Open To Work
Kara Goney, CWC ACA
Lakeland,FL
Work Preference
Summary
Results-driven Claims Examiner skilled in catastrophic reserving and vendor negotiation. Experienced in claims litigation and settlement, utilizing strong communication and detail-oriented approach. Multi-state licensed, focused on comprehensive claim management and customer service. Accredited Claims Adjuster (ACA) with expertise in resolving complex cases.
Overview
22
22
years of professional experience
Work History
CLAIMS EXAMINER
Packard Claims Administration
Holiday
01.2023 - Current
- Managed insurance claims exceeding $1M, specializing in catastrophic reserving and negotiating vendor contracts to optimize outcomes.
- Acted as one of two Catastrophic Adjusters for SPLI, overseeing comprehensive claim management and delivering quality service.
- Managed claims from initiation to settlement, including litigation processes, ensuring timely resolutions.
- Demonstrated proficiency in navigating high-pressure situations with professionalism and empathy.
- Maintained active licenses across several states, including FL, GA, NC, NJ, and CO.
- Possessed experience in handling CA claims to broaden claims management capabilities.
CLAIMS EXAMINER
Sedgwick
Lake Mary
01.2022 - 12.2022
- Managed claims for Colorado, Mississippi, Alabama, and Florida, ensuring compliance with state regulations.
- Reviewed and reserved legacy claims, determining eligibility and administering benefits to ensure timely support for claimants.
- Collaborated with PEO team, enhancing coordination for national operations.
LEGAL SECRETARY
DeZayas Law Group
Lakeland
07.2019 - 06.2020
- Handled workers compensation claims as part-time legal assistant.
- Managed correspondence with opposing counsel, filed documents, summarized medical records, and transcribed dictation.
LEGAL SECRETARY
Conroy Simberg
Tampa
06.2018 - 06.2019
- Scheduled appointments, prepared correspondence, and organized trial files; streamlined settlement process from document receipt to file closure.
- Managed administrative tasks for the Worker’s Compensation Partner in the Tampa office.
- Responsible for meeting with Pro Se claimants and assisting them with their settlement documents.
LOST TIME CLAIMS ADJUSTOR
USIS
Orlando
12.2017 - 04.2018
- Reviewed and reserved legacy claims to determine eligibility, ensuring accurate administration of benefits.
- Negotiated settlements within desk authority and provided additional recommendations to clients for timely resolution.
- Collaborated with insolvency team for State of Florida to manage complex claims effectively.
LOST TIME CLAIMS ADJUSTOR
The Best IRS
Winter Haven
03.2017 - 09.2017
- Served as independent lost time adjustor for multiple companies, ensuring compliance and effective claims management.
- Obtained licenses in multiple states to ensure compliance with local regulations.
- Reviewed and managed new and legacy claims, facilitating prompt resolutions and support for affected employees.
- Administered worker's compensation benefits in accordance with state guidelines, ensuring timely support for injured workers.
LOST TIME CLAIMS ADJUSTOR
Broadspire
Tampa
11.2014 - 03.2017
- Handled lost time claims at PEO level, ensuring timely resolution and compliance.
- Investigated new claims and legacy files, providing actionable recommendations to stakeholders.
- Conducted monthly live file reviews to ensure compliance and accuracy.
- Supervised team of 6 adjustors for 1.5 years, coordinating activities to enhance claim processing.
LOST TIME CLAIMS ADJUSTOR
Summit Consulting
01.2004 - 08.2014
- Handled Worker's Compensation claims for self-insured accounts, including catastrophic injuries for Law Enforcement and Fire Personnel.
- Achieved licensure as an Accredited Claims Adjuster, demonstrating expertise in claims management.
- Obtained Board Certification in Workers' Compensation, underscoring commitment to professional standards.
Education
High School Diploma -
Lakeland Senior HS
Lakeland, FL05.2002
Skills
- Typing - 85 WPM
- Catastrophic reserving
- Vendor negotiation
- Claims litigation and settlement
- Effective communication
- Conflict resolution
- Time management
- Attention to detail
- Claims processing
- Investigative skills
- Accredited claims adjuster (ACA)
- Microsoft Office proficiency
- Customer service excellence
- Legal and medical terminology familiarity
References
Available upon request.
Timeline
CLAIMS EXAMINER
Packard Claims Administration
01.2023 - Current
CLAIMS EXAMINER
Sedgwick
01.2022 - 12.2022
LEGAL SECRETARY
DeZayas Law Group
07.2019 - 06.2020
LEGAL SECRETARY
Conroy Simberg
06.2018 - 06.2019
LOST TIME CLAIMS ADJUSTOR
USIS
12.2017 - 04.2018
LOST TIME CLAIMS ADJUSTOR
The Best IRS
03.2017 - 09.2017
LOST TIME CLAIMS ADJUSTOR
Broadspire
11.2014 - 03.2017
LOST TIME CLAIMS ADJUSTOR
Summit Consulting
01.2004 - 08.2014
High School Diploma -
Lakeland Senior HS