HOLLY BOWEN
SALISBURY,NC
Summary
To obtain a challenging professional position in a prominent company, where my Experience, Interpersonal communication and computer skills will be beneficial to the company with opportunity for advancement. Versatile Workers Compensation Specialist with results-driven and focused approach to completing work. Skilled leader, planner and problem-solver with 35-year career in Insurance Industry. Known for excellent attention to detail and great work ethic.
Overview
36
36
years of professional experience
1
1
Certification
Work History
SR. WORKERS COMPENSATION SPECIALIST
CORVEL CORPORATION
12.2023 - Current
- Handles NC, SC, VA and GA jurisdictions Manages complex and problematic claims within company standards and best practices
- High visibility workers compensation claims within delegated limited authority to determine benefits
- Establishes reserves within authority
- Work closely with case managers and attorneys, manages subrogation and negotiate settlements to ensure specific customer service requirement to achieve the most probable best outcome in the claim
- Work closely with each customer and account
- Developed and maintains customer relationships Provide excellent customer service, supporting the goals of claims department and Corvel
- Determine Validity and compensability of the claim by investigating and gathering information regarding the claim and files documentation with state agencies
- Adheres to client and carrier guidelines and participates in cliams reviews
- Communicates claims status with customer and claimants
- Reports claims to excess carrier when applicable.
WC CLAIMS SPECIALIST
OLD DOMINION FREIGHT LINE
06.2023 - 12.2023
- Responsible for the quality handling and resolution of work comp claims in a timely and professional manner
- Handles claims of a complex nature for self insured company
- Handle litigated files and negotiate settlements within settlement authority up to 50,000
- Discuss settlements over authority limit to request for approval over assigned limits
- Work with defense attorneys as needed
- Investigate evaluate and prepare settlements for resolution of claim
- Calculates and assigns timely appropriate reserves and manages reserve adequacy throughout the life of the claim
- Collaboration with other departments on any claim issues
- Maintain an effective diary system and document claim file activities in accordance with established procedures
- Evaluate bills for accuracy and pay timely
- Provides excellent customer service for external and internal customers
- Manage file inventory to ensure timely resolution of claims
- Handle subrogation from start to finish and follow up with all parties for reimbursement of lien.
SR. RESOLUTION MANAGER
GALLAGHER BASSETT SERVICES
01.2023 - 06.2023
- Handles NC, SC , VA, LA, MS, GA Investigates,evaluates, disposes and settles most complex claims and high exposures
- Settlement authority up to 25,000
- Dedicated to customer service
- Exercises proper judgement and decision making to analyze claims
- Interacts with various parties through the claim process
- Communicate clearly and provide concise action plans and present moving claim to resolution
- Answer client/claimant and Broker questions
- Processes claims consistent Best Practices guidelines and in accordance to any statutory ,regulatory and ethics requirements
- Pursue any subrogation
- Handles a heavy case load with very skilled organization
- Critical thinker and problem solver.
CLAIMS EXAMINER I
EMC INSURANCE COMPANY
01.2016 - 12.2022
claims
- Duties include Timely acknowledge claims assigned
- Review loss notice and all information
- Verify coverage
- If any coverage issues escalate to someone with needed expertise
- Document coverage
- Make initial contacts to all parties timely and document file
- Communicate with all parties and explain Claims process to all parties involved
- Investigate details
- Formulate action Plan to resolve the claim
- Use appropriate vendors
- Continue to update Action Plan with current known information
- Document file in a timely manner and work diary system timely
- Establish timely reserves for the exposure type based on EMC’s claim Reserving philosophy
- Assign litigation to defense counsel as needed
- Negotiations as Claim develops
- Discuss settlements with supervisor
- Pursue any subrogation opportunities
- Collaborate with internal and external partners including nurses,Vendors and defense counsel
- Prepare file reviews.
MEDICAL ONLY EXAMINER
THE ZENITH INSURANCE COMPANY
01.2010 - 01.2016
- Duties Include: Investigate all claims
- Complete 3 point contact with all parties which could include taking recorded statements if needed
- Processes claims, setting Reserves, Evaluating exposures and setting subsequent reserves when needed
- Collaborated with nurses and vendors
- Collaborate with defense counsel
- File state forms timely
- Making timely payments
- Works diary timely.
CLAIMS EXAMINER II
SEDGWICK
01.2009 - 01.2010
- Duties Include: Responsible for overseeing the small exposure claims and the medical only claims for the Family Dollar account
- I managed multi-state jurisdictions forms and made sure payments were made timely
- Completed investigations including taking recorded statements on every claim.
OWNER
POODLEDUCK & CO PET STORE
01.2007 - 01.2009
- Duties Include: Owner and operator of entire store
- Maintained and managed store Quality
- Managing day to day business activities including Customer service, Sales, Purchasing, Accounting, Advertising, Inventory Control and hiring and training Employees
- Ordered all supplies to ensure store was sufficiently stocked for customer satisfaction
- Caring for and maintaining a healthy environment for pets including: puppies, kittens, small animals, reptiles, and fish
- Growing the business by increasing sales and decreasing overhead costs
- Looked at financial needs daily.
STORE MANAGER
SEASHELL PET SHOP
01.2006 - 01.2007
- Duties Include: Oversee the operation of store
- Has direct authority over Sales Manager and associates
- Planning of all activates required to ensure that all operations within the store are prioritized and performed efficiently and effectively
- Responsible for completing payroll and making bank deposits
- Complete store review to ensure store conditions, customer satisfaction
- Product quality, availability is in store guidelines
- Access staffing needs with owner, Ensure customer service needs are met
- Managing all customer inquiries and questions
- Ordering all supplies and inventory
- Sales within the store
- Responsible for the cash register
- Provide leadership and motivation among team members
- Completing performance Reviews
- Ensure store security is followed including backdoor and key control.
CLAIMS ASSISTANT II
THE ZENITH INSURANCE COMPANY
01.2004 - 01.2006
- Duties Include: Support to several adjusters and working closely with other claim Support staff on day-to-day assignments
- This would include typing state forms for NC, SC AL and GA
- Typing letters or correspondence to attorneys, employees, and insurers
- Processing payments in a timely manner
- Handling phone calls to and from customers
- Preparing claims reviews for account visits
- Control of branch Right fax and ensuring emails are promptly delivered, assisting with back up phone support with back up phone support
- Back up support for Medical only adjuster which includes assisting with three point contacts.
MEDICAL ONLY SPECIALIST
ROYAL & SUNALLIANCE
01.2000 - 01.2004
- Duties Include: Responsible for medical only claims for several major accounts
- This would include making contacts and investigations of claims
- Claim creations of NC/SC industrial forms
- Coding and processing medical payments/ bills
- Contacting medical providers regarding CPT codes, proper forms, notes, and authorization
- Medical transcription and indexing of mail.
ADMINISTRATION SUPPORT
ROYAL & SUNALLIANCE
01.2000 - 01.2004
- Duties Include: Support to several adjusters including typing of state forms for NC, SC and FL
- Typing letters or correspondence to attorneys, employees, employers, and providers
- Coding bills and processing payments
- Handling phone calls to and from customers and Providing customer service
- Preparing spreadsheets for bill reviews
- Assisting with training new employees
- Processing checks, Opening and indexing mail.
SPECIAL ACCOUNTS TECHNICAL ASSISTANT/MEDICAL ONLY ADJUSTER
GALLAGHER BASSETT SERVICES
01.1998 - 01.2000
- Duties Include: Responsible for assisting WC adjusters/Liability adjusters with major client
- Assist client with multi states which include NC, SC, VA, TN, MS, AL, GA, PA, LA, CT and ME
- Coding/processing unpaid bills, voiding/recovering checks, typing various forms and filing with states Industrial Commission, Data entry of new claims, maintaining two filing systems for each adjuster, Assist adjusters in claim review preparations
- Medical only.
Executive Administrative Assistant
L.R. GORRELL COMPANY
01.1997 - 01.1998
- Duties Include: Answered multi-line switchboard, assisting manager with typing various Forms and correspondence, typing of quotes for sales representatives, Responsible for AP/AR of customers and collections of delinquent accounts
- Ordering all supplies
- Hotel Accommodations for manager
- Tracking orders, maintain filing system
- Petty cash Control
- Training of new clerical employees and supervision of office in managers absence
Multi-line switchboard operator/receptionist
TUBELITE COMPANY INC
01.1996 - 01.1997
- Duties Include: Answered switchboard, taking messages, and greeting customers
- Typing various forms and letters
- Typing quotes for outside sales representatives
- Invoicing clients and collections, opening and distributing the mail, checks, maintain supplies and operation of cash drawer
CLAIMS CLERK III/ RECEPTIONIST
KEMPER INSURANCE COMPANY
01.1988 - 01.1995
- Duties Include: Responsible for answering switchboard phone and greeting customers, typing various forms and letters, date entry of claims reports, taking claims over the phone, assisting adjusters, assisting insurers, claimants, agencies and attorneys with inquires
- Opening and distributing the mail, signing checks and other office duties.
Education
Senior Claim Law Associate - Insurance
American Educational Institute Inc
06-2020
Workers Compensation Claim Law Associate - Insurance
American Educational Institute Inc
05-2019
North Carolina State Adjusters License -
NORTH CAROLINA DEPARTMENT OF INSURANCE
01.2006
INSURANCE CONTINUING EDUCATION COURSES -
THE INSURANCE SCHOOL
Business Administration Courses -
CENTRAL PIEDMONT COMMUNITY COLLEGE
Diploma -
NORTH MECKLENBURG HIGH SCHOOL
Skills
- Microsoft Word
- Microsoft Windows
- Microsoft Outlook
- WordPerfect
- Word Mill
- Excel
- PowerPoint
- Internet
- Intranet
- Data Entry
- HP Scanjet
- QuickBooks
- Host
- Athena
- Zeus
- CLMS
- RiskFacs
- Oragami
- Caremc
- Various other programs
- Customer Relations
Jurisdictions
- NC
- SC
- VA
- TN
- GA
- LA
- MS
- IL
- IA
- AL
- CT
- PA
- FL
- ME
Office Skills
- Multi-Line Switchboard
- AP/AR
- Typing
- Faxing
- Copying
- Postage
- Check Signer
- Printing
- Filing
- Writing
- Transcription
- Computer
References
AVAILABLE UPON REQUEST
Certification
- WCCLA
- SCLA
Work Phone
(980)390-2419
References
References available upon request.
Timeline
SR. WORKERS COMPENSATION SPECIALIST
CORVEL CORPORATION
12.2023 - Current
WC CLAIMS SPECIALIST
OLD DOMINION FREIGHT LINE
06.2023 - 12.2023
SR. RESOLUTION MANAGER
GALLAGHER BASSETT SERVICES
01.2023 - 06.2023
CLAIMS EXAMINER I
EMC INSURANCE COMPANY
01.2016 - 12.2022
MEDICAL ONLY EXAMINER
THE ZENITH INSURANCE COMPANY
01.2010 - 01.2016
CLAIMS EXAMINER II
SEDGWICK
01.2009 - 01.2010
OWNER
POODLEDUCK & CO PET STORE
01.2007 - 01.2009
STORE MANAGER
SEASHELL PET SHOP
01.2006 - 01.2007
CLAIMS ASSISTANT II
THE ZENITH INSURANCE COMPANY
01.2004 - 01.2006
MEDICAL ONLY SPECIALIST
ROYAL & SUNALLIANCE
01.2000 - 01.2004
ADMINISTRATION SUPPORT
ROYAL & SUNALLIANCE
01.2000 - 01.2004
SPECIAL ACCOUNTS TECHNICAL ASSISTANT/MEDICAL ONLY ADJUSTER
GALLAGHER BASSETT SERVICES
01.1998 - 01.2000
Executive Administrative Assistant
L.R. GORRELL COMPANY
01.1997 - 01.1998
Multi-line switchboard operator/receptionist
TUBELITE COMPANY INC
01.1996 - 01.1997
CLAIMS CLERK III/ RECEPTIONIST
KEMPER INSURANCE COMPANY
01.1988 - 01.1995
Senior Claim Law Associate - Insurance
American Educational Institute Inc
Workers Compensation Claim Law Associate - Insurance
American Educational Institute Inc
North Carolina State Adjusters License -
NORTH CAROLINA DEPARTMENT OF INSURANCE
INSURANCE CONTINUING EDUCATION COURSES -
THE INSURANCE SCHOOL
Business Administration Courses -
CENTRAL PIEDMONT COMMUNITY COLLEGE
Diploma -
NORTH MECKLENBURG HIGH SCHOOL
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