Workers Compensation Customer Service

BARBARA PEREZ

Torrance, CA ***** • 310-***-**** • *****************@*****.***

Professional Summary

** ***** ** ************ ******** experience in management, OWCP federal work comp, hardworking, passionate leader, and problem-solver dedicated to serve and use independent decision-making skills and sound judgment to positively impact the injured worker's care and claim.

Skills / Strengths

● Customer Service

● Claims Management

● Leadership

● Management

● Problem Solving

● Time Management

● Training and Development

● Attention to Detail

Work History

● Fully Bilingual in Spanish

● Team Player

● Positivity

● Decision Making

● Empathy

● Multitasking

● Work Ethic

● Work well under pressure

Business Consultant / Federal Work Comp Specialist, 05/2021 to Current RISE UP CONSULTING – Fullerton, CA

● OWCP federal work comp consulting and case management for injured federal employees

● Development and management of the federal workers compensation claim from the inception of the claim, including every stage in between, and the final schedule award impairment rating

- 6th edition.

Federal Workers Compensation Specialist, 11/2002 to 09/2021 RENEWED STRENGTH MEDICAL GROUP – Torrance, CA

● In charge of overseeing the development and management of the federal workers compensation department which handles work injuries for government agency employees from the inception of the claim, every stage in between, and the final schedule award impairment rating - 6th edition.

● Act as liaison between the federal injured worker, OWCP claims examiners, senior claims examiners, claims managers, CNSI, Conduent (billing & authorization company for OWCP), US Congress, various unions, nurse case managers, vocational rehabilitation reassessment program counselors, federal attorneys, personal injury attorneys, safety & HR departments, primary treating physicians, psychiatrists, neurosurgeons, foot & ankle specialists, orthopedic surgeons, federal agencies, MRI companies, hospitals, postal inspectors, and various other medical specialists

● Interpret various labor laws, regulations, policies, and requirements, including FECA, schedule awards (impairment ratings) both in fifth and six editions, disability retirement, FMLA

● Provide training, guidance, and advisory services to employees, patients, unions, employers

● Ensure compliance and promote collaborative process between all parties, manage projects, deadlines, collection and analysis of evidence, medical documentation, grievances, patient outside employment and activities

● Prepare and analyze data and reports to determine most cost effective treatment, work independently, make final determinations and financial decisions on each federal case

● Educate and market to community and employers services, offer free ergonomic training to reduce injuries in workforce

● Work marketing events to promote business

● Advise and brief staff and medical doctors of all necessary information daily to proactively maintain good communication and accuracy of information pertaining to each patient's case, work status, and treatment

● Report monthly statistical reports to owners, screen new potential cases daily, assist patients with reimbursement of pay/mileage, educate them on their federal rights, benefits, conduct weekly new patient orientations, scan, log, track correspondence received, translate for patients that are Spanish speaking, assist with upgrade of diagnoses, billing coding, ICD-10 codes, CPT codes, cross referencing treatment suites, surgery coordinating, MRI's and nerve test appointment setting and follow through, medical records review, history taking

● Review and oversee work injury cases, ie: first federal report of injury, progress reports, work duty status

● FCE and range of motion reports, causal narrative reports to ensure accurate information, causation, medical rationale, assist with surgery pre op, surgery authorizations, including expediting pending authorizations and overturning denied surgeries

● Instruct patients how to get involved as well and how to reopen their case if closed by OWCP, covering the front desk when needed, assisting heavy flow of patients and heavy phone volume, and assisting doctors, assistant, and staff.

● Conduct day-to-day administrative tasks to maintain information files and process paperwork.

● Examine claims forms and other records to determine insurance coverage.

● Research claims and incident information to deliver solutions and resolve problems.

● Identify insurance coverage limitations with thorough examinations of claims documentation and related records.

● Maintain contact with claimants and attorneys to determine treatment status.

● Analyze information gathered by investigation and reported findings and recommendations.

● Interview agents and claimants to correct errors or omissions and investigate questionable claims.

District Marketing Manager, 01/2002 to 10/2002

PEOPLE GROWERS OF AMERICA – Lakewood, CA

● Organized educational & wellness outreach programs to corporations and to their employees through health screenings, lowering the incidence of illness and injury, offering value added benefits and wellness education to maximize employee retention and productivity

● Networked very closely with hospitals, police, fire stations, non-profit organizations, professional associations such as PIHRA, nurse associations, wellness councils, chamber of commerce, and retail businesses

● Focused on all aspects of nutrition, physical fitness, employee safety, letting go of unhealthy habits, corporate image workshops, team building, time management, nutrition and weight management, etc.

Director of Human Resources, 10/2000 to 10/2001

THE PARTY STAFF, INC – Los Angeles, CA

● In charge of running corporate human resources department with total of 600 employees

● Handle all hiring, training, benefits, work comp, LOA, COBRA, unemployment claims, counseling, new patient orientations, OSHA, job fairs, heavy marketing and recruiting, open enrollment, and enforced company policies

● Educate job applicants on expected job tasks, compensation and benefits to set clear expectations

● Stay current on EEO

● ADA and other applicable federal and state policies governing employment

● Help management improve appraisal, counseling and performance optimization techniques to maximize workforce satisfaction and productivity

● Challenge and refine current recruitment and sourcing processes by suggesting actionable improvements and innovations.

● Managed other HR staff and oversaw completion of tasks and initiatives. Human Resources Administrator, 01/1996 to 01/1999

THE PORTOFINO HOTEL & YACHT CLUB – Redondo Beach, CA

● Assist with administration of HR function including employee benefits, hiring standards, procedures, maintaining personnel files, recruiting, orientations open enrollment and terminations, COBRA, LOA, unemployment claims and 401k plan, coordinate and assist all employee related events and activities as well as co-chaired employee communication committee and employee focus group, counseling staff, translating for Spanish speaking staff, and assist General Manager of hotel

● Answer employee questions regarding health benefits and 401k options

● Build and develop lasting relationships with employees, peers, upper management and outside vendors

● Educate job applicants on expected job tasks, compensation and benefits to set clear expectations

● Coordinate company-wide events structured to boost employee morale

● Stay current on EEO

● ADA and other applicable federal and state policies governing employment

● Interpret, explain, and enforce human resources policies to keep staff in compliance with standards

● Sort job applications, vetted candidates and recommend individuals for key positions

● Brainstorm with other human resource personnel to determine ways to recruit top talent

● Handle employee conflicts efficiently while following all company procedures. Education

Human Resources Management Certification

University of Phoenix - Gardena, CA

Additional training & skills

Currently enrolled in certification course for Disability Ratings, attended seminars focusing in state and federal workers compensation, labor laws, recruiting, marketing, sales, interviewing, COBRA, sales, communications, public relations, corporate marketing, Bob Proctor, Proctor Gallagher Institute, RMT Robbins, NLP - Neuro Linguistic Programming, Chloe Madanes strategic intervention, training coaching program, and STAR program on dealing with different personality types.

Languages

English, Spanish

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