Gloria R. Wilson
Claims Professional
Denton,TX.
Summary
OBJECTIVE FUNCTIONAL SUMMARY Successful Claims handling experience in multi-state jurisdictions, with increasing levels of responsibilities and independence in decision making and resolutions of claims. Extensive Human Resource/Risk Management experience in varying levels of responsibility and accountability. Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy.
Overview
41
41
years of professional experience
4
4
years of post-secondary education
Work History
Senior Claims Specialist /Worker’s Compensation
AIG Claims Service
Dallas, Texas
12.2001 - 08.2020
- Responsible for handling lost time claims from initial investigation to file closure /resolution
- Have demonstrated ability to make independent judgments and deal effectively with employers / injured workers and medical professionals in a professional manner
- Accountable for compensability decisions and quality of customer care within the perimeters set by the Workers Compensation laws for large dedicated national accounts
- Responsible for significant file load consisting of Texas and Oklahoma lost time and litigated claims.
- Conducted full claim investigations and reported updates and legal actions.
- Utilized appropriate cost containment techniques to reduce overall claim costs.
WC Compensability Specialist
Liberty Mutual Insurance Co
Irving, Texas
01.1999 - 01.2001
- Conducted claim file management activities involving the investigation, evaluation, litigation management, and resolution of workers compensation claims for multiple states.
Workers Compensation Claims Specialist
CMI, AIG Claims Services
Carrollton, Texas
01.1998 - 01.1999
- Responsible for the case management of lost time and medical only claims for the dedicated Wal-Mart account.
Claims Coordinator
Texas Dept Of Mental Health/Mental Retardation
Denton, Texas
06.1986 - 10.1998
- Responsible for case management for WC cases aged over 60 days for a facility of 1500 employees
- Processed and investigated WC claims and injuries, while aggressively pursuing return to work with minimal lost time.
- Mitigated client claim exposures through strategic management of claims.
- Analyzed losses and current claim statuses to determine need for updated loss runs.
Human Resource Specialist
Texas Dept Of Mental Health/Mental Retardation
Denton, TX
08.1979 - 06.1986
- Responsible for case management for WC cases, handled insurance and payroll functions and provided customer service for a facility of 1500 employees.
- Reviewed and screened applicant resumes to identify qualified candidates.
- Developed and coordinated employee training programs to improve productivity and performance.
- Conducted workplace compliance training to reduce liability risks and operate effectively.
Receptionist ( Part Time)
Federal Emergency Management Agency, FEMA
Denton, Texas
04.1994 - 03.2002
- Responded to inquiries from callers seeking information.
- Managed multiple tasks and met time-sensitive deadlines.
- Answered central telephone system and directed calls accordingly.
- Answered phone promptly and directed incoming calls to correct offices.
Education
BAAS - Rehabilitation Studies w, Emergency Administration/Planning
08.1994 - 08.1998
- Dean's List
- Honor Roll
Skills
Interpersonal Communication
undefinedTimeline
Senior Claims Specialist /Worker’s Compensation - AIG Claims Service
12.2001 - 08.2020
WC Compensability Specialist - Liberty Mutual Insurance Co
01.1999 - 01.2001
Workers Compensation Claims Specialist - CMI, AIG Claims Services
01.1998 - 01.1999
University of North Texas - BAAS, Rehabilitation Studies w, Emergency Administration/Planning
08.1994 - 08.1998
Receptionist ( Part Time) - Federal Emergency Management Agency, FEMA
04.1994 - 03.2002
Claims Coordinator - Texas Dept Of Mental Health/Mental Retardation
06.1986 - 10.1998
Human Resource Specialist - Texas Dept Of Mental Health/Mental Retardation
08.1979 - 06.1986
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