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Michelle Newton
West Jordan,UT
Work Preference
Desired Job Title
Senior Claims AdjusterSenior Workers' Compensation Claims AdjusterWork Type
Full TimeLocation Preference
RemoteImportant To Me
Career advancementWork-life balancePersonal development programsHealthcare benefitsWork from home optionPaid time offPaid sick leave401k matchSummary
Results-driven Senior Claims Adjuster with a proven track record in complex case management. Expertise in effective communication and strategic decision-making, contributing to streamlined processes and enhanced team performance. Proven team leader with a track record of driving operational excellence by mentoring junior adjusters and championing a collaborative, high-performance work culture.
Overview
1
1
Certification
19
19
years of professional experience
Work History
Senior Claims Adjuster
CorVel
Salt Lake City, UT
10.2022 - 04.2026
- Evaluated complex claims to determine liability and negotiate settlements effectively.
- Led investigations into claims, utilizing analytical skills to assess facts, validate evidence, and determine compensability based on the Utah jurisdictional laws or rules.
- Navigated complex interactions with various insured employers and excess carriers to ensure effective risk management.
- Collaborated with legal teams to resolve disputes and resolve claims.
- Mentored junior adjusters on best practices for claims handling and customer service excellence.
- Developed streamlined processes for claim reviews, enhancing workflow efficiency within the team.
- Executed subrogation processes and managed MSA agreements to ensure compliance and efficiency.
- Managed CMS submission processes, facilitating efficient and accurate content updates.
- Analyzed settlement options and engaged with employers, and defense attorneys to achieve timely resolutions of litigated claims ahead of hearings.
Senior Workers' Compensation Claims Adjuster
Sedgwick Claims Management
Salt Lake City, UT
10.2007 - 10.2022
- Managed complex workers' compensation claims, ensuring adherence to regulatory requirements and company policies.
- Administrated claims for dedicated insured employer for UT, AZ, & CO jurisdictions.
- Analyzed claim data to identify trends and improve processing efficiency across multiple case types.
- Collaborated with medical professionals and employers to facilitate timely resolution of claims disputes.
- Conducted thorough analysis of investigative data and presented findings with actionable recommendations.
Education
High School Diploma -
No Degree -
Realtor -
Skills
- Effective communication
- Professionalism and integrity
- Team leadership qualities
- Computer software proficiency
- Strategic Decision-making
- Analytical problem solving
- Data entry efficiency
- Complex case management
- Conflict resolution
Accomplishments
- Served as Lead Adjuster for complex claims.
- Maintained a consistent closing ratio of 95% or better.
- Met or exceeded internal and excess carrier audit scores.
- Skilled in leading quarterly claim reviews with clients, attorneys, and nurse case managers to offer employers practical resolution options.
Certification
- AZ Insurance License -
Timeline
Senior Claims Adjuster - CorVel
10.2022 - 04.2026
Senior Workers' Compensation Claims Adjuster - Sedgwick Claims Management
10.2007 - 10.2022
Granite High School - High School Diploma,
Dental Assistant Training - No Degree,
Stringham RealEstate School - Realtor,