Dwayne Britt

• Analyze reported lower-level workers compensation claims to determine benefits due; and ensure ongoing adjudication of claims within company standards and industry best
• Adjust medical-only/future medical claims and minor lost-time workers compensation claims under supervision.
• Support other claims representatives, examiners and leads with larger or more complex
  claims as necessary.
• Process workers compensation claims determining compensability and benefits due; monitor reserve accuracy, and file necessary documentation with state agency.
• Communicate claim action/processing with claimant, client and appropriate medical contact.
• Ensure claim files are properly documented and claims coding is correct.
• May process routine payments and prescriptions and status reports for lifetime medical claims and/or defined period medical claims. Maintain professional client relationships.
• Report claims to the excess carrier; respond to requests of directions in a professional and timely manner.
• Communicate claim activity and processing with the claimant and the client; maintain professional client relationships.
• Ensure claim files are properly documented and claims coding is correct.
• Refer cases as appropriate to supervisor and management.

Claims Examiner 1999 - 2018

• Analyzes and processes complex or technically difficult workers' compensation claims by
  investigating and gathering information to determine the exposure on the claim; manages
  claims through well-developed action plans to an appropriate and timely resolution.
  • Negotiates settlement of claims within designated authority. Calculates and assigns timely and appropriate reserves to claims; manages reserve
  adequacy throughout the life of the claim.
  Calculates and pays benefits due; approves and makes timely claim payments and
  adjustments; and settles clams within designated authority level.
  • Prepares necessary state fillings within statutory limits.