Summary
Overview
Work History
Skills
Timeline
Generic

Julie M. Maye

Montgomery,IL

Summary

Seasoned Workers' Compensation Claims Adjuster with over 25 years of experience managing complex and high-exposure claims from inception to resolution. Proven track record of conducting thorough investigations, determining compensability, negotiating settlements, and ensuring compliance with state and federal regulations. Skilled in collaborating with employers, attorneys, medical providers, and injured workers to achieve fair and cost-effective outcomes. Adept at mentoring junior adjusters and streamlining claims processes to improve efficiency and reduce claim duration. Known for a strong analytical mindset, excellent communication skills, and a commitment to integrity and best practices in claims management.

Overview

25
25
years of professional experience

Work History

Senior Account Claim Specialist

Employers Claim Service Inc.
02.2018 - 02.2025
  • Managed and resolved complex workplace injury claims, ensuring timely and accurate claim processing.
  • Conducted thorough investigations to determine liability and compensability.
  • Administered benefits in compliance with legal and regulatory standards.
  • Communicated effectively with stakeholders, including claimants, employers, attorneys, and medical providers.
  • Prepared documentation for litigation and assisted in trial preparation.
  • Negotiated and executed settlements to achieve optimal outcomes.
  • Identified opportunity for subrogation and managed recovery efforts.
  • Implemented cost-containment strategies to reduce claim and account-level expenses.
  • Monitored and reported on claim trends and identified potential fraudulent activities.
  • Provided risk management support to accounts, safeguarding financial and reputational interests.
  • Maintained expertise in workers' compensation laws and claim handling best practices.
  • Demonstrated strong analytical, negotiation, problem-solving, and communication skills.
  • Worked independently and adapted quickly to changing priorities.

Senior Workers' Compensation Claims Adjuster

PMA Companies
08.2013 - 02.2018
  • Evaluated complex workers' compensation claims to determine eligibility and benefits.
  • Negotiated settlements with claimants and legal representatives to ensure fair outcomes.
  • Collaborated with medical professionals to assess injury treatment and recovery timelines.
  • Analyzed claims data to identify trends, informing strategic decision-making and policy adjustments.

Travelers Insurance

Workers Compensation Investigative Case Unit Claims Representative
06.2007 - 08.2013
  • Investigated thoroughly for claim compensability.
  • Handled disputed claims alongside defense counsel through litigation and negotiate settlements on a disputed basis.
  • Coordinated return to work efforts with employer

Medical Only Claims Representative

The Hartford
01.2000 - 06.2007
  • Evaluated and processed insurance claims to ensure compliance with policy guidelines.
  • Coordinated communication between claimants, insurers, and medical providers for efficient resolution.
  • Analyzed claim documentation for accuracy, identifying discrepancies and initiating corrective actions.

Skills

  • Exceptional problem solving skills
  • Settlement negotiation
  • Claim resolution management
  • Legal compliance
  • Case reserving accuracy
  • Return-to-work strategies
  • Claims investigation expertise
  • Teamwork and collaboration
  • Dependable and responsible
  • Disability management understanding
  • Excellent organizational skills, with the ability to work in a high volume, fast paced environment with strict deadlines

Timeline

Senior Account Claim Specialist

Employers Claim Service Inc.
02.2018 - 02.2025

Senior Workers' Compensation Claims Adjuster

PMA Companies
08.2013 - 02.2018

Travelers Insurance

Workers Compensation Investigative Case Unit Claims Representative
06.2007 - 08.2013

Medical Only Claims Representative

The Hartford
01.2000 - 06.2007

Similar Profiles

CREATE PROFILE
Julie M. Maye