Adrianne Oliver
Sunland/Tujunga,CA
Summary
Astute insurance professional offering 20+ years in Workers' Compensation Insurance in multiple jurisdictions throughout the United States. Meticulous, systematic and highly experienced with strong case management and relationship-building abilities. Results-driven Claims Specialist bringing proven skills in administering workers' compensation risk management programs. Effective in training team members to proactively identify and highlight potential risks. Dedicated to long-term risk management by building strong internal protocols and instilling culture of responsibility and attentiveness.
Overview
27
27
years of professional experience
Work History
Risk & Safety Claims Specialist
Mars/VCA
10.2016 - Current
- Manages Workers' Compensation Claims ( 130-170 claims per month) in multiple jurisdictions throughout United States, as assigned until closure; Acts as liaison between VCA and Third party Administrator with emphasis on employee safety, return to work, and cost containment. Duties include:
- Timely accurate reporting of all workers' compensation claims.
- Conducts initial investigation and gathers all initial documentation.
- Medical Management-Directs Care to appropriate medical providers utilizing all available cost containment measures either via established medical panels for individual hospital locations or use of networks such as MPN Network in California or HCN Network in Texas.
- Coordinating transition from total disability to modified duty to full duty or permanent modified full duty.
Case Management Process Support Specialist
Bank Of America
12.2005 - 12.2012
- Supporting portfolio of 125+ home loans in default and imminent default, focusing on loan modifications. Duties include:
- Research, prepare, document validation
- Net present value model running
- Completion of second mortgage modifications
- Execution of short sale/DIL
- Addressing technical foreclosure questions; identifying solutions that will improve account in timely manner.
Sr. Workers Compensation Claims Adjuster
Multiple Employers - Insurance Companies
, CA, MD,NJ,DE
10.1990 - 10.2004
- Conducted day-to-day administrative tasks to maintain information files and process paperwork.
- Examined claims forms and other records to determine insurance coverage.
- Read over insurance policies to ascertain levels of coverage and determine whether claims would receive approvals or denials.
- Delivered exceptional customer service to policyholders by communicating important information and patiently listening to issues.
- Researched claims and incident information to deliver solutions and resolve problems.
- Negotiated/paid outstanding medical liens.
- Reviewed police reports, medical treatment records and physical property damage to determine extent of liability.
- Conducted comprehensive interviews of witnesses and claimants to gather facts and information.
- Reviewed and analyzed suspicious and potentially fraudulent insurance claims.
- Resolved complex, severe exposure claims using high service oriented file handling.
- Maintained contact with claimants and attorneys to determine treatment status.
- Analyzed information gathered by investigation and reported findings and recommendations.
- Interviewed agents and claimants to correct errors or omissions and investigate questionable claims.
- Learned new skills and applied to daily tasks to improve efficiency and productivity
- Identified issues, analyzed information and provided solutions to problems
Education
Bachelor of Arts - Government & International Studies
University of Notre Dame
Notre Dame, IN05.1990
Skills
- Insurance Carrier Applications
- Settlement Determinations
- Coverage Determination
- Insurance Claim Forms Review
- Accident Investigations
- Claim Validity Determination
- Fraud Detection
- Documentation Review
- Claim Amount Calculations
- Database Updates
Timeline
Risk & Safety Claims Specialist
Mars/VCA
10.2016 - Current
Case Management Process Support Specialist
Bank Of America
12.2005 - 12.2012
Sr. Workers Compensation Claims Adjuster
Multiple Employers - Insurance Companies
10.1990 - 10.2004
Bachelor of Arts - Government & International Studies
University of Notre Dame
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