Mary Moran
Morristown,TN
Summary
Experienced service-oriented claims adjuster with a strong background in handling workers' compensation claims. Proficient in the intake process for claimant information, as well as records documentation and fraudulent investigation protocols. Skilled in analyzing data, consulting with legal counsel, and effectively communicating with insured employers, injured workers, and medical providers to gather necessary details for claims processing. Demonstrated ability to work independently and remotely, managing multiple projects simultaneously while meeting deadlines. Known for building successful partnerships and establishing credibility with insured employers, attorneys, and staff.
Overview
23
23
years of professional experience
Work History
Claims Adjuster II
AmTrust Financial
11.2022 - Current
- Evaluate the extent of damages related to claims, utilizing expertise in workers' compensation
- Interpret policy language to determine coverage eligibility and identify potential exclusions, ensuring claims fall within policy guidelines.
- Negotiate settlements with claimants or their representatives, balancing the company's financial interests with the claimant's needs.
- Monitor for potential fraudulent activity within claims and report suspicious circumstances to appropriate parties.
- Maintain accurate and detailed claim documentation, including investigation findings, damage assessments, and settlement details, through the company's claims management system.
- Adhere to all applicable insurance regulations, company policies, and claims handling standards.
- Direct claims negotiations within allowable limit of $25,000 and supported successful litigations for advanced issues.
Paralegal Manager
TENTINDO, KENDALL, CANNIFF & KEEFE LLP
06.2008 - 11.2022
- Managerial duties include oversight of all aspects (i.e., employee development, performance reviews, personnel concerns, scheduling issues, compliance with in-firm mandates, workload evaluation and adjustment, and other aspects as needed) of staff of twelve (12) paralegals while simultaneously performing regular daily paralegal duties
- Advise attorneys and paralegals on complex issues, new and updated legal procedures
- Manage new and high valued accounts and special project assignments
- Conduct training seminars to clients regarding workers’ compensation practices and procedures
- Participate in claim review client meetings involving high exposure and complex litigation issues
- Coordinate and conduct client compliance audits
- Responsible for comprehensive training and onboarding processes for all newly hired paralegals
- Extensive network and contacts with experts, attorneys, claims personnel and myriad other professionals in all disciplines relating to workers’ compensation claims.
Paralegal
TENTINDO, KENDALL, CANNIFF & KEEFE LLP
06.2001 - 06.2008
- Paralegal duties include conduct comprehensive in-depth case reviews and write detailed case summaries outlining claim history including medical treatment and identification of legal and medical issues and provide recommendations for additional investigation and defense strategies
- Assist firm partners and senior attorneys in the defense preparation of workers’ compensation cases to be heard before all six (6) New England states differing workers’ compensation systems
- Evaluate cases for liability, indemnity and medical exposure and provide settlement value recommendations
- Work closely with claims adjusters, third-party administrators, risk managers, employers, excess insurers, and brokers during entire claim process
- Draft various motions, agreements, and correspondence
Education
Bachelor of Science in Business Administration, Management -
Bryant College
Smithfield, RI05.1986
Skills
- Workers' compensation claims
- Exposure analysis
- Claims Processing
- Legal proceedings knowledge
- Claims Investigation
- Claims file documentation
- Advanced oral and written communication skills
- Settlement management
Successfulprojects
- FirstReturn, Wrote the subrogation, litigation management, fraud, and reserve sections of the claim’s manual. Developed various informational correspondence to be shared with FirstReturn’s agents, prospective and new clients, including an explanation of the exclusive Preferred Provider Network. Researched and compiled information on Rhode Island, Connecticut and Vermont’s workers’ compensation laws, forms, and procedures.
- Crum & Forster Insurance Company, Inc., Facilitated workshops on Workers’ Compensation Field Investigation, Litigation Management, Subrogation and Workers’ Compensation Claims Handling Skills.
Timeline
Claims Adjuster II
AmTrust Financial
11.2022 - Current
Paralegal Manager
TENTINDO, KENDALL, CANNIFF & KEEFE LLP
06.2008 - 11.2022
Paralegal
TENTINDO, KENDALL, CANNIFF & KEEFE LLP
06.2001 - 06.2008
Bachelor of Science in Business Administration, Management -
Bryant College
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