Carin E. Spitzer
Apopka,Florida
Summary
Talented professional considered knowledgeable leader, detail oriented, strong organizational skills and dedicated problem solver. Brings twenty eight years of valuable expertise to forward company objectives. Attentive to detail with experience in coordinating projects, programs, and improvements.
Overview
18
18
years of professional experience
Work History
Workers Compensation Program Manager
Rothman Orthopaedics
02.2022 - Current
- Established strong relationships with key stakeholders, ensuring support for program initiatives while working with 33 orthopedic doctors.
- Developed strategic plans, setting clear objectives and achievable milestones for the Workers Compensation Program.
- Facilitated workshops and conducted one-on-one training to educate team members on the Work Comp Forms and Process.
- Conducted comprehensive program evaluations, identifying areas for improvement and recommending actionable solutions.
- Identified program obstacles and communicated possible impacts to the Vice President and Regional Manager.
- Improved program efficiency by streamlining processes and implementing areas for future revenue.
- Increased customer satisfaction through effective communication of program goals and expectations.
- Demonstrated strong writing and presentation skills to develop briefs, memorandums and analytical reports for clients.
Senior Claims Adjustor
AdventHealth
11.2018 - 02.2022
- Managed a desk with 125-145 lost time-litigated claims for Florida and Kansas,
- Managed litigation, mediations, payment of indemnity benefits, state filings, setting reserves, submission of EDI, and authorization of medical treatment
- Interviewed claimants and witnesses to gather factual information.
- Minimized company exposure to financial risk by diligently identifying fraudulent claims and coordinating with legal teams for resolution.
- Optimized workload management, prioritizing time-sensitive cases to ensure timely resolutions for clients.
- Maintained detailed records of all case-related activities, ensuring accurate documentation for auditing purposes and future reference.
- Enhanced customer satisfaction by promptly addressing and resolving complex claim issues through thorough investigation and analysis.
- Participated in ongoing professional development opportunities such as industry conferences, workshops and webinars to stay current with industry trends and advancements.
- Expedited claims settlements with successful negotiation strategies and effective communication skills.
Senior Claims Adjustor
CCMSI
11.2017 - 11.2018
- Manage litigation, mediations, payment of indemnity benefits, state filings, setting reserves, submission of EDI, and authorization of medical treatment
- Managed the Health First Account with 125 claims and an additional account with SC, NC, GA, and FL claims.
- Interviewed claimants and witnesses to gather factual information.
- Collaborated with cross-functional teams to expedite claim handling processes, enhancing overall efficiency and client satisfaction scores.
- Expedited claims settlements with successful negotiation strategies and effective communication skills.
- Developed strong relationships with external partners such as nurse case managers, medical providers, and legal professionals to facilitate seamless claim resolutions.
- Maintained contact with claimants and attorneys to determine treatment status.
- Worked with private investigators and attorneys on preparation of evidence, witness statements, and other documentation in preparation for trial.
Senior Claims Adjustor
Adventist Health System
09.2006 - 11.2017
- Managed a desk with 125-145 litigated claims for IL, NC, and FL
- Manage litigation, mediations, payment of indemnity benefits, state filings, setting reserves, submission of EDI, and authorization of medical treatment.
- Interview claimants and witnesses to gather factual information a week
- Minimized company exposure to financial risk by diligently identifying fraudulent claims and coordinating with legal teams for resolution.
- Optimized workload management, prioritizing time-sensitive cases to ensure timely resolutions for clients.
- Maintained detailed records of all case-related activities, ensuring accurate documentation for auditing purposes and future reference.
- Enhanced customer satisfaction by promptly addressing and resolving complex claims through investigation and analysis.
- Participated in ongoing professional development opportunities such as industry conferences, workshops and webinars to stay current with industry trends and advancements.
- Settlement claims with successful negotiations strategies and effective communication skills.
Education
Some College (No Degree) - Business Administration And Management
Valencia College
Orlando, FLSome College (No Degree) - Business Administration And Management
Seminole State College of Florida
Sanford, FLAssociate of Arts - Cosmetology
Roffler Cosmetology College
Altamonte Springs, FLSkills
- Problem-Solving
- Decision-Making
- Policy and procedure improvements
- Critical Thinking
- Flexible and Adaptable
- Team training and development
- Attention to Detail
- Multi-level communication
- Customer Service
- Relationship Building
- Scheduling and Planning
- Performance monitoring
- Data Analysis
- Documentation proficiency
- Electronic and communication systems
- Software Documentation
- Program Leadership
References
Available upon request
Certificationslicensure
- Florida Bar Certification, 2014
- Board Certification—Worker’s Compensation, 2011
- Independent Study-Worker’s Compensation, 1996
Timeline
Workers Compensation Program Manager
Rothman Orthopaedics
02.2022 - Current
Senior Claims Adjustor
AdventHealth
11.2018 - 02.2022
Senior Claims Adjustor
CCMSI
11.2017 - 11.2018
Senior Claims Adjustor
Adventist Health System
09.2006 - 11.2017
Some College (No Degree) - Business Administration And Management
Valencia College
Some College (No Degree) - Business Administration And Management
Seminole State College of Florida
Associate of Arts - Cosmetology
Roffler Cosmetology College
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