Alicia Short
Fort Worth
Summary
Service-oriented Claims Adjuster skilled at applying creative approaches to solving complex problems. Adept at developing profitable and quality-focused processes.
Overview
15
15
years of professional experience
1
1
Certification
Work History
Workers Compensation Adjuster (Contract Assignment)
Davies Group
02.2025 - 10.2025
- Handled complex litigated and non-litigated workers compensation indemnity claims for the state of Texas.
- Investigate and evaluate workers' compensation claims to determine validity and extent of liability.
- Analyze medical reports and employment records to assess the nature and extent of injuries or illnesses.
- Communicate with claimants, employers, and medical professionals to gather necessary information and clarify details.
- Calculate and authorize appropriate compensation payments in accordance with company policies and legal guidelines.
- Maintain detailed and accurate records of claims, correspondence, and settlements in the claims management system.
- Collaborate with legal counsel to prepare for and participate in hearings or mediations when disputes arise.
- Provide guidance and support to claimants throughout the claims process, ensuring a clear understanding of their rights and responsibilities.
- Monitor and review ongoing claims to ensure compliance with regulatory requirements and company standards.
- Identify and implement strategies to reduce claim costs and improve overall claims management efficiency.
- Stay updated on changes in workers' compensation laws and industry best practices to ensure compliance and enhance service delivery.
- Remote
Workers Compensation Claims Adjuster
CSC ServiceWorks
02.2020 - 01.2025
- Handled complex litigated and non-litigated workers compensation indemnity claims in TX, CO, IL, MO, and TN.
- Conducted thorough claims investigations to determine compensability and ensure compliance with relevant statutes and regulations.
- Collaborated with clients and business partners to provide updates and manage the development of claims.
- Maintained communication with injured employees, medical providers, and employers to facilitate timely return to work.
- Reviewed and managed medical treatment and documentation to support claims management and legal proceedings.
- Remote
Medical Claims Adjuster
Revive Community Health
02.2011 - 02.2015
- Analyzed policy details and supporting documents to make informed decisions on claims approvals or denials.
- Resolved complex claims issues to ensure expedited processing and resolution.
- Collaborated with healthcare providers to obtain necessary documentation for claim support.
Skills
- Exposure analysis
- Workers' compensation claims
- Regulatory compliance
- Advanced computer skills
- Best practices implementation
- Caseload management
- Attention to detail
- Litigation resolution
Certification
All Lines -TX
Timeline
Workers Compensation Adjuster (Contract Assignment)
Davies Group
02.2025 - 10.2025
Workers Compensation Claims Adjuster
CSC ServiceWorks
02.2020 - 01.2025
Medical Claims Adjuster
Revive Community Health
02.2011 - 02.2015