Dedicated Claims Manager professional with history of meeting company goals utilizing consistent and organized practices. Skilled in working under pressure and adapting to new situations and challenges to best enhance the organizational brand.
Overview
22
22
years of professional experience
1
1
Certification
Work History
Claims Manager
Procare HR
03.2025 - Current
Managed claims in all states except Minnesota and Wisconsin.
Liaison between Insured, Carrier, and Claimant.
Established strong relationships with key stakeholders, including insurance providers, attorneys, and medical professionals.
Achieved significant reduction in outstanding reserves through proactive case management strategies and timely settlement negotiations.
Negotiated favorable settlements on behalf of the company, minimizing potential exposure to costly litigation proceedings.
Reduced claims processing time by implementing efficient workflow systems and streamlining procedures.
Claims Manager
Foundation Risk Partners
12.2023 - 03.2024
Specialized managing claims for Amazon DSP's.
Streamlined communication between adjusters and clients, expediting claim resolution times.
Conducted thorough investigations of complex claims, gathering evidence to support decision-making processes.
Negotiated settlements with claimants, achieving fair outcomes while controlling costs.
Workers' Compensation Case Manager
CertiPay
09.2003 - 12.2023
Resolved complex, severe exposure claims using high service oriented file handling.
Researched claims and incident information to deliver solutions and resolve problems.
Collected claim information from customers to complete claims and legal files.
Followed up with insured individuals regarding premium and deductibles payments.
Evaluated original investigation reports and documents to resolve secondary concerns.
Examined claims forms and other records to determine insurance coverage.
Worked with private investigators and attorneys on preparation of evidence, witness statements and other documentation in preparation for trial.
Maintained contact with claimants and attorneys to determine treatment status.
Documented information gathered in field and uploaded data to company database for efficient processing using Certipay Database.
Corrected class codes to properly classify claims.
HR Manager Advisor I HR Trainer at HR Consultant - HR People Manager AdvisorHR Manager Advisor I HR Trainer at HR Consultant - HR People Manager Advisor