Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

Michael Harrison

Carver,MA

Summary

Service-oriented Claims Adjuster skilled at applying creative approaches to solving complex problems. Adept at developing profitable and quality-focused processes. Jurisdiction Focused in Massachusetts, licensed in Connecticut and Rhode Island Workers Compensation Claims.

Handles simple to complex medical issues within the laws of the workers compensation. Works with the employee, doctors and or their counsel to bring the employee back to work.

litigates and resolves claims when necessary, within the authority levels authorized by the client and employer.

Overview

12
12
years of professional experience
1
1
Certification

Work History

Claims Consultant

CCMSI
Reading, MA
09.2011 - 06.2022
  • Followed up with customers on unresolved issues.
  • Reviewed new files to determine current status of injury claim and to develop plan of action.
  • Conducted full claim investigations and reported updates and legal actions.
  • Reported policy changes and company conditions affecting customer satisfaction.
  • Modeled exceptional customer service skills and appropriate diagnostic sales techniques to team members.
  • Addressed average of 150 customer inquiries and complaints each week.

Claims Representative

Meadowbrook Insurance Group
Quincy, MA
02.2009 - 06.2010

Followed up with customers on unresolved issues.
Reviewed new files to determine current status of injury claim and to develop plan of action.
Conducted full claim investigations and reported updates and legal actions.
Reported policy changes and company conditions affecting customer satisfaction.
Modeled exceptional customer service skills and appropriate diagnostic sales techniques to team members.
Addressed average of 150 customer inquiries and complaints each week.

Education

Associate of Science - Computer Science

Massachusetts Bay Community College
Wellesley Hills, MA
1977

Skills

  • Investigate, evaluate and adjust claims in accordance with established claim handling standards and laws
  • Establish reserves and/or provide reserve recommendations within established reserve authority levels
  • Review, approve or provide oversight of medical, legal, damage estimates and miscellaneous invoices to determine if reasonable and related to designated claims Negotiate any disputed bills or invoices for resolution
  • Authorize and make payments of claims in accordance with claim procedures utilizing claim payment program in accordance with industry standards and within established payment authority
  • Prior to litigation: Conciliations, Pre Trial hearings Dispute Resolution, and Hearings makes recommendations with counsel, as appropriate
  • Negotiate settlements in accordance with Corporate Claim Standards, client specific handling instructions and state laws, when appropriate
  • Assess and monitor subrogation claims for resolution
  • Review and maintain personal diary on claim system
  • Prepare reports detailing claim status, payments and reserves, as requested
  • Effective and timely coordination of communication with clients, claimants and appropriate parties throughout claim adjustment process
  • Handle more complex and involved claims than lower-level claim positions with minimum supervision
  • Conduct claim reviews and/or training sessions for designated clients, as requested
  • Compliance with Corporate Claim Handling Standards and special client handling instructions as established
  • Performs other duties as assigned
  • Legal Documentation

Certification

  • Licensed Claims : Connecticut All Lines Adjuster, Rhode Island .

Timeline

Claims Consultant

CCMSI
09.2011 - 06.2022

Claims Representative

Meadowbrook Insurance Group
02.2009 - 06.2010

Associate of Science - Computer Science

Massachusetts Bay Community College

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Michael Harrison