Lenneta Williams

Seeking temporary or full time employment

Los Angeles, CA 90033

adxm0q@r.postjobfree.com

+1-213-***-****

To achieve employment that will concentrate on my background skills and education. Also to establish strong leadership skills in the field of social services or workers compensation. Authorized to work in the US for any employer

Work Experience

Senior Workers' Compensation Claims Examiner

Intercare Holdings Insurance Services - Glendale, CA July 2022 to October 2022

Description:

PRIMARY PURPOSE: To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements. ESSENTIAL FUNCTIONS and RESPONSIBILITIES • Analyzes and processes complex or technically difficult workers' compensation claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution.

• Negotiates settlement of claims within designated authority.

• Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim.

• Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles clams within designated authority level.

• Prepares necessary state fillings within statutory limits.

• Manages the litigation process; ensures timely and cost effective claims resolution.

• Coordinates vendor referrals for additional investigation and/or litigation management.

• Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients.

• Manages claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets.

• Reports claims to the excess carrier; responds to requests of directions in a professional and timely manner.

• Communicates claim activity and processing with the claimant and the client; maintains professional client relationships.

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

• Refers cases as appropriate to supervisor and management. ADDITIONAL FUNCTIONS and RESPONSIBILITIES • Performs other duties as assigned.

• Supports the organization's quality program(s).

• Travels as required.

QUALIFICATION

Education & Licensing

Professional certification as applicable to line of business preferred. Skills & Knowledge • Subject matter expert of appropriate insurance principles and laws for line-of- business handled, recoveries offsets and deductions, claim and disability duration, cost containment principles including medical management practices and Social Security and Medicare application procedures as applicable to line-of-business.

• Excellent oral and written communication, including presentation skills

• PC literate, including Microsoft Office products

• Analytical and interpretive skills

• Strong organizational skills

• Good interpersonal skills

• Excellent negotiation skills

• Ability to work in a team environment

• Ability to meet or exceed Service Expectations

WORK ENVIRONMENT

When applicable and appropriate, consideration will be given to reasonable accommodations. Mental: Clear and conceptual thinking ability; excellent judgment, troubleshooting, problem solving, analysis, and discretion; ability to handle work-related stress; ability to handle multiple priorities simultaneously; and ability to meet deadlines

Physical: Computer keyboarding, travel as required Auditory/Visual: Hearing, vision and talking

The statements contained in this document are intended to describe the general nature and level of work being performed by a colleague assigned to this description. They are not intended to constitute a comprehensive list of functions, duties, or local variances. Management retains the discretion to add or to change the duties of the position at any time. I am certified to handle California WC claims. I have a Self Insured Certificate. Intake Specialist

Apple One- Home At Last - Los Angeles, CA

July 2021 to July 2022

Position Summary

The Intake Specialist is responsible for providing intake services to participants entering Bell Shelter non- treatment program. The Intake Specialist will collaborate closely with The Lead Intake Coordinator to ensure all bed vacancies are filled, participant data is accurate, and all intake items are submitted within given deadlines. The Intake Specialist will promote the self-sufficiency of the participant during their stay, while providing the required documentation per our requirements. Essential Functions

• Collaborate closely with the Lead Intake Coordinator to ensure all bed vacancies are filled.

• Ensure all intake calls and/or emails are answered professionally and within a timely manner.

• Responsible for submitting all intake items are within given deadlines.

• Ensure that intake department is properly staffed during designated intake operating hours.

• Monitor daily chores and bed checks for shelter non-treatment programs and submit daily chore report to Lead Intake Coordinator, Case Managers and Program Managers.

• Assist Lead Intake Coordinator in completing daily data entry. This includes but not limited to daily bed services and program enrollments.

• Complete required intake testing and property searching, such as UA testing and Covid testing.

• Assist Lead Intake Coordinator with ensuring that all required program reports and/or documents are submitted in a timely manner. This includes but not limited to daily DMH occupancy reports, daily census report, occupancy statistics, monthly tracking sheets for applicable contracts, daily house roster, daily bed services.

• Conduct daily phone screenings for program eligibility, schedule, and complete daily intakes for potential participants for all programs.

• Ensure that all incoming participants are run through registered sex offender registries prior to entry into program.

• Actively collaborate, develop, and foster linkages with Veteran Outreach Manager and other social service agencies to ensure all bed vacancies are filled accordingly.

• Assist Lead Intake Coordinator to maintain all intake documentation necessary, regularly, and accurately, for each participant across all Programs. This includes but not limited to data entered and uploaded onto the applicable database and in the paper file (example: initial case note, bed services, etc.)

• Assist Lead Intake Coordinator with reporting all vacancies daily to each funder and/or department as deemed necessary.

• Ensure that all entering program participants are enrolled into HMIS system with 24hrs of entering program.

• Assist in assigning and transferring files to case managers within one (1) business day of participant’s enrollment.

• Ensure and assist in creating badges for all participants and staff within one (1) business day of participant’s enrollment or request of replacement card.

• Assist Lead Intake Coordinator in creating participant sign in sheets upon entry and ongoing/monthly basis, this includes but is not limited to GPD, CAST and DMH.

• Attend intake department meetings with Lead Intake Coordinator, Program Managers and Quality Assurance Coordinator to ensure that all intake forms are current and in compliance with program requirements for all Programs.

• Ensure all program enrollment requirements are met before enrolling participant.

• Collaborate with Problem Solver Coordinator and Lead Intake Coordinator in order to apply diversion methods to reduce inflow to shelter for individuals who have access to other housing resources.

• Assist in conducting daily orientation of all new intakes on house rules and shelter services.

• Responsible for the accuracy and data integrity of participant data entered on and/or uploaded onto database and in the paper file.

• Work with Lead Intake Coordinator, Case Managers, and Quality Assurance Coordinator to ensure database accurately reflects current bed occupancy.

• Assist with audit preparation and assigned file auditing to maintain all elements of participant data both digital and paper format with emphasis on accuracy, thoroughness, and timeliness.

• Ensure intake team is assisting in conducting all Housing Follow ups within the given timeframe as required by the funder/supervisor. Including but not limited to THP contract, and GPD contracts.

• Ensure all intakes are conducted with a “whatever it takes” approach, while practicing Trauma Informed Care, Harm Reduction and Housing First Models.

• Ensure basic essentials are provided at initial intake meeting such as basic hygiene, linen, and clothing.

• Ensure linen closet is properly stocked with bed rolls and ensure front desk has bed rolls for walk-ins.

• Attend trainings and meeting as deemed necessary by funders and/or management, both on and off site.

• Communicate effectively and collaborate with Lead Intake Coordinator, all participants, peers in all departments, outside providers and/or management.

• Report all disciplinary concerns and notable incidents to program staff. Responsible for deescalating, investigating, and/or problem-solving participant incident reports and/or grievances. If necessary, file appropriate mandated incident report.

• Must be able to work evenings, weekends, holidays, and temporarily beyond normal working hours and/or in other positions/departments, when necessary.

• Perform other duties as assigned by Program Managers, Director of Clinical Programs, Associate Director, and/or Director.

• Other duties include but not limited to assist in random locker searches, daily rounds, U/A testing, COVID testing, property roll-ups/return, downsizing of participant property, monitoring chore/meal/snack time, regularly monitoring participant bed and common areas for potential health or fire hazards. Working Conditions

Ability to walk, stand, bend, squat, climb, kneel and twist on an intermittent or sometimes continuous basis. Ability to grasp, push, pull objects such as files, file cabinet drawers, and reach overhead. Ability to operate computer, fax, and telephone. Ability to lift up to 25 lbs. Is subject to frequent interruptions from residents, shelter personnel, visitors, agencies/personnel, etc., under all conditions and circumstances. Is subject to hostile and emotionally upset residents and visitors. Due to licensing requirements, all employees/candidates for employment must be fully vaccinated and have booster shot or accept booster shot within 15 days of eligibility, unless they have an official exemption approved by The Salvation Army. This position requires employee to be vaccinated and have a booster shot against Covid-19 or to provide an approved exemption request form. Employees with exemptions must be tested for COVID-19 on a weekly basis and must provide a written copy of their test results per compliance regulations.

Minimum Qualification:

• Current knowledge of and interest in homeless populations and available supportive resources.

• If in recovery, must have 2 years of sobriety.

• Understand and support the mission of The Salvation Army.

• Must obtain CPR and First Aid certification prior to employment.

• TB-cleared prior to hire.

• Due to licensing requirements, must be fully vaccinated and have booster shot or accept booster shot within 15 days of eligibility. This position requires employee to be vaccinated from Covid-19. Skills, Knowledge & Abilities

• Driving Test and clean MVR check (if applies).

• Knowledge in HMIS preferred.

• Computer literate, Proficient in Microsoft Office applications, and ability to type 45 wpm. Basic math skills.

• Excellent time management and communication skills, both verbal and written. Professional telephone etiquette.

• Strong work ethic; must be able to complete tasks well and efficiently. Meet deadlines and work with attention to detail.

• Ability to maintain confidentiality of verbal and written information about participants, facility operations and personnel.

• Possess necessary initiative, adaptability, and responsibility to work with minimum supervision.

• Ability to work independently and/or interact with team members at all levels and promote teamwork.

• Strong interpersonal skills with both participants and staff in a professional, respectful manner. Senior Workers' Compensation Claims Examiner

Canon Recruiting Group - Santa Clarita, CA

January 1986 to September 1997

Under general supervision, this position adjudicates workers compensation insurance claims. Work involves the interpretation of insurance contracts and benefits schedules and requires excellent judgment and accurate computation ability. Work also involves extensive personal contact with others and/or can be of personal or sensitive nature. Work may involve motivating or influencing others. Recognizes the unique needs of elderly claimants and their families and acts to fulfill those needs courteously. Fostering sound, amicable relationships with individuals or entities inside and outside the Company is necessary. Primary Responsibilities:

1. Accurately interprets Long Term Nursing Care policy language and executes accordingly. 2. Makes eligibility recommendations for Supervisor consideration. 3. Accurately documents for claim direction and updates as needed. 4. Assesses various types of new information to support claim direction. 5. Recommends Nurse Care Manager Visits, Medical Consultant Reviews, Surveillance, and Independent Medical Evaluations when required.

6. Timely handling of mail and correspondence to meet/exceed company standards. 7. Communicate with claimants/representatives via phone, e-mail, or fax. 8. Handles incoming calls and returns voice mail messages timely. 9. Manages daily reports to assure productive claim handling. 10. Ability to work in an environment that embraces Best Practices. Prerequisites for the Job:

• Previous long-term care or disability claims experience or equivalent.

• Proficiency in oral and written English language communication.

• Willingness to work cooperatively with others.

• Detail-oriented.

• Able to manage multiple tasks and projects under time constraints.

• Previous experience using e-mail, Windows and Microsoft Office, and other applicable computer systems.

• Well organized.

Education

Associate in Arts (AA) in Labor Studies

Los Angeles Trade Technical College - Los Angeles, CA September 1991 to June 1993

College Degree in Workers Compensation

Insurance Educational Association - Newport Beach, CA June 1989 to June 1991

Skills

• Intake Experience

• Phone Etiquette

• Workers' Compensation

• Analysis Skills

• Computer Literacy

• Basic Math

• Quality Assurance

• Employee Orientation

• Project Management

• Communication Skills

• Case Management

• Presentation Skills

• Recruiting

• Troubleshooting

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