Summary
Overview
Work History
Education
Skills
Skills And Tools
Timeline
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Mari Black

Herriman,UT

Summary

Accomplished Claims Professional with extensive experience managing complex injury claims in fast-paced, high-detail environments. Skilled in liability assessments, coverage analysis, and strategic settlement decisions. Former IME Supervisor with expertise in coordinating independent medical exams, report development, and quality auditing to ensure accuracy, compliance, and medical necessity. Background includes evaluating wage loss, treatment plans, and auto damage to strengthen causation and claim outcomes. Recognized for effective communication with legal professionals, healthcare providers, and insureds. Applies a solid foundation in physiology, biology, and compliance standards to drive precise claim resolutions.

Overview

17
17
years of professional experience

Work History

Personal Injury Protection (PIP) Representative

Progressive Insurance
05.2024 - Current
  • Investigate and resolve complex, non-litigated injury claims involving multi-vehicle accidents, pedestrian incidents, and bodily injury
  • Analyze liability and coverage by reviewing accident reports, policy terms, photos, and recorded statements
  • Set and manage reserves based on injury severity, treatment plans, and recovery timelines
  • Review wage documentation and medical records to assess wage loss eligibility and reimbursement
  • Communicate with attorneys, providers, insureds, and witnesses to clarify coverage and secure documentation
  • Review claims for potential SIU involvement, questionable billing, and medical necessity of treatment plans following auto accidents
  • Evaluate property damage and vehicle dynamics to support injury causation and treatment reasonableness
  • Refer eligible claims for subrogation after confirming third-party liability
  • Shadow CURBI specialists to expand knowledge in liability evaluation, negotiations, and claim assessments; mentor teammates and assist with training
  • Recognized for accurate documentation, timely resolutions, and professionalism with strict attention to deadlines

Case Review Supervisor

Medical Review Institute of America
07.2019 - 05.2023
  • Supervised and mentored a team of 25 clinical analysts reviewing complex medical necessity cases across multiple specialties
  • Ensured compliance with HIPAA, URAC, and internal policies through coaching and weekly quality audits
  • Managed high-volume appeals and SIU referrals involving excessive billing and suspected fraud
  • Cross-trained with pharmacy review, becoming the first analyst to support both teams during peak volume
  • Designed and launched a scalable cross-training program to assist pharmacy workflows during surge periods
  • Led process improvements across four claims platforms, reducing errors and boosting efficiency through automation
  • Coordinated multidisciplinary case reviews to ensure consistency in medical decision-making
  • Collaborated with leadership to update audit protocols and align reviews with evolving payer standards
  • Recognized for bridging clinical and operational needs through innovation and cross-functional leadership

Encoding Specialist

United States Postal Service
04.2008 - 03.2019
  • Maintained a 99.9% accuracy rate in high-volume national data entry and barcode encoding operations.
  • Interpreted and corrected complex routing issues under tight deadlines, supporting nationwide logistics efficiency.
  • Applied detailed knowledge of address standards, geocoding, and system logic to resolve data discrepancies.

Flight Attendant

Delta Air Lines
02.2016 - 04.2017
  • Delivered world-class service to international passengers, ensuring in-flight safety, comfort, and adherence to FAA regulations
  • Completed intensive training in emergency procedures, conflict resolution, CPR, and cultural sensitivity
  • Managed challenging onboard situations with empathy, adaptability, and professionalism while meeting strict flight schedules and regulatory requirements

Education

Associate of Science - Nursing

Salt Lake Community College
Salt Lake City, UT

Information Systems and Technology -

Salt Lake Community College
Salt Lake City, UT

Certificate of Technical Studies - Computer Programming

Bottega Tech
Lehi, UT

Skills

  • Claims Handling & Resolution
  • Investigation & Analysis
  • Medical Knowledge
  • Process Improvement
  • Technical Tools
  • Compliance & Documentation
  • Communication & Negotiation

Skills And Tools

Core Skills & Experience

  • Handles PIP, BI, and non-litigated injury claims
  • Determines coverage and liability; reviews accident reports
  • Reviews ICD/CPT codes; calculates wage loss and treatment needs
  • Coordinates IMEs; strong understanding of anatomy and physiology
  • Evaluates auto damage and sets reserves
  • Refers qualifying claims for subrogation
  • Improves workflows across multiple systems and teams
  • Supports cross-functional teams to boost efficiency
  • Proficient in Power BI, Excel, Word, Teams, SharePoint, and claims systems
  • Knowledgeable in HIPAA and URAC compliance
  • Processes appeals and documents case reviews
  • Communicates with attorneys, providers, insureds, witnesses, and peers

Timeline

Personal Injury Protection (PIP) Representative

Progressive Insurance
05.2024 - Current

Case Review Supervisor

Medical Review Institute of America
07.2019 - 05.2023

Flight Attendant

Delta Air Lines
02.2016 - 04.2017

Encoding Specialist

United States Postal Service
04.2008 - 03.2019

Information Systems and Technology -

Salt Lake Community College

Associate of Science - Nursing

Salt Lake Community College

Certificate of Technical Studies - Computer Programming

Bottega Tech

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Mari Black