Case Management Workers' Compensation

Oliver Rodriguez

626-***-**** *****************@*****.*** 14522 Barrydale St. La Puente CA 91746

Solomon Rogers PC – Hearing Rep/Settlement Specialist Oct. 2024 – March 07, 2024.

MSC Attendance & Case Management: Attended Mandatory Settlement Conferences (MSCs) as required, effectively representing clients and negotiating settlements with opposing counsel and insurance companies.

Claims Negotiation & Settlement Preparation: Led negotiations on workers' compensation cases, preparing settlement documentation and coordinating with legal teams to ensure successful outcomes for clients.

Case Load Management: Efficiently managed a caseload of 600 clients, prioritizing and managing tasks in a fast-paced environment to ensure the timely processing of all cases.

Settlement Demand Preparation: Prepared and sent demands for settlement finalization, ensuring all necessary documentation was provided to facilitate a smooth resolution process.

Client Communication & Advocacy: Maintained regular communication with clients, keeping them informed about their cases and advocating for their best interests at every stage of the claim process. Acuity Eye Group- Call Center Representative

Aug. 07, 2020 – Jan 06, 2023

High-Volume Call Management: Efficiently handled a large volume of incoming and outgoing calls, maintaining professionalism and clarity while addressing patient needs and inquiries.

Patient Demographics & Insurance Collection: Collected and verified patient demographic information, including insurance details, ensuring accurate records and facilitating seamless processing.

Scheduling Coordination: Scheduled patient appointments for 40 locations, ensuring appointments were correctly booked and coordinated to meet patient and operational needs.

Internal Communication: Sent timely and accurate messages to the corresponding office teams, facilitating the smooth flow of information and reducing any potential delays.

Customer Service Excellence: Delivered exceptional service by addressing patient concerns, scheduling conflicts, and other needs, while ensuring high levels of satisfaction. Spine Care & Orthopedic Physicians

July 2019 – Aug. 2020

Liens & Medical Bill Negotiation: Negotiated and resolved outstanding liens and past-due medical bills, working with healthcare providers, attorneys, and insurance companies to settle claims efficiently.

Liens Conference Preparation: Prepared files for liens conferences, ensuring all necessary documentation was accurate, complete, and ready for presentation to resolve claims.

Workers' Compensation Appeal Board Attendance: Attended Workers' Compensation Appeal Boards to represent clients and resolve outstanding liens, collaborating with legal teams to ensure favorable outcomes.

High-Volume Caseload Management: Managed an extensive caseload of 3,500 files, prioritizing cases, tracking progress, and ensuring timely resolution of each claim.

Efficient File Organization: Maintained accurate records and up-to-date files, ensuring that all information was readily available for negotiations and conference presentations. Oracle Medical Collections

Jan. 2016 – Mar. 2019

Medical Liens Collection & Negotiation: Negotiated and collected on past-due medical liens, working with medical providers, attorneys, and insurance companies to secure fair settlements.

Pharmaceutical & Physician Bill Negotiation: Negotiated with pharmaceutical companies and primary treating physicians to settle outstanding medical bills, ensuring appropriate reimbursement and minimizing client liability.

High-Volume Account Management: Managed and updated a portfolio of 2,200 medical files, ensuring all information was accurate and up-to-date for efficient processing and follow-up.

File Preparation for Court: Prepared medical files for hearings at the Workers’ Compensation Appeal Board, ensuring all documentation was complete, organized, and ready for legal presentation.

Daily Account Updates & Communication: Regularly updated account information, collaborating with internal teams, medical providers, and legal representatives to facilitate smooth case progression. Xtreme Liens Inc.

Jan. 2013 – Jan. 2016

Medical Liens Collection: Collected on outstanding medical liens for physician services, including laboratories conducting urine sample testing and pharmacies (Costal Pharmacy, California Pharmacy, Long Beach Prescription), all involved in dispensing pain medications.

Billing & Invoice Negotiation: Negotiated and settled past-due billing for pharmaceutical medications and testing services, working directly with medical providers, pharmacies, and insurance companies to ensure timely payments and resolutions.

DOR Filing & Documentation: Filed and tracked DORs (Declarations of Readiness) to streamline the case process and prepare for upcoming hearings, ensuring the accurate presentation of case details.

Lien Filing & Dispute Resolution: Filed liens for past-due medical billing and participated in resolving disputes with medical providers to facilitate settlements and prevent further delays in workers’ compensation cases.

Account Management: Managed a high-volume caseload of 1,800 files, ensuring that each account was properly updated, tracked, and followed through to resolution. True Sleep / Los Angeles Sleep Institute

Mar. 2008 – Jan. 2013

Polysomnograph & Sleep Study Liens: Negotiated liens for polysomnograph (sleep study) services, working with sleep study centers and healthcare providers to resolve outstanding medical bills.

Consultation Liens for Dr. Pedram Navab: Collected and negotiated medical bills related to sleep study consultations provided by Dr. Pedram Navab, ensuring fair settlements for workers’ compensation cases.

High-Volume Caseload Management: Managed a caseload of 2,000 files, ensuring all accounts were accurately tracked, updated, and processed in a timely manner to avoid delays in case resolution.

Lien Filing & Dispute Resolution: Filed and negotiated liens for medical billing disputes, including working with providers to resolve billing conflicts and facilitate payments.

Documentation & Case Preparation: Ensured all necessary documentation, including lien filings and DORs, were accurately completed and submitted for case hearings and settlements. Education

Basset High School – Graduated June 2002

Experience with Microsoft Data Entry Bilingual / Spanish Call Center Experience Total 8 years of workers comp. Expert at filing liens and researching on EAMS

Experience working with FS and other collection software. Collected on MRI, Chromatography, Pharmacy/Compound Meds, Physical Therapy, Chiro and Orthopedic treatment.

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