Worker's Compensation Claims Adjuster
Resume:
BRANDON BURKE
Email: ************@*****.***
Phone: 334-***-****
Objective
Motivated and detail-oriented workers comp claims professional seeking a position as a Workers Compensation Claims Adjuster with a strong foundation in claims management, a commitment to legal compliance, and skills in settlement negotiation. SUMMARY OF QUALIFICATIONS
- Extensive knowledge of worker's compensation laws and regulations, ensuring compliance and minimizing risk.
- Proven track record in implementing and maintaining effective safety programs, resulting in reduced workplace accidents and injuries.
- Skilled in conducting thorough investigations of workplace incidents and accidents to determine root causes and develop corrective measures
- Manage multiple cases simultaneously, working directly with employers, employees, and medical providers to guide them through the claims process in a caring and professional manner.
- Investigate claims to determine an injured worker's entitlement to Workers Compensation benefits, administer indemnity and medical benefits for valid claims, and manage a caseload of claims from inception to closing or settlement. LICENSES
- Texas Adjuster All Lines
- Mississippi Adjuster
- Oklahoma Adjuster
- Florida Adjuster
- Georgia Adjuster
- North Carolina Adjuster
- Alabama Adjuster
- Indiana Adjuster
- Kentucky Adjuster
- Michigan Adjuster
- Minnesota Adjuster
CERTIFICATIONS
- Worker's Compensation Claims Handling Course, Claims Adjuster Academy, Dallas, Texas
- Comprehensive Workers' Compensation Claims Management Program, Claims Adjuster Academy, Dallas, Texas
- State Farm ECS Fire Core Curriculum
- State Farm Auto External Claim
- Resource Broadcast State Farm Auto
- Auto Catastrophe Estimator Final Assessment
- State Farm Fire Estimatics and State Farm Fire Policy
- Worker's Compensation Adjuster Training Course
- Worker's Compensation Adjuster Claims Handling Course WORK EXPERIENCE
Wardlaw Claims Services - Worker's Compensation Claims Adjuster 08/2021 – Present
- TPA Experience
- Handle indemnity claims.
- Maintain a caseload of 80 claims.
- Investigated and reviewed litigated and lost time claims.
- Performed telephonic and in person file reviews.
- Determined reserves up to $50,000.
- Monitored medical case management.
- Elevated claims for settlement with client.
- Follow through, ongoing investigation and information up until resolution of claims.
- Identifying fraud indicators and subrogation opportunities and maintaining state regulatory requirements.
- Detailed-oriented Senior Worker’s Compensation Adjuster demonstrating superior knowledge of current Worker’s Compensation Laws and applying creative approaches to solving complex claims.
Hyundai Motor Manufacturer of Alabama - Worker's Compensation Associate 01/2015 - 06/2021
- Assisted in the intake process for new patients, gathering necessary information and completing required documentation.
- Conducted initial assessments of patients' needs and coordinated their care with the appropriate healthcare professionals.
- Managed scheduling and appointments for patients, ensuring timely and efficient service delivery.
- Maintained accurate and up-to-date patient records, ensuring confidentiality and compliance with privacy regulations.
- Collaborated with insurance companies to verify coverage and obtain authorization for services.
Aerotek - Worker's Compensation Claims Coordinator 11/2011 - 01/2015
-- Assisted claims associates in reviewing and processing worker's compensation claims.
- Conducted initial claim intake, gathering necessary information and documentation.
- Prepared claim files, ensuring all required documents and forms were included.
- Assisted with claim investigations, including obtaining witness statements and conducting research.
- Communicated with claimants, employers, and medical providers to gather additional information as needed.
- Maintained accurate and organized claim files and documentation.
- Assisted with claim payment processing and reserve management. Education
Alabama A&M University
School of Business
08/2001 - 05/2004
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