Nally Walter

• Manage a block of long-term disability claims, analyzing medical, financial, and occupational information to determine ongoing eligibility and liability decisions.

• Evaluate medical documentation, functional capacity information, and vocational evidence to assess disability status and support defensible claim outcomes.

• Interpret policy provisions and contractual language to ensure accurate benefit determinations consistent with plan guidelines and regulatory requirements.

• Produce clear, objective written rationales outlining claim decisions, ensuring transparency, consistency, and compliance with internal standards.

• Maintain productivity and quality expectations while handling complex claim scenarios requiring sound analytical judgment.

• Communicate effectively with claimants, employers, medical providers, and other stakeholders to gather information and resolve discrepancies impacting claim determinations.

• Identify potential return-to-work opportunities through evaluation of medical and occupational information.

• Ensure adherence to federal and state regulatory requirements governing disability claims.

• Investigated complex property claims by analyzing coverage, damages, and policy provisions to determine appropriate claim outcomes.

• Evaluated independent adjuster reports to verify accuracy of scope, causation, and estimate recommendations.

• Applied policy language to determine coverage eligibility and appropriate claim payments.

• Established and adjusted reserves based on exposure evaluation and claim development.

• Managed high-volume caseloads while meeting productivity and quality performance expectations.

• Investigated equipment breakdown and property losses by analyzing cause of loss, damage scope, and policy coverage.

• Reviewed technical reports and documentation to support claim determinations.

• Maintained strong audit results through accurate documentation and timely claim resolution.

• Consistently met performance expectations for claim quality and cycle time.

• Investigated claims by reviewing statements, police reports, and supporting documentation to determine liability and coverage decisions.

• Interpreted policy language and applied guidelines to ensure accurate claim outcomes.

• Negotiated settlements and communicated claim decisions clearly to customers and stakeholders.