HOLLY W. EASTER
Indian Land,SC
Summary
Dynamic WC claims adjuster with proven expertise in claims investigations and compliance at Charles Taylor TPA. Skilled in optimizing report generation and building strong client relationships. Utilizes strong analytical skills and active listening to achieve favorable outcomes while ensuring regulatory adherence. Enhances team performance in high-stakes environments.
Overview
10
10
years of professional experience
1
1
Certification
Work History
WC Claims Adjuster
Charles Taylor TPA
08.2025 - Current
- Direct the comprehensive management of intricate workers compensation claims, encompassing both litigated and non-litigated claims.
- Manage case lifecycles from initiation through to resolution, ensuring adherence to regulatory requirements and company policies.
- Adjust a variety of workers compensation claims from concurrent, indemnity and medical only claims for NC & SC.
- Specialize in the handling of claims primarily situated in the Southeast jurisdictions, demonstrating an understanding of state-specific laws and jurisdictions.
- Conducted thorough investigations into workers compensation claims, assessing injuries, liabilities, and billing details to support accurate coverage determinations.
- Developed and executed strategic action plans for claims, employing risk assessment techniques to effectively minimize organizational exposure.
- Collaborate with legal teams, medical professionals, and stakeholders to gather information, evaluate evidence and negotiate settlements, ensuring fairness.
Sr. Claims Quality Assurance Specialist
FallsLake Insurance Company
05.2020 - 06.2025
- Managed TPA programs claims to provide reserve approval and settlement authority up to $300,000.00 over multiple jurisdictions.
- Prepared bi-annual data analysis spreadsheets of audits to identify trends and challenges to increase opportunities for favorable claim outcomes.
- Participated in quarterly claim reviews to assess claim status and provide actionable feedback and recommendations for improved claims resolution.
- Reviewed TPA program files and prepared monthly audit spreadsheets, ensuring compliance with Client Service Instructions and Claims Handling Guidelines.
- Prepared monthly audit packet to include audits, scorecards and report for Sr. Management review.
- Compiled monthly reports on claim status and reserve adequacy for 3 TPA programs, facilitating informed decision-making for management.
- Developed audit forms to capture information and opportunities for positive claim resolutions and outcomes.
Sr. Claims Examiner
FallsLake Insurance Company
03.2018 - 05.2020
- Direct the comprehensive management of intricate workers compensation claims, encompassing both litigated and non-litigated claims.
- Manage case lifecycles from initiation through to resolution, ensuring adherence to regulatory requirements and company policies.
- Conducted thorough investigations into workers compensation claims, assessing injuries, liabilities, and billing details to ensure accurate coverage determinations.
- Developed and executed strategic action plans for each claim, employing risk assessment techniques to mitigate organizational exposure.
- Collaborate with legal teams, medical professionals, and stakeholders to gather information, evaluate evidence and negotiate settlements, ensuring fairness.
- Specialize in the handling of claims primarily situated in the Southeast jurisdictions, demonstrating an understanding of state-specific laws and jurisdictions.
- Identified opportunities for subrogation and recovery, proactively taking steps to reduce financial impacts.
WC Claims Supervisor
Patriot Risk Services
Charlotte, USA
10.2016 - 01.2018
- Led high-performing team of four claims examiners, two administrative assistants, and mailroom personnel, guiding day-to-day claims and administrative tasks to ensure effective operations.
- Led efforts to resolve complex customer issues and escalations, ensuring prompt and satisfactory resolution.
- Conducted thorough audits of claim files, offering actionable insight and guidance to expedite resolution.
- Established and implemented training programs to enhance team competencies and ensure adherence to best practices and company policies.
- Provided ongoing coaching and mentorship to team members, fostering their professional growth and development.
- Implemented performance management strategies, including regular feedback sessions and goal setting to optimize individual and team performance.
- Charlotte, NC
Education
NC State University
Raleigh, NCSkills
- Workers' Compensation Processes
- Claims Investigations
- Claims Estimation
- Claims Documentation
- Claim cycle
- Compliance & Quality Assurance
- Risk Management
- Client Servicing & Engagement
- Customer Relations
- Customer support
- Account Management
- Project Management
Certification
P&C/WORKERS COMP licenses in multiple jurisdictions
Timeline
WC Claims Adjuster
Charles Taylor TPA
08.2025 - Current
Sr. Claims Quality Assurance Specialist
FallsLake Insurance Company
05.2020 - 06.2025
Sr. Claims Examiner
FallsLake Insurance Company
03.2018 - 05.2020
WC Claims Supervisor
Patriot Risk Services
10.2016 - 01.2018
NC State University