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Customer Service Workers Compensation

Location:
Fort Mill, SC
Posted:
September 01, 2023

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Resume:

NATASHA S. SIMPSON

**** ******* **. *****: 803-***-****

Indian Land, SC 29707 Email: adzebp@r.postjobfree.com

Professional Profile

Highly organized professional with extensive customer service experience in a variety of sectors, including insurance, retail, telecommunications and mortgage industries. Accomplished in delivering quality service in fast paced, dynamic environments with a proven ability to maintain and project a confident, professional manner while addressing customer needs. Excellent written, verbal and telephone communication skills with strengths in leadership, customer service, strategic planning and attention to detail

Education & Training

Associate Degree, Accounting, York Technical College, Rock Hill, SC – 2002

Licensed Adjuster in the following states: SC, NC, GA, FL

Areas of Expertise

•Microsoft Office Suite

•Word, Excel, PowerPoint, Outlook

•Problem Resolution

•Office Operations, Scheduling

•Data Entry, Typing 60-70 WPM

•New Business Development

•Phone Etiquette

•Faxing, Filing, Scanning

•Payroll, Financial Reporting

Professional Experience

CCMSI, Charlotte, NC 2020 – Present

Senior Compensation Claims Consultant

•Responsible for the investigation and adjustment of assigned workers compensation claims.

•Review medical, legal and miscellaneous invoices to determine if reasonable and related to the ongoing workers compensation claims. Negotiate any disputed bills for resolution. Authorize and make payment of workers compensation claims utilizing a claim payment program in accordance with industry standards and within settlement authority. Negotiate settlements with claimants and attorneys in accordance with client's authorization.

•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.

LIBERTY MUTUAL, Charlotte, NC 2015 – 2020

Workers Compensation Adjuster / STD Claims Specialist

•Communicate with injured workers, employers, various medical professionals and attorney ‘s to gather information regarding the work accident, injury and medical status, while completing a thorough investigation of the case facts to determine the needs of the file for case management, compensability and expected exposure costs.

•Manage claims within multiple funding arrangements, loss management (disability mgmt., settlement, impairment rating processing and payout)

•Document claim system and files on actions taken and establish future action plan and case direction.

SIGNATURE WASTE SYSTEMS, Charlotte, NC 2014 – 2015

OFFICE ASSISTANT/DISPATCH (Contract Position)

•Handle customer calls for new business, missed pick ups and other customer related inquires

•Work with Word, Excel, Outlook and Industry specific software (Trux/NexTraq)

•Handle check deposits, account receivable, billing, follow up on route sheets and other clerical/customer service duties

•Dispatch trucks for new pick ups, any missed pick ups and customer related calls

CITI MORTGAGE, Fort Mill, SC 2012 – 2014

Document Review Specialist-Administrative (Laid Off- Position outsourced)

•Reviewed current day documents, verifying information and validating in File Net

•Updated Mat Tool with File Net ID for government modifications, note to DRI with document reviewed

•Email customers additional information required to complete package

•Refer to program guidelines to validate accounts ready for submission to underwriter for review

AON Hewitt, Charlotte, NC 2011 – 2012

Benefits Care Claims Specialist

•Handled incoming/outgoing calls, and work related professional correspondence, including emails

•Maintained successful completion of various projects assigned by the Content Manager

•Management and coordinate of benefits and assist with any benefit inquiries.



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