Risk Management Medical Billing

Carrie Walker

Worker’s Compensation Professional

Dallas, Texas 469-***-**** ************@*****.***

Dedicated Risk Management and Workers’ Compensation Specialist with 20+ years of experience handling complex claims, medical billing, and compliance processes across multiple states. Skilled at managing claims from intake to resolution, supporting return-to-work programs, and ensuring adherence to state and federal regulations. Adept at collaborating with adjusters, legal teams, and cross-functional stakeholders to reduce claim costs, improve accuracy, and deliver superior client service.

AREAS OF EXPERTISE

Risk & Claims Management Workers’ Compensation (Multi-State) Return-to-Work (RTW) Program

Support Regulatory Compliance Liability & Medical Claims Processing Adjuster & Client Relations

Data Analysis & Reporting (Excel, Guidewire) EDI Systems & Claim File Maintenance

TECHNICAL SKILLS

Microsoft Word, Excel, Guidewire, Mitchell / CWS, EDI Systems

PROFESSIONAL EXPERIENCE

Risk Management Specialist June 2024 – October 2025

G2 Secure Staff Irving, TX

•Reported and managed Workers’ Compensation and general liability claims across multiple states in compliance with corporate and regulatory guidelines.

•Conducted three-party contacts to ensure accuracy and timeliness of new claims processing.

•Collaborated with insurance adjusters and field personnel to resolve claims and support investigations.

•Assisted in administration of the Return-to-Work (RTW) program, facilitating employee reintegration and minimizing claim costs.

•Maintained confidential internal claim files, producing Excel-based reports and charts for internal risk and compliance reviews.

•Coordinated with HR and cross-departmental leadership to ensure alignment with corporate risk management strategy.

Workers’ Compensation Medical Only Adjuster / WC Claims Support Representative

Berkley Environmental Irving, TX 2019 – 2024

•Investigated and confirmed policy coverage, claim validity, and compensability for Workers’ Compensation cases.

•Established reserves, authorized payments, and managed lifetime/pension claims across all states.

•Authorized medical treatments, scheduled appointments, and requested medical records in compliance with state requirements.

•Filed state forms online, processed re-open/reclose claims, and maintained claim documentation.

•Supported adjusters by processing failed mail, invoices, faxes, medical and legal expense bills, and claim re-evaluations.

•Ensured accurate communication with claimants, customers, and clients throughout the claim lifecycle.

WC Claims Support Specialist / Claim Service Representative 2014 – 2019

Berkley Entertainment Irving, TX

•Processed Workers’ Compensation medical and legal expense bills, re-evaluations, and claim documentation.

•Supported adjusters by scanning and distributing claim files, producing medical reports, and managing ShareFile transfers.

•Handled provider inquiries on medical bill status and resolved claim discrepancies.

•Maintained claim data in Mitchell and CWS systems, set up new losses, and processed EOBs.

EDI Specialist / Claim Service Representative / Administrative Assistant IT 2002 – 2013

AIG Dallas, TX

•Managed Electronic Data Interchange (EDI) processes and error reporting to ensure compliance with state reporting requirements.

•Coordinated with adjusters to correct claim submissions, processed First Reports of Injury, and ensured accurate PLN filings.

•Provided provider/vendor claim service support, processed bill payments, reconciled duplicate payments, and managed TWCC forms.

•Assisted IT/Claims leadership with special projects, first paycheck processing, audit prep, and abandoned property tracking.

EDUCATION

David W. Carter High School — General Studies, Graduated 1981

CERTIFICATIONS

•TX – All Lines Adjuster License

•Multi-State Workers’ Compensation Adjuster Licenses: AL, AZ, CT, DE, FL, GA, LA, NC, NH, NM, OK, RI, SC

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