Claims Adjuster Workers' Compensation

Jennifer Pettit

***************@*****.*** 206-***-****

Professional Summary

Dedicated Claims Adjuster with 10+ years of experience in workers' compensation and military personal belongings claims. Skilled in high-volume caseload management, claim investigations, and accurate, fair adjudications. Proven strengths in policy interpretation, regulatory compliance, and client relations. Seeking a Claims Adjuster role to leverage leadership skills and claims expertise to drive successful outcomes.

Core Competencies

Claims Adjudication & Processing: Extensive experience resolving complex workers' compensation and personal belongings claims.

Policy Interpretation: Proficient in analyzing policies to determine coverage and assess liability.

Investigative & Analytical Skills: Skilled in conducting in-depth investigations to validate claims and negotiate settlements.

Client Relationship Management: Adept at fostering relationships with clients, attorneys, and vendors.

Regulatory Compliance: Knowledgeable in state and federal insurance regulations and laws.

Data Verification & Documentation: Experienced in maintaining accurate claim records and data.

Professional Experience

Claims Adjudicator

Return to Work, MD LLC — Seattle, WA — Jan 2019 – Present

Adjudicates workers' compensation claims, ensuring compliance with state regulations and company policies.

Investigates claim validity, focusing on medical-only cases, and collaborates with medical providers to expedite claim resolution.

Builds strong relationships with stakeholders to enhance claim processing efficiency.

Advises management on improvements to streamline claim workflows and reduce costs.

Claims Adjudicator I

Archbright — Seattle, WA — Apr 2016 – Aug 2018

Processed and adjudicated high-volume workers' compensation and medical claims, ensuring thorough and timely resolution.

Reviewed medical records, policy language, and regulations to determine eligibility, coverage, and liability.

Provided clear, detailed claims decisions and explanations to stakeholders.

Identified and addressed claim discrepancies to maintain compliance with policies. Military Personal Property Claims Adjuster

Denali Group — Sea-Tac, WA — Jul 2012 – Jan 2016

Managed personal belongings claims for military personnel, ensuring prompt, fair settlements.

Acted as the primary contact for service members, resolving disputes efficiently and effectively.

Coordinated with departments to streamline claims processing and improve service quality.

Sales Coordinator & Front Desk Roles

Various Hotels — Seattle & Bellevue, WA — Jan 2004 – Jul 2012

Managed front desk operations, reservations, and guest services with a focus on enhancing guest experiences.

Supervised and trained front desk staff, implementing procedures to improve service quality and efficiency.

Education

Shoreline Community College

Criminal Justice

Tyee High School

General Studies

References

Patrick Koenig, Claims Manager, Archbright - 206-***-****

Michelle Crevling, Claims Manager, Archbright - 425-***-****

Jamie Thompson, Supervisor, Denali Group — 253-***-****

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