Case Manager Medical Records
Resume:
LISA CAUDILL
Pea Ridge, AR *****
***********.**@*****.***
Professional Summary
Dedicated and detail-oriented individual seeking a claims adjuster position to utilize strong analytical and communication skills in accurately assessing and processing claims for optimal client satisfaction and organizational success. Adapt at sorting and prioritizing work with excellent judgment and analytical problem-solving.
Work Experience
Workers Compensation, Case Manager, II
Wal Mart-Bentonville, AR
December 2018 to December 2024
Key Responsibilities:
Claim Intake and Investigation:
Receive and review initial worker’s compensation claims, gather relevant information through interviews with injured employees, witnesses, and supervisors, and conduct investigations to determine the cause and circumstances of the injury.
Medical Management:
Review medical records, coordinate with treating physicians to monitor treatment plans, obtain medical opinions, and assess the reasonableness and necessity of medical services. Compensability Determination:
Evaluate the validity of claims based on company policies and state workers’ compensation laws to determine if the injury is compensable.
Claims Resolution:
Negotiate settlement amounts with injured employees or their legal representatives, considering medical expenses, lost wages, and disability evaluations.
Communication and Reporting:
Maintain regular communication with injured employees, their healthcare providers, and internal stakeholders, providing updates on claim status and addressing concerns. Legal Compliance:
Adhere to all applicable workers’ compensation laws and regulations, including reporting requirements and deadlines.
Claims Monitoring and Auditing:
Track claim progress, identify potential risk areas, and conduct regular reviews to ensure efficient and effective claim management.
Intake Specialist
McKinnon Law Firm-Fayetteville, AR
January 2017 to December 2014
Claim Intake:
Interviewing prospective clients by phone and email to become familiar with their cases, conducting basic research to investigate whether they’re in line with the areas of practice and experience of the firm. Scheduling initial consultation appointments with attorneys for promising potential candidates, onboarding new clients by filling out necessary paperwork and putting together initial case files, entering client information into computer systems, performing administrative support tasks as assigned. Case Manager
Rainwater, Holt & Sexton, P.A.-Little Rock, AR
January 2014 to December 2012
Claim Intake and Investigation:
Review initial motor vehicle claims, gather relevant information through interviews with claimants and witnesses and conduct though investigations to determine the cause and circumstances of the injury. Medical Management:
Review medical records, coordinate with treating physicians to monitor treatment plans, obtain medical opinions, and assess the reasonableness and necessity of medical services. Compensability Determination:
Evaluate the validity of claims to determine if the injury is compensable. Claims Resolution:
Negotiate settlement amounts with claimants or their legal representatives, considering medical expenses, lost wages, and disability evaluations.
Communication and Reporting:
Maintain regular communication with claimants, their healthcare providers, and internal stakeholders, providing updates on claim status and addressing concerns. Legal Compliance:
Adhere to all applicable laws and regulations, including reporting requirements and deadlines. Claims Monitoring and Auditing:
Track claim progress, identify potential risk areas, and conduct regular reviews to ensure efficient and effective claim management.
Medical Malpractice Paralegal
Malcom Law Firm-Little Rock, AR
January 2012 to December 2010
Draft legal documents including deposition notices, certifications, contracts, briefs, complaints, subpoenas, motions, and pleadings
Conduct legal research into case law and interviewing clients and witnesses Create summaries of depositions and testimonies
Provide additional support to Attorneys for court hearings, depositions and trials Organize and maintain legal files
File documents with any applicable court systems
Paralegal
Huckabay, Munson, Rowlett & Moore, P.A.-Little Rock, AR January 2006 to December 2009
Draft legal documents including deposition notices, certifications, contracts, briefs, complaints, subpoenas, motions, and pleadings
Conduct legal research into case law
Create summaries of depositions and testimonies
Provide additional support to Attorneys for court hearings, depositions and trials Organize and maintain legal files
File documents with any applicable court systems
Personal Injury Paralegal
Moody & Ritchey, P.A.-Little Rock, AR
January 1999 to December 2004
Education
ASSOCIATES OF PARALEGAL STUDIES in ACCOUNTING CERTIFICATE Pulaski Technical College - North Little Rock, AR
January 1995 to December 1999
HIGH SCHOOL DIPLOMA
Mount Saint Mary’s Academy - Little Rock, AR
January 1995 to December 1995
Skills
• Proficiency in Windows, Word, Excel and Outlook
Web-based claims system Needels and Clearsight
• Legal Research
• Legal Drafting
• Administrative Experience
• Microsoft Outlook
• Case Management
• Adobe Acrobat
• Proofreading
• Negotiation
• Research
• Personal Assistant Experience
• Databases
• Transcription
• Calendar Management
• Typing
• Document Management
• Intake Experience
• Medical Records
Certifications and Licenses
Paralegal Certificate
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