Summary
Overview
Work History
Education
Skills
Timeline
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Ginger Walker

Pea Ridge,AR

Summary

Thorough Fraud Investigator with background in Claims Administration and successful record of fraud investigations and team management. Excels in gathering, analyzing and reporting evidentiary findings with process gap identification.

Overview

12
12
years of professional experience

Work History

Fraud Investigator

Wal-Mart
06.2022 - Current


  • Conducted prompt and thorough investigations on referred files.
  • Summarized all key information regarding investigation into detailed report for delivery to client.
  • Interviewed witnesses thoroughly, asking appropriate questions to ascertain critical details about each case.
  • Produced detailed reports of fraud investigations and presented findings to senior management.
  • Tracked fraud cases and monitored trends to develop strategies for prevention.
  • Coached and trained staff on fraud prevention techniques to increase awareness and reduce risk.

Workers Compensation Manager

Claims Management, Inc. (Wal-Mart)
10.2014 - 06.2022
  • Associate/Adjuster training and development
  • Oversight of workers compensation claims and trends for the state of AL / IL/ IA/ LA/ CT
  • Training and development of outside counsel to ensure litigation is resolved timely and effectively within outside counsel guidelines
  • Organize and conduct settlement/mediation conferences
  • Participate in interviewing and candidate selection for open case manager positions
  • Strategic planning to ensure goals are set appropriately to encourage positive business outcomes as a result of meeting production goals.
  • Created rewards and recognition programs for acknowledging employees' achievements.
  • Skilled at working independently and collaboratively in a team environment.
  • Self-motivated, with a strong sense of personal responsibility.
  • Proven ability to learn quickly and adapt to new situations.
  • Worked well in a team setting, providing support and guidance.
  • Excellent communication skills, both verbal and written.
  • Proved successful working within tight deadlines and a fast-paced environment.
  • Strengthened communication skills through regular interactions with others.
  • Organized and detail-oriented with a strong work ethic.
  • Complied with established internal controls and policies.

Workers Compensation Case Manager

Claims Management, Inc. (Wal-Mart)
10.2011 - 01.2014
  • Investigation of work injuries
  • Perform analysis of complex medical records to determine if the treatment is causally related to the mechanism of injury reported at the time of the incident
  • Develop and maintain a working relationship with medical personnel and legal representatives
  • Set appropriate reserves and issue payments to satisfactorily resolve claims
  • To complete continuing education classes as required for various state licenses
  • Ensure compliance with state regulations
  • Mentoring and development of less experienced adjusters
  • Research into goals, performance to assist team leader with establishing and meeting production goals
  • States managed: VA / AL
  • Complied with established internal controls and policies.
  • Analyzed information gathered by investigations to report findings and recommendations.
  • Collected and tracked evidence in support of legal processes.
  • Directed claims negotiations within allowable limit of $[Amount] and supported successful litigations for advanced issues.
  • Reviewed police reports, medical treatment records, and physical property damage to determine extent of liability.
  • Substantiated legitimate claims and denied unjustified claims.

Education

High School Diploma -

Fayetteville High School
Fayetteville, Arkansas

Skills

  • Forensic Research
  • Anomaly Detection
  • Dispute Resolution
  • Training Junior Team Members
  • Critical Thinking
  • Safety Violations
  • Fraud Investigations
  • Data Analysis
  • Fraud Prevention and Detection
  • Loss Mitigation
  • Internal Fraud
  • Witness Interview Skills
  • Case Management
  • Case Analyzation
  • Surveillance and Evidence Gathering

Timeline

Fraud Investigator

Wal-Mart
06.2022 - Current

Workers Compensation Manager

Claims Management, Inc. (Wal-Mart)
10.2014 - 06.2022

Workers Compensation Case Manager

Claims Management, Inc. (Wal-Mart)
10.2011 - 01.2014

High School Diploma -

Fayetteville High School

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Ginger Walker