Gina T. Jesinsky
EASTNORTHPORT,NY
Summary
Accomplished claims management professional with expertise in overseeing the complete lifecycle of workers' compensation claims. Skilled in facilitating communication, ensuring regulatory compliance, and developing strategic resolution plans that align with client objectives, delivering measurable improvements in claim outcomes.
Overview
22
22
years of professional experience
Work History
Senior Workers’ Compensation Claims Specialist
Amtrust
09.2021 - Current
- Oversaw workers’ compensation claims lifecycle across healthcare and construction sectors in New York, maintaining compliance and timely outcomes.
- Achieved faster claim resolutions through strategic coordination with defense counsel, leading to a measurable reduction in processing times.
- Enhanced investigation processes by synchronizing efforts between internal teams and external vendors, improving assessment speed and accuracy.
- Developed comprehensive claim updates and presented findings in account review meetings to strengthen stakeholder engagement.
- Identified emerging trends from accident analyses, delivering insights that supported proactive risk management initiatives.
Senior Workers’ Compensation Oversight Examiner
Total Program Management
05.2010 - 09.2021
- Coordinated effective communication between TPA insurance carriers and healthcare clients in NY, NJ, and CT.
- Oversaw accurate claims reporting to multiple carriers, including excess carriers, ensuring regulatory compliance.
- Conducted thorough evaluations of reserves, action plans, and litigation reports to develop strategic resolution plans.
- Facilitated claim reviews and underwriting meetings to align claim management protocols with client objectives.
Senior Workers’ Compensation Claims Specialist
Gallagher Bassett Services
10.2008 - 05.2010
- Managed all aspects of Workers’ Compensation claims for Construction Business Unit including USLH from inception to closure.
- Collaborated closely with the Subrogation Department to strategically identify and pursue recovery opportunities, resulting in [specific outcomes, e.g., a percentage increase in recoveries or reduced costs].
- Evaluated compensability and actively managed medical treatment for claims, issued lost time benefits, scheduled independent medical examinations, coordinated surveillance efforts, and negotiated settlements with claimant attorneys, achieving favorable outcomes while ensuring compliance with industry regulations.
- Participated in team presentations for stewardship meetings, claim reviews, and client visits.
- Led the training and onboarding of new employees, developing comprehensive training materials and programs that enhanced their understanding of Workers’ Compensation processes and improved team performance.
Senior Workers’ Compensation Claims Specialist
Zurich North America
07.2004 - 10.2008
- Assigned to construction business unit to include OCIP, CCIP and Joint Ventures.
- Handled all aspects of the workers’ compensation claims until resolution.
- Coordinated with Subrogation unit for possible recovery opportunities.
- Attended site visits, claim reviews, stewardship meetings.
- Responsible for training medical only adjusters for construction business unit.
- Received Customer Service Excellence award.
Skills
- Claims management and loss adjustment
- Regulatory compliance
- Medical evaluation and risk assessment
- Insurance negotiation
Timeline
Senior Workers’ Compensation Claims Specialist
Amtrust
09.2021 - Current
Senior Workers’ Compensation Oversight Examiner
Total Program Management
05.2010 - 09.2021
Senior Workers’ Compensation Claims Specialist
Gallagher Bassett Services
10.2008 - 05.2010
Senior Workers’ Compensation Claims Specialist
Zurich North America
07.2004 - 10.2008