Customer Service Insurance
Resume:
Post Falls, ID ***** Cell: 714-***-****
Home: 208-***-****
Email:
Frances Maxine Lewis
Objective My Objective is to work with an organization in an Administrative capacity where I am able to apply and utilize my extensive experience in medical claims processing or a related field.
Experience 2008-2011 Sedgwick Claims Management Fullerton, CA
Title Claims Examiner III
Responsible for Indemnity Files for St. Joseph Hospital.
Transfer of Kemper files to Obtain Reimbursement.
Resolution of Old Files by MSA/C&R.
2000-2008 Specialty Risk Services/Hartford Brea,CA
Account Consultant/Team Leader
Responsible for all Phases of Caseload of 185 Everest National Claims
Responsible for all Phases of Workers' Compensation Claims for Team.
Interaction on Accounts, Training, Structure Settlements and Medicare Set Asides.
Prepared and Presented Employee Reviews for Adjusters and Team.
Management of Hiring and Disciplinary Process.
Training, Development and Mentoring of Team Members.
1999-2000 Universal Self Insurance Company Garden Grove, CA
Workers' Compensation Manager
Responsible for all Phases of Claims/Interaction on Accounts.
Preparation of Self-Insured Annual Reports.
Preparation for E.D.I. Compliance and Implementation.
1998-1999 Golden Eagle Insurance Corporation Orange, CA
Team Leader
Supervision of Senior Examiners/Assign Claims and Review Reserves
Referrals for Litigation and Investigation.
Reviewing Settlements and Structures.
Handles all aspects of Workers' Compensation Caseload.
Caseload of Over 200.
Frances Maxine Lewis
1997-1998 Great States Insurance Company Anaheim, CA
Sr. Claims Specialist/Independent Contractor
Handle all aspects of Workers' Compensation Claim Files.
Caseload of 175.
Management of Claims for Talbert Medical Group and Affiliations.
1993-1997 Boeing North American Seal Beach, CA
Litigation Specialist/Certified Hearing Representative
Accountable for Performing Litigation and Resolution Tasks.
Initial File Review and Recommendation for Defense Strategy.
Prepared Legal Documents – Pleadings, Depositions, Review and
Secularization of Documents.
Evaluation and Negotiation of Lien Claims and Represent the
Company at all Hearings.
Professional
Certification
1987-2011 Instructor – Insurance Education Association
1997 Certified Hearing Representative
1996 Workers' Compensation Claims Professional Certification
1985 State Certified Self-Insurance Certification
Professional Experience Medical Terminology, Negotiations, Depositions, Litigation, Extensive Computer Data, Customer Service, Advanced Workers' Compensation Case Law.
References References Are Available Upon Request
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