Summary
Overview
Work History
Education
Skills
Timeline
Generic
Ann Marie Thomas-Ray

Ann Marie Thomas-Ray

Eagle,ID

Summary

Results-driven Manager experienced in structuring programs and administering benefits in fair and equitable fashion. Diplomatic, articulate and decisive with capability to build and develop productive relationships with internal and external stakeholders. Desiring to offer expertise in field and excellent judgment to challenging role within the Workers Compensation and/or Insurance industry.

Overview

34
34
years of professional experience

Work History

Claims Supervisor

TriStar Risk Management
2022.05 - Current
  • Monitored team performance, enforcing compliance with corporate claims processes and procedures.
  • Cultivated productive relationships with stakeholders, facilitating claims lifecycle.
  • Optimized case management with establishment of best practices.
  • Investigated, evaluated and adjusted claims in accordance with standards and laws.
  • Determined proper course of action for claims processing.
  • Documented and communicated timely claims information while supporting accurate outcomes.
  • Handled claims consistent with client and corporate policies, procedures, best practices and regulations.

Information & Assistance Officer

Department Of Industrial Relations
2021.03 - 2022.05
  • Assist Judges to resolve issues before the courts
  • Explain and facilitate settlements to injured workers
  • Provide workers' compensation process information to Claims examiners, attorneys and injured workers
  • Educate the public to navigate the workers' compensation system
  • Arrange conferences to facilitate communication between all parties
  • Provide basic workers' compensation training to the public

Claims Manager

Adventist Health West
2014.02 - 2019.12
  • Manage Staff Of 17 Clerical and Claims Examiners
  • Attend Claims Reviews with Clients
  • Provide Yearly WC Training to Clients
  • Schedule Ongoing Training for Technical Staff
  • Proactively Improve Work Flow Process
  • Insure that Technical Staff Is Current with Rules & Regulations and Current Laws
  • Aggressively Maintain Staff Engagement
  • Maintain Best Claims Practices
  • Work with Senior Management to Support Mission Statement and Goals
  • Maintain & Improve Client Relations
  • Implement Company Policies and Procedures
  • Handled claims consistent with client and corporate policies, procedures, best practices and regulations
  • Championed insurance claims process by providing expert knowledge and building positive, trusting relationship to support clients during challenging times
  • Determined proper course of action for claims processing

Senior Claims Examiner

Adventist Health System
2004.06 - 2014.02
  • Aggressively Monitor and Control Litigation
  • Administer All Aspects of WC Benefits
  • Control Cost/Expenses While Maintaining Positive Client and Employee Relations
  • Counsel and Provide Guidance to Hospitals for Efficiency, Timeliness and Compliance with Regulations and Statutory Law
  • Provide Yearly Training for Executive Management Staff at the Hospitals
  • Arrange Regular Training for WC Department
  • Maintain Positive Client and Employee Relations

Senior Claims Examiner

Tuell & Associates
2000.06 - 2004.06
  • Reduced claim resolution time by conducting thorough investigations and timely decision making.
  • Collaborated with legal counsel on complex claims, ensuring compliance with regulatory guidelines.
  • Maintained up-to-date knowledge of industry trends and legislative changes, ensuring accurate claim evaluations.
  • Coordinated with medical professionals to obtain necessary documentation for evaluating injury claims accurately.
  • Negotiated settlements with claimants, balancing fairness with fiscal responsibility to the company.
  • Interviewed claimants and witnesses to gather factual information.
  • Investigated and processed [Type] insurance claims for policyholders.
  • Worked with private investigators and attorneys on preparation of evidence, witness statements and other documentation in preparation for trial.
  • Delivered exceptional customer service to policyholders by communicating important information and patiently listening to issues.

Supervisor

LWP Claims
2002.09 - 2003.06
  • Increased team productivity by implementing efficient workflows and setting clear expectations for staff members.
  • Streamlined operations for increased efficiency through regular process reviews and implementing necessary changes.
  • Reduced employee turnover by fostering a positive work environment and providing ongoing feedback to staff members.
  • Improved customer satisfaction with timely response to inquiries, addressing concerns, and finding effective solutions.
  • Developed staff skills through targeted training programs, resulting in improved performance and career growth opportunities.
  • Conducted performance evaluations for staff members, identifying areas of improvement and guiding professional development plans.

Senior Claims Examiner

Professional Risk Management
1996.01 - 1999.06

Administered all aspects of Workers Compensation benefits from investigation, evaluation to resolution.

Senior Claims Examiner

Claim Net
1994.06 - 1996.01

Administered all aspects of Workers Compensation benefits from investigation, evaluation to resolution.

Senior Claims Examiner

California Indemnity
1993.12 - 1994.06

Administered all aspects of Workers Compensation from investigation, evaluation to resolution.

Senior Claims Examiner

Kemper Insurance
1993.01 - 1993.12

Administered all aspects oof Workers Compensation benefits from investigation, evaluation to resolution.

Senior Claims Examiner

Aetna Insurance
1990.01 - 1993.01

Administered all aspects of Workers Compensation from investigation, evaluation to resolution.

Education

J.D. -

McGeorge Law School
Sacramento
12.1998

BA -

University of California - Davis
Davis, CA
06.1989

Skills

  • Excellent written and verbal skills
  • Experienced work comp trainer
  • Strong leadership skills
  • Over 30 years of WC claims handling
  • Word and Excel proficient
  • Excellent time management
  • Adept with interpretation, compliance and implementation of Labor Code, Rules and Regulations and case law
  • Experienced Account Manager Relations
  • MS Office Suite
  • Claims analysis
  • Planning and Organization
  • Customer expectations management
  • Insurance policy review

Timeline

Claims Supervisor

TriStar Risk Management
2022.05 - Current

Information & Assistance Officer

Department Of Industrial Relations
2021.03 - 2022.05

Claims Manager

Adventist Health West
2014.02 - 2019.12

Senior Claims Examiner

Adventist Health System
2004.06 - 2014.02

Supervisor

LWP Claims
2002.09 - 2003.06

Senior Claims Examiner

Tuell & Associates
2000.06 - 2004.06

Senior Claims Examiner

Professional Risk Management
1996.01 - 1999.06

Senior Claims Examiner

Claim Net
1994.06 - 1996.01

Senior Claims Examiner

California Indemnity
1993.12 - 1994.06

Senior Claims Examiner

Kemper Insurance
1993.01 - 1993.12

Senior Claims Examiner

Aetna Insurance
1990.01 - 1993.01

J.D. -

McGeorge Law School

BA -

University of California - Davis
Ann Marie Thomas-Ray