Jared Overton

Manage ongoing future medical claims for LAPD officers under Labor Code 4850/IOD provisions.
Review and authorize medical treatment requests under UR/IMR protocols.
Maintain timely diary entries to monitor medical progress and treatment plans.
Coordinate with physicians, injured workers, attorneys, and internal stakeholders.
Evaluate Medicare Set-Asides and future medical reserves.
Ensure compliance with applicable state laws, regulations, and LAPD protocol.
Utilize claims management software to document all actions and decisions.

• Determined Liability, Estimated, Approved And Processed Benefit Payments.
• Maintained Comprehensive Documentation For Each Claim In The Database System, Improving Overall Organization And Efficiency Within The Department.
• Collaborated With Legal Counsel For Complex Cases, Ensuring Proper Handling And Compliance With Company Policies.
• Conducted Comprehensive Interviews Of Witnesses And Claimants To Gather Facts And Information.
• Substantiated Legitimate Claims And Denied Unjustified Claims.
• Maintained Contact With Claimants And Attorneys To Determine Treatment Status.
• Maintained Claims Data In ECOS Systems.
• Worked With Private Investigators And Attorneys To Gather Evidence, Witness Statements, And Other Documentation In Preparation For Trial.
• Negotiated Terms And Handled Settlements And Adjustments With Defense Attorneys.
• Interviewed Claimants And Witnesses To Gather Factual Information.

• Conduct Investigations of Workers' Compensation Claims.
• Gather Information And Evidence About Injury Allegations.
• Complete An AOE/COE Investigative Report To Be Submitted To A Claims Adjuster.
• Conduct Job Site Investigation, Taking Photos of MPN Postings And Incident Area.
• Coordinate With Insured And HR Manager To Schedule Interviews And Statements To Be Obtained.
• Maintain Daily Diaries To Manage Caseload.
• Collected, analyzed and interpreted information, documentation, and physical evidence associated with investigations.

• Maintain Diaries on All Open Claims - Monitor Medical Treatment And Coordinate Modified Duty When Necessary.
• Review Reserves Set By Carriers/TPA - Coordinate AOE/COE Investigations.
• Perform Three Point Contact With Client, Claimant and Clinic.
• Managed high-volume caseloads, prioritizing tasks to ensure timely completion of all claims.
• Conducted thorough investigations into each claim, gathering relevant data and documentation to support decision-making processes.
• Streamlined workflow processes for improved efficiency and reduced claim resolution times.

• Review Legal Documents.
• Review AOE/COE Investigative Reports.
• Checked Documentation For Accuracy And Validity On Updated Systems.
• Carried Out Administrative Tasks Such As Communicating With Clients, Distributing Mail And Scanning Legal Documents.
• Maintained HR Compliance.
• Assisted With Claims Investigations.

• Educate Clients In Business/Mortgage/Financial Processes.
• Provide Solutions Including Up and Cross-Selling.
• Organized regular sales meetings to review progress, share best practices, and set achievable targets for continued success.
• Resolved customer issues quickly to close deals and boost client satisfaction.
• Handled customer relations issues, enabling quick resolution, and client satisfaction.
• Maintain Global HR Proficiency.

• Managed Client Relationships.
• Serviced Accounts.
• Answered Incoming Calls.
• Corresponded With Law Firms Regarding Claims.
• Strengthened Relationships With Key Clients, Leading To Increased Repeat Business.

• Exceeded Service Objectives By Applying Proven Customer Service And Sales Best Practices.
• Received Incoming Calls To Procure New Business.
• Made Follow-up Calls On Renewable Policy Holders.
• Log/Memo Account Information and Communications.
• Built Client Relationships By Acting As Liaison Between Customer Service And Sales Teams.
• Enhanced customer satisfaction by addressing inquiries and resolving issues promptly and professionally.