years of experience and excellent judgment. Louisiana Notary Public with Statewide Jurisdiction. Ability to coordinate, multitask, prioritize, work remotely and work well under pressure, with minimal or no supervision. Outstanding communication skills both in written and verbal form. Strong planning, self-starter with strong organizational and computer troubleshooting skills. Ability to work as a team member in a rapidly changing environment. Accomplished in Microsoft Office 2000, 2003 and 2013, Excel, Citrix, Aderant Total Office, OneNote, Pulse, iceBar4, Source, iManage, Carpe Diem, CMS, Hummingbird DM5, WestLaw and WordPerfect. Knowledge of Local and Federal Court rules and procedures. Knowledge of electronic filing in Federal and State Court. Typing skills 90+ words per minute.
EXPERIENCE
2020 – PRESENT CCMSI
Workers' Compensation Claim Representative I
Investigate and adjust workers compensation claims in accordance with established claims handling procedures using CCMSI guidelines and direct supervision;
Review medical, legal and miscellaneous invoices to determine if reasonable and related to the ongoing workers compensation claims. Negotiation any disputed bill for resolution;
Authorize and make payment of workers compensation claims utilizing a claim payment program in accordance with the industry standards and within settlement authority;
Negotiate settlements with claimants and attorneys in accordance with client’s authorization;
Assist in selection and supervision of defense attorneys;
Assess and monitor subrogation claims for resolution;
Prepare reports detailing claims, payments and reserves;
Provide reports and monitor files, as required by excess insurers;
Compliance with Service Commitments as established by team;
Delivery of quality claim service to clients; and
Performs other duties as assigned.
2018 – 2019 The Hartford
California, Workers’ Compensation Claims Adjuster (Remote Worker)
Completed 3-point contact on new claims within 24 hours in order to obtain information necessary to make a compensability decision on the claim;
Determined liability, initiated and control delivery of accurate and timely compensation, medical and rehabilitation benefits to qualified injured workers as prescribed by law and within State Fund's guidelines and procedures;
Drafted correspondences and reports; provided and coordinated all medical and vocational rehabilitation services to the injured worker; ANDREA BEVERLY
2227 SUMMERTREE DRIVE, SLIDELL, LOUISIANA 70460
504-***-****, *************.******@*****.***
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Handled unrepresented worker’s compensation lost time and medical only claims;
An excellent aptitude for customer service and relationship building with strong organizational skills;
Understanding of California (CA) Workers Compensation Statutory benefits and state regulatory requirements;
Calculated and assigned timely an appropriate reserve to claims and continued to manage reserve adequacy throughout the life of the claim;
Developed and managed claims though well-developed action plans; continued to work the action plan to bring the claim to an appropriate and timely resolution;
Calculated and paid indemnity and medical benefits due in a timely manner;
Participated in virtual claim file reviews;
Coordinated vendor referrals for additional investigation and/or litigation management;
Managed the progression of the claims process through collaboration with physicians, nurses, and other parties as needed
Determined if subrogation exists and takes the steps necessary to initiate recovery efforts
Annotates, categorizes and addresses incoming mail on a daily basis. 2013 – 2018 The Hartford
The Law Offices of Julie E. Vaicius
Legal Secretary, (Tort and Workers’ Compensation) Insurance Defense
Provide legal secretarial support for two senior attorneys or more. Duties include word processing, filing, and composing cover letters, Preparation of Correspondences, Petitions, Motions, Notices of Depositions, Settlement Documents, Subpoenas, Affidavits and other Legal Documents for all tort cases.
Manage all workers’ compensation cases from filing of Answer to trial preparation.
Handle Telephone Status Conference calls with the Court.
Schedule all appointments (including IME’s and SMO’s), depositions, make professional business calls, liaison between attorneys, and communicate with our clients, adjusters, insured’s, and healthcare providers.
Exercise independent judgment and decision-making abilities, and a high level of confidentiality.
Set and maintain a calendar system.
Maintain electronic files with a paperless filing system. ANDREA BEVERLY
2227 SUMMERTREE DRIVE, SLIDELL, LOUISIANA 70460
504-***-****, *************.******@*****.***
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2011 – 2013 Ungarino & Eckert, L.L.C., Metairie, Louisiana Legal Secretary, Insurance Defense
Provide legal secretarial support for two Partners or more. Duties include word processing, filing, and composing cover letters, Preparation of Correspondence, Petitions, Motions, and Notices of Depositions, Settlement Documents, Subpoenas, Affidavits and other Legal Documents.
Schedule appointments, depositions, make professional business calls and greet clients; Set and maintain a calendar system.
Open, organize and close files for clients.
Run conflicts check on new clients.
2006 - 2011 Adams, Hoefer, Holwadel & Eldridge, LLC, New Orleans, LA 70130 Legal Secretary, Insurance Defense
Provide legal secretarial support for two attorneys (Partner/Associate) or more. Duties include word processing, filing, and composing cover letters, Preparation of Correspondence, Petitions, Motions, and Notices of Depositions, Settlement Documents, Subpoenas, Affidavits and other Legal Documents.
Preparation of timesheets and billing.
Schedule appointments, depositions, make professional business calls and greet clients.
Set and maintain a calendar system.
Open, organize and close files for clients.
Run conflicts check on new clients.
EDUCATION AND TRAINING
Herzing Community College, Kenner, LA
October 2016 - Bachelor of Science in Legal Studies Herzing Community College, New Orleans, LA
July 2001 – Associates Degree, Paralegal
LICENSES AND CERTIFICATIONS
08/2019 – California Workers’ Compensation Adjuster License 07/2018 – Louisiana Auto Adjuster License
Louisiana Workers Compensation Adjuster License
01/2016 - Notary Public for the State of Louisiana My Commission is for Life
ANDREA BEVERLY
2227 SUMMERTREE DRIVE, SLIDELL, LOUISIANA 70460
504-***-****, *************.******@*****.***
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SPECIAL SKILLS AND ABILITIES
Excellent Attendance, Punctuality and Excellent Communication Skills
Typing 90+ wpm/Word Perfect 5/6/7/8/9/11, Windows 95/97/98/00/03 and 10, Windows XP/Microsoft Word and Lotus Word Pro/Excel/OneNote
InterAction/iManage/Hummingbird DM5/Workshare Delta View/WordMill/Citrix/Aderant Total Office/Source/Carpe Diem/Microsoft PowerPoint/Juris/WestLaw/ECOS
Knowledge of Medical Terminology
Handle multiple phone lines
Usage of Bates Label Generator and Electronic Transcription Module PROFESSIONAL ORGANIZATIONS
Member of the Louisiana Notary Association
Member of the National Notary Association
REFERENCES UPON REQUEST
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