Summary
Overview
Work History
Education
Skills
Certification
References
Timeline
Generic

Jennifer Schoolcraft

Elkview

Summary

Dynamic Complex Claims Specialist with extensive experience in the Workers' Compensation Insurance industry, while excelling in claims processing and regulatory compliance. Specializing in managing large and complex accounts, while maintaining a proficient track record and a strong relationship with internal and external clients. Highly detail-oriented and proficient in Microsoft applications.

Overview

27
27
years of professional experience
1
1
Certification

Work History

Complex Claims Specialist, Workers Compensation

Encova Insurance
Charleston
02.2020 - Current

Responsible for handling claims primarily in West Virginia; however, I also have experience in handling claims in the following states: Georgia, Illinois, Kentucky, North Carolina, South Carolina, Tennessee, Virginia, and Wisconsin. I handle a diverse caseload, ensuring compliance with state regulations while providing exceptional customer service to claimants and policyholders.

  • Work with adjusters, agents, legal counsel, and policyholders in processing workers' compensation claims, while maintaining a professional relationship.
  • Review the insurance policy, state requirements, and the case of loss for coverage determination.
  • Establish appropriate reserves based upon competent analysis of coverage, liability, and damages. Adjust reserves as necessary, promptly upon receipt of additional relevant information.
  • Assist colleagues with claims handling and relevant questions.

Claims Examiner

Sedgwick CMS
Charleston
04.2007 - 02.2020

Managed workers' compensation claims in multiple states from inception to resolution. Key responsibilities included gathering evidence, conducting interviews in regards to claims, and ensuring that the rules and regulations were followed.

  • Assists other claims examiners and claims supervisors as necessary.
  • Process workers' compensation claims, determining compensability and benefits due.
  • Monitor reserve accuracy, and file necessary documentation with the state agency.
  • Monitor reserve accuracy, and file necessary documentation with the state agency.
  • Communicate claim action, processing with the claimant, physicians, and our client. While maintaining a professional claimant-client relationship.
  • Review medical records to determine the compensability of various medical conditions.

Customer Service Representative/Administrative Assistant

Poca Valley Bank
Elkview
02.2001 - 04.2007

Provided customer service by answering or referring financial questions to the correct supervisory staff.

  • Processed customer deposits, maintained and balanced the cash drawer, handled ATM and night-drop activities, and assisted customers with opening new accounts.
  • Provided assistance to the Branch Manager in the preparation of departmental loan agreements.
  • Coordinated teller rotation schedules for seven branch offices.
  • Served as a liaison between team leaders and branch administration.
  • Provided administrative assistance to the Vice President of Retail Operations, including coordinating staff meetings and preparing agendas/packet presentations, maintaining files, ordering and maintaining office supplies, gathering and processing information on special assignments, including creating spreadsheets to track new customer accounts, executing word processing projects, and preparing departmental reports for distribution.
  • Provided training, and designed and implemented testing procedures and manuals for new hire employees.

Management Trainee

Little General / Baskin Robbins
Elkview
08.1998 - 02.2001
  • Hired, trained, and coordinated staff.
  • Created and maintained employee schedules.
  • Handled inventory and requisitioning of supplies.
  • Opened/closed store; handled customer service complaints, and cash control.
  • Prepared bank deposits and daily sales reports.

Education

BBA - Finance

West Virginia State (College) University
Institute, WV
12-2004

Skills

  • Excellent customer service
  • Claims processing, including indemnity and medical management
  • Regulatory compliance
  • Litigation management
  • Evidence gathering, investigation of claims
  • Excellent communication skills
  • Excels in paying attention to detail
  • Proficient time management
  • High proficiency in Microsoft

Certification

I currently hold an Adjusters Licenses in the following States: Delaware, Georgia, Indiana, Kentucky, Minnesota, North Carolina, South Carolina, and West Virginia. I also have claims management experience in the following sates that does not require a licenses: Illinois, Tennessee, Virginia, and Wisconsin.

References

References available upon request.

Timeline

Complex Claims Specialist, Workers Compensation

Encova Insurance
02.2020 - Current

Claims Examiner

Sedgwick CMS
04.2007 - 02.2020

Customer Service Representative/Administrative Assistant

Poca Valley Bank
02.2001 - 04.2007

Management Trainee

Little General / Baskin Robbins
08.1998 - 02.2001

BBA - Finance

West Virginia State (College) University
Jennifer Schoolcraft
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