Bonnie Scott
Foothill Ranch,CA
Summary
Accomplished and reliable manager demonstrating high level of ownership and initiative with extensive experience in workers compensation management, specializing in team leadership, data analysis and streamlining processes to improve operational efficiency. Proven ability to foster collaboration and enhance stakeholder satisfaction. Eager to leverage expertise to drive success and innovation.
Overview
1
1
Certification
25
25
years of professional experience
Work History
Manager, Workers Compensation
San Diego Unified School District
San Diego
07.2024 - 01.2026
- Managed the newly self-administered workers compensation program with a team of 7 claims examiners, 2 claims assistants and 1 Return to Work Coordinator.
- Facilitated team huddles and one-on-one meetings fostering collaboration and improving team morale.
- Led the administration of the workers compensation claims from inception to resolution.
- Simplified settlement review process, enabling early settlements and enhancing cost-effectiveness.
- Streamlined treatment authorization process with a pass through program resulting in quicker approvals and improved stakeholder satisfaction.
- Utilized strong analytical and problem-solving skills to address operational issues.
- Prepared and submitted responses for internal audits as well as to the DWC Audit Unit.
- System Administrator for the Riskonnect Claims System. Managed user access. Identified discrepancies with claim data conversion and worked extensively with data team to research and resolve issues. Maintained the voluminous vendor database. Processed daily check print jobs and monitored vendor FTP files. Assisted with troubleshooting technical issues and testing. Processed stop payments and voids. Created and configured business rules for diaries and new claim alerts.
- Formatted and uploaded all DWC benefit notices.
- Prepared reports including financial reports to the executive team, loss runs for actuary, 1099, OSIP Annual Reports, Medicare, OSHA 300/300A and FROI/SROI.
- Addressed and resolved customer inquiries to provide superior standard of service.
- Consulted on vendor contracts and collaborated with vendors to optimize workflows, enhancing operational efficiency through AI utilization for print management and medical report analysis.
- Maintained relationships with key medical providers to ensure optimal outcomes for claimant care.
Team Leader
Sedgwick CMS
Orange, California
01.2009 - 07.2024
- 2015-2024 - San Diego Unified School District account. Supervised a team of 6 including senior examiners, future medical/medical only examiner and claims assistant.
- Onboarded and trained new colleagues. Coordinated and led continuing education and system update training.
- Reviewed claims, including reserves, payments, and settlement requests, ensuring compliance with Sedgwick's Best Practices and client instructions.
- Generated reports on closures and settlements to support team objectives.
- Collaborated with other departments to ensure successful completion of projects including MPN transfer of care.
- Resolved problems and escalated issues timely providing excellent customer service.
- 2009-2015 - County of Orange account. Supervised and managed a team of 6 colleagues including resolution specialist, senior examiners, future medical examiner and claims assistant.
- Resolution Unit: Implemented creative methods to bring files to quick resolution. Negotiated compromise and release settlements as early as 30 days leading to 3.6 million in salvage in 2015.
- Reviewed large settlement proposals for submission to County Of Orange Board Of Supervisors.
- Supported office operations and collaborated with building management to resolve facility issues.
- Ran reports to assist examiners with stagnant files, closures and current action plans.
- Facilitated meetings with MPN providers to address issues with medical treatment and prolonged disability.
- Conducted performance reviews and proactively addressed performance issues quickly.
- Subject Matter Expert (SME) and assisted the office with claim system training.
Senior Claims Examiner
Gallagher Bassett Services Inc.
Aliso Viejo, California
04.2007 - 12.2009
- Managed workers compensation claims for UPS, conducting thorough recorded statements to ensure accurate documentation.
- Collaborated with client to develop strategies for settling claims, contributing to cost minimization.
- Coordinated with MPN doctors to expedite return to work and surgeries, reducing lost time for injured employees.
Senior Claims Examiner
Tristar Risk Management
Irvine, California
07.2003 - 04.2007
- Managed workers compensation claims for Los Angeles County Sheriff's Department, ensuring compliance with relevant regulations.
- Administered benefits for peace officers, leveraging knowledge of LC4850 and applicable presumptions to support claims processing.
Claims Examiner
Farmers Insurance Exchange
Orange, California
12.2000 - 06.2003
- Managed workers compensation claims for multiple employers, including oversight of special accounts to ensure compliance and timely resolution.
- Conducted field investigations and recorded statements for delayed and catastrophic claims, facilitating accurate assessments and timely claim resolution.
- Identified and successfully recovered over $500,000.00 in subrogation.
- Reviewed and validated insurance policies, confirming coverage details to mitigate risks and ensure client protection.
- Continued education to keep abreast on current case law.
Education
Bachelor of Arts - English
California State University
Fullerton06-1998
Skills
- Claims Analysis
- Regulatory Compliance
- Customer relationship management
- Cross-department collaboration
- Team leadership
- Decision-making
Certification
- California Self-Insured Plan Administrator (SIP) June 2006
- Workers Compensation Claims Administration (WCCA) Sept 2004
Timeline
Manager, Workers Compensation
San Diego Unified School District
07.2024 - 01.2026
Team Leader
Sedgwick CMS
01.2009 - 07.2024
Senior Claims Examiner
Gallagher Bassett Services Inc.
04.2007 - 12.2009
Senior Claims Examiner
Tristar Risk Management
07.2003 - 04.2007
Claims Examiner
Farmers Insurance Exchange
12.2000 - 06.2003
Bachelor of Arts - English
California State University