Summary
Overview
Work History
Education
Skills
Timeline
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Mamie Barber

Blue Island,IL

Summary

  • Objectives I am a highly motivated Workers’ Compensation Specialist
  • Seeking a challenging position that will allow me to utilize my skills and abilities. I’m a positive team player prepared to take on any challenges.
  • An energetic self-starter with a successful track record.
  • Customer Service in many forms, Particular strengths include excellent interpersonal skills, detail oriented, logical, and with a creative mind with the ability to help develop innovative ways to learn.
  • improve productivity. Results-focused professional with strength.
  • Proactive leader with strengths in communication and collaboration.
  • Proficient in leveraging and knowledge to promote .
  • Adept at managing concurrent objectives to promote efficiency and influence positive outcomes.

Overview

7
7
years of professional experience

Work History

Workers' Compensation Claims Examiner

Gainwell Technologies
10.2022 - 01.2024
  • Successful in claim cost reductions and expedite claim resolution.
  • Responsible for developing, maintaining, the company's workers' compensation program.
  • Develop and implement Workers’ Comp Injury reporting & investigation.
  • Report all recordable injuries to TPA and monitor status from inception to completion.
  • Maintain constant communication with injured workers and their Managers to ensure their full recovery and provide support.
  • Investigate accidents & incidents to identify root cause for prevention and for consideration with AOE/COE.
  • Monitor work status reports to avoid delays in treatment and avoid possible unnecessary or excessive treatment.
  • Manage the Return-to-Work Program.
  • Establish aggressive Defense Panel and Investigation Panel.
  • Work closely with Defense Panel with objective to expedite resolution of litigated claims while being cost effective.
  • Monitoring of reserves.
  • Review and approve all claim settlements proposed.
  • Facilitate quarterly claim review meetings with TPA, defense attorneys, and broker to obtain status and/or plan of action to strategize and close claims expeditiously.
  • Assist CFO with Insurance renewals, assessment of current TPA effectiveness; provide reports, interview potential TPA candidates.
  • Assist Safety Department with injury analysis and creating Safety Programs.
  • Support Safety Department with developing training material and corrective actions.
  • Assist In-house counsel with complex cases such as harassments claims, FEHA / EEOC claims, S&W claims, reasonable suspicions and reprimands.
  • Create and manage clinic protocols.
  • OSHA recordkeeping and postings mandated by State (CA, AZ, NV).
  • Determined insurance coverage levels and restrictions by thoroughly examining claims forms and associated records.
  • Checked into questionable claims, interviewing agents and claimants to resolve errors and omissions.
  • Reviewed police reports, medical treatment records, medical bills and physical property damage to determine extent of liability.
  • Gathered and documented evidence to support court proceedings.
  • Created master spreadsheet to record procedures, denials and approvals.
  • Spearheaded claims negotiations up to $[Amount] and contributed to litigation processes for unsuccessful settlements.
  • Worked closely with team members to deliver project requirements, develop solutions and meet deadlines.
  • Juggled multiple projects and tasks to ensure high quality and timely delivery.
  • Demonstrated self-reliance by meeting and exceeding workflow needs.
  • Demonstrated leadership by making improvements to work processes and helping to train others.

Workmen Compensation Claim Examiner

SEIU Health And Welfare Fund
03.2022 - 12.2022
  • Review Workers Compensation forms for accuracy and completeness.
  • Investigate accidents to identify root cause.
  • Follow up with Management for pending actions items, i.e.: missing forms, pictures, evidence, witness statements, red flags.
  • Report all recordable injuries to TPA and monitor status from inception to completion.
  • Review and authorize payment for First Aid clinic services.
  • Communicate verbally and in writing on non-routine matters which involve interpretation of policy and procedures.
  • Work closely with Safety Manger with development and implementation of Safety trainings, i.e: Ergonomics, PPE, New Hire Orientation.
  • OSHA recordkeeping & postings.
  • Provide daily guidance to Management with Safety/WC, Associate work status, reporting, policies.
  • Assist with preparation of quarterly file reviews.
  • Responsible for conducting the New Hire Orientations and providing required benefit notices.
  • Maintain a complex system of confidential departmental records and reports.
  • Maintain financial records and prepare reports upon request.
  • Assist with Industrial Clinic management.
  • Assist in the review and evaluation departmental procedures.
  • Attend workshops, conferences, meetings and keep abreast of new W/C regulations or changes to codes and regulations.
  • Monitor First Aid kits for replenishment and cost containment.
  • Assist with managing the Return-to-Work Program.
  • Provide support to the TPA, Defense Panel, and Broker.
  • Assist with implementation and management of Accident Free incentive program.
  • Promoted to Workers’ Compensation Manager.

Workmen Compensation Claims Representative

BCBSIL
01.2021 - 12.2021
  • Provide full support in the processing of orders from start to finish in a high paced environment and to high profile customers.
  • Significant interfacing with sales agents, customers, and other teammates.
  • Schedule activations, conference calls, and troubleshooting with all parties involved.
  • Maintain accurate records of each customer’s services and requirements.
  • Review contracts and all documentation related with processing and order.
  • Create proposals and presentations.
  • Provide accurate data for dispute research.
  • Provide feasible timelines and meet deadlines.
  • Work closely with the SVP of Operations on special projects.
  • Keep abreast on new policies and products with little or no training.
  • Consistently assist with training new hires.
  • Assessed, monitored and reported on work progression.
  • Updated and distributed weekly project schedules and milestones.
  • Collaborated with cross-functional teams to draft project schedules and plans.
  • Oversaw adherence to project timelines and budget constraints.
  • Set project goals and schedule with owners and team members.
  • Liaised with project managers to evaluate project scope and define milestones and deadlines.
  • Cultivated lasting partnerships with stakeholders and created innovative strategies and functions to promote products and offerings.
  • Eliminated downtime by troubleshooting installation issues through timely completion.

Workmen Compensation Claims Representative

Harris & Harris
03.2017 - 12.2019
  • Responsible for analyzing client’s financial documents, credit history, demographics to identify and manage credit risk.
  • Through judgmental lending, manage credit limits, and develop new credit products.
  • Data entry into various systems.
  • Comply with regulations including USA Patriot ACT.
  • Analyze financial status for possible increase/decrease of interest rates and change in terms.
  • Work in conjunction with Fraud Dept for security clearance and when fraud risk identified.
  • Promoted to Team Leader.
  • Reviewed customer financial data to ascertain level of risk involved for extending credit.
  • Collaborated closely with customers, using effective communication and interpersonal strengths to gather important financial information.
  • Analyzed loan applications submitted by corporations, using standard metrics such as liquidity, leverage and credit history to evaluate risk associated with issuing loans.
  • Implemented risk assessment techniques to identify indicators of potential attempts at fraud or other unethical activity, denying suspicious applications to protect company.
  • Utilized automated underwriting and credit analysis systems to generate reports on applications, analyzing debt-to-income ratios and other metrics to assess applications.
  • Met with upper management and provided insight into credit decisions.
  • Handled customer service correspondence from clients, assisting with application completion, explaining qualification criteria and resolving complaints.
  • Managed various tasks simultaneously and made sure all job duties were completed in order of priority.

Education

IEA – Workers Comp Claim Administration, Certification (in Progress)IEA & CCWC – Attend WC Seminars & Conferences UEI – Business Office Administration - Medical Insurance Billing

Rockford Career College
Rockford, IL
11.2024

Billing & Coding

Medical Administrative Assistant
Merrionette Park IL
09.2010

Diploma - Medical Assistant

Illinois School of Health Careers - Chicago
Chicago, IL
11.2006

Skills

  • Managing compensation claims
  • Workers compensation examinations
  • Claims process explanation
  • Denied claims identification
  • Proof of claims understanding
  • Insurance claims

Timeline

Workers' Compensation Claims Examiner

Gainwell Technologies
10.2022 - 01.2024

Workmen Compensation Claim Examiner

SEIU Health And Welfare Fund
03.2022 - 12.2022

Workmen Compensation Claims Representative

BCBSIL
01.2021 - 12.2021

Workmen Compensation Claims Representative

Harris & Harris
03.2017 - 12.2019

IEA – Workers Comp Claim Administration, Certification (in Progress)IEA & CCWC – Attend WC Seminars & Conferences UEI – Business Office Administration - Medical Insurance Billing

Rockford Career College

Billing & Coding

Medical Administrative Assistant

Diploma - Medical Assistant

Illinois School of Health Careers - Chicago

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Mamie Barber