Kristin Sandberg
Ishpeming,Michigan
Summary
Motivated Claims Examiner committed to diligently investigating, evaluating and negotiating workers compensation claims. Licensed and knowledgeable in multiple jurisdictions. Handled numerous multi client desks each with their own individual client service instructions averaging 100-200 claims at any given time. The majority of claims being litigated. Successfully hits over 100% closing ratio each month. Skilled in recognizing potential fraudulent claims. Adept at training and supporting new adjusters.
Overview
13
13
years of professional experience
Work History
Claims Examiner
Sedgwick Claims Management
03.2016 - Current
- Complete a detailed investigation on each claim in a timely manner that complies with state guidelines and fully document the file with pertinent information
- Maintain consistent contact with involved parties to keep all informed of claim progress
- Set accurate reserves on each claim within given authority level and promptly bring claims that will require reserves in excess of their authority to their supervisor’s attention
- Closely manage defense counsel and the litigation process to ensure that loss adjustment expenses are appropriate
- Handled complaints and grievances using negotiating and problem-solving skills.
- Worked with private investigators and attorneys on preparation of evidence, witness statements and other documentation in preparation for trial.
- Interviewed claimants and witnesses to gather factual information.
- Conducted day-to-day administrative tasks to maintain information files and process paperwork.
Liaison
Bell Memorial Hospital
09.2014 - 03.2016
- Greeting patients professionally both in person and on the phone
- Quickly answering or properly referring questions and issues
- Optimizing provider schedules and patient satisfaction with efficient scheduling
- Obtaining prior authorizations for scheduled testing & referrals
- Ensuring availability of treatment information by retrieving and updating patient records
Liaison Coordinator Hematology Oncology
Marquette General Health System
01.2011 - 09.2014
- Greeting patients professionally both in person and on the phone
- Quickly answering or properly referring questions and issues
- Ensuring availability of treatment information by retrieving and updating patient records
- Optimizing provider schedules and patient satisfaction with efficient scheduling.
- Scheduling chemotherapy sessions
- Providing teacher & materials on specific chemotherapy
- Obtaining prior authorizations for scheduled testing, referrals & radiation
Education
No Degree - Clinical Laboratory Science
Northern Michigan University
Marquette, MISpecialist - Workers Compensation Claims Specialist
American Educational Institute, Inc
05.2021
High School Diploma -
Gwinn High School
Gwinn MI 05.2007
Skills
- Claims processing
- Conflict resolution
- Time management
- Computer proficiency
- Investigative skills
- Organizational skills
- Medical terminology
- Multitasking
- Critical thinking
- Decision-Making
- Settlement Negotiations
- Liability Determination
- Litigation Management
Section name
Modern Stained Glass Artist
Timeline
Claims Examiner
Sedgwick Claims Management
03.2016 - Current
Liaison
Bell Memorial Hospital
09.2014 - 03.2016
Liaison Coordinator Hematology Oncology
Marquette General Health System
01.2011 - 09.2014
No Degree - Clinical Laboratory Science
Northern Michigan University
Specialist - Workers Compensation Claims Specialist
American Educational Institute, Inc
High School Diploma -
Gwinn High School