Senior Claims Specialist

Ilda Stewart

**** **** ******* *****, **** CA, **821

562-***-**** **********@*****.***

OBJECTIVE_________________________________________________________________________

Senior Workers Compensation Claims Specialist

WORK EXPERIENCE _______________________________________________________________

10/10-11/11: Vons, Arcadia, CA

Senior Workers Compensation Insurance Claims Specialist

• Utilize States Workers’ Compensation system principles, statutes and judicial protocol.

• Analyze each case assigned for all issues, and provide analysis and plan of action.

• Evaluate and maintain timely claim reserves.

• Provide timely and accurate benefits.

• Work with injured workers, facility managers and physicians to aid in the return to full or modified work duties.

09/07-10/10: Corvel Corporation, Chino, CA

Senior Workers Compensation Insurance Claims Adjuster

• Establish action plans based on case facts, best practices, protocols and regulatory issues.

• Discuss plans of action with client and employer on a periodic basis.

• Negotiate settlement within authority limits.

• Coordinate with the employer return to work efforts on a temporary and permanent basis.

• Communicate with the medical, legal and employer community on a daily basis.

• Administer benefits timely and appropriately.

05/06-09/07: Sedgwick Claims Management Services, Orange, CA

Workers Compensation Insurance Claims Adjuster

• Analyze claims by gathering information to determine exposure, assign reserve values to claims, making claims payments as necessary and settling claims up to designated authority levels.

• Develop and manage workers compensation claims' action plans to resolution, coordinate return-to-work efforts, and approve claim payments.

• Manage subrogation, negotiation of claims, and report claims to the excess carrier.

• Provide consistent delivery of quality claims service utilizing a paperless system.

• Maintain professional client relationships with attorneys, physicians and clients.

06/04- 05/06: State Compensation Insurance Fund, Commerce, CA

Workers Compensation Insurance Claims Adjuster-State Contracts)

• Fiscal management of all claims consisting of providing disability and medical benefits.

• Negotiate settlements via stipulations and compromise and release.

• Communicate with the medical community, injured workers, state agencies, applicant/defense

attorneys, and Workers Compensation Appeals Board.

10/97-06/04: Albertsons Supermarket, Long Beach, CA

Customer Service/Assistant Manager

• Offer customer service to customers.

• Assisting with management of the different departments within the store.

• Accurately accounting for all cash drawers.

• Communicating and working with higher management, vendors, and sales reps.

• Complied with union, government, and state regulations on a daily basis.

EDUCATION________________________________________________________________

09/1996-08/2002 Cal State University, Long Beach, CA

Bachelors of Science, Finance

Delta Sigma Pi- Coed professional Business Association: Vice President of Finance Fall Semester 2001

Associated Business Students Organizations Council (ABSOC)

LICENSES/CERTIFICATES____________________________________________________

Claims Adjuster or Medical-Only Claims Adjuster Designation, Total 203.25 Hours, February 22, 2006

Self Insurance Administrators Examination Certificate, November 4, 2006

Workers Compensation Claims Administration Certificate, December 31, 2007

Workers Compensation Claims Professional designation, May 31, 2008

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