Mary E. Quillen
Grove City
Summary
Work independently and efficiently with minimal supervision Ability to prioritize and remain focused on the essence of an issue Adept at learning new concepts with quick application Worker’s compensation experience with claims management since 2001 (both Self-Insured and State Fund) Dedicated to customer service that exceeds expectations
Overview
28
28
years of professional experience
Work History
Legal Assistant
Miller Law Practice, LLC
Columbus, OH
01.2018 - Current
- Document information received and telephone conversations in an organized fashion with clear concise notes.
- File necessary appeals to C9 denials, Bureau of Workers’ Compensation orders and Industrial Commission orders.
- Review Bureau of Workers’ Compensation and Industrial Commission orders for accuracy and request corrections as needed.
- Send letters to medical providers in relation to denied requests for treatment. Follow up with providers if the requested narrative response have not been received timely.
- Prepare files for hearing (organize pertinent medical documents for attorney review and obtain missing documentation).
- Generate letters to clients to advise of hearing dates and any changes to the docket.
- Request hearing continuances, change of venue and/or cancellations.
- Communicate in a professional manner with claim parties.
- Answer client questions, discuss claim direction and obtain important information (such as dates of surgery, diagnostic testing, office visit dates or consult dates).
- Schedule clients for Permanent Total Disability, C92/C92A and additional allowance exams.
- Prepare letter and medical packet to send to the examining doctor.
- Send forms to new clients. Make the appropriate follow-up with the client for the forms when not returned timely.
- File C92/C92A applications with the Bureau of Workers’ Compensation. Follow up for exam dates, the issuance of the Tentative Order and the subsequent C92/C92A award.
- Generate letters to the Third-Party Administrator requesting medical information on file for Self-Insured injured workers.
- Review Bureau of Workers’ Compensation orders to ensure that all wage information is available and has been calculated correctly.
- Assist with filing C86 motions for additional allowances, treatment denials and compensation.
Legal Assistant
Weller, Steele, Miller LLC
Columbus, OH
10.2011 - 12.2017
- Document information received and telephone conversations in an organized fashion with clear concise notes.
- File necessary appeals to C9 denials, Bureau of Workers’ Compensation orders and Industrial Commission orders.
- Review Bureau of Workers’ Compensation and Industrial Commission orders for accuracy and request corrections as needed.
- Send letters to medical providers in relation to denied requests for treatment. Follow up with providers if the requested narrative response have not been received timely.
- Prepare files for hearing (organize pertinent medical documents for attorney review and obtain missing documentation).
- Generate letters to clients to advise of hearing dates and any changes to the docket.
- Request hearing continuances, change of venue and/or cancellations.
- Communicate in a professional manner with claim parties.
- Answer client questions, discuss claim direction and obtain important information (such as dates of surgery, diagnostic testing, office visit dates or consult dates).
- Schedule clients for Permanent Total Disability, C92/C92A and additional allowance exams.
- Prepare letter and medical packet to send to the examining doctor.
- Send forms to new clients. Make the appropriate follow-up with the client for the forms when not returned timely.
- File C92/C92A applications with the Bureau of Workers’ Compensation. Follow up for exam dates, the issuance of the Tentative Order and the subsequent C92/C92A award.
- Generate letters to the Third-Party Administrator requesting medical information on file for Self-Insured injured workers.
- Review Bureau of Workers’ Compensation orders to ensure that all wage information is available and has been calculated correctly.
- Assist with filing C86 motions for additional allowances, treatment denials and compensation.
Team Lead
CareWorks of Ohio
Dublin, OH
08.1998 - 10.2011
- Collaborate with team supervisor to run the team effectively and efficiently while meeting company timeframes and guidelines.
- Complete yearly reviews for Case Specialists.
- Handle HR issues with associates, ranging from behavioral to attendance related.
- Manage customer service complaints/issues.
- Manage associates’ caseloads to ensure even distribution.
- Work reports daily for proper claim coding, provider of record selection and new claims.
- Weekly claim and C9 audits for associates to ensure they are following proper protocol.
- Oversee the training of new associates.
- Serve as a resource for co-workers’ questions or problems.
- Attend employer claim staffings as needed for employee support.
- Monitor a caseload with an average of 60 claims functioning as a Case Specialist.
- Team Lead (2005-2011)
Case Specialist
CareWorks of Ohio
Dublin, OH
01.2002 - 01.2005
- Work with Case Managers to effectively manage work related injury claims.
- Authorize or deny treatment based on medical appropriateness and claim allowances.
- Assist injured workers and employers with claim questions.
- Responsible to train new associates.
- Imaging and database mentor. Worked with committee to indicate necessary enhancements.
- Prepare files for appeals process as well as following the claim through to resolution.
- Attend employer claim staffings to provide claim updates and discuss proactive management.
- Case Specialist (2002-2005)
Team Assistant
CareWorks of Ohio
Dublin, OH
01.2000 - 01.2002
- Forwarded incoming faxes and C9’s to the appropriate specialists.
- Faxed completed C9’s to the necessary recipients.
- Completed C23 forms with copies to all claim parties.
- Team Assistant (2000-2002)
Health Information Management
CareWorks of Ohio
Dublin, OH
01.1999 - 01.2000
- Routed incoming faxes and mail to the appropriate associates.
- Imaged documents into the system, filing them in the correct claims.
- Health Information Management (1999 to 2000)
Education
Bachelor of Arts - Women’s Studies
The Ohio State University
06-1998
Skills
- Fast learner
- Scheduling/Planning
- Microsoft office
- File organization
- Calendar management
- Client communication
- Administrative support
- Document preparation
- Document filing
- Client support
- Task prioritization
- Client service and support
- Confidentiality
Timeline
Legal Assistant
Miller Law Practice, LLC
01.2018 - Current
Legal Assistant
Weller, Steele, Miller LLC
10.2011 - 12.2017
Case Specialist
CareWorks of Ohio
01.2002 - 01.2005
Team Assistant
CareWorks of Ohio
01.2000 - 01.2002
Health Information Management
CareWorks of Ohio
01.1999 - 01.2000
Team Lead
CareWorks of Ohio
08.1998 - 10.2011
Bachelor of Arts - Women’s Studies
The Ohio State University