Pamela Williams

• Maintained compliance with industry regulations and standards by staying current on relevant laws, policies, and best practices for handling WC claims.
• Evaluated and settled complex WC insurance claims.
• Enhanced client/company satisfaction by efficiently managing claims processes and providing timely resolutions.
• Maximized client satisfaction by addressing concerns promptly and professionally, consistently demonstrating empathy and understanding during the claim process.
• Expedited claim resolutions through effective negotiation with clients and plaintiff attorneys.
• Followed up with team members on unresolved issues.
• Delivering exceptional customer service during claim investigations and settlements.
• Negotiated settlements effectively, ensuring fair outcomes for the claimant and client.
• Streamlined communication with policyholder to clarify claim procedures, requirements, and enhancing overall transparency.
• Maintained up-to-date knowledge of regulatory changes, ensuring compliance in all claim handling procedures.
• Accurate claim reserve management.
• Communicated effectively with staff, management operations, and clinical departments to facilitate claim resolution.

• Verified insurance claims and determined fair amount for settlement.
• Negotiated favorable settlements with claimants, attorneys, and to minimize financial risk for the company.
• Conducted thorough investigations of complex insurance claims, gathering evidence and analyzing relevant documentation.
• Contributed to a positive work environment through active participation in team meetings and collaborating on cross-functional projects.
• Conducted comprehensive interviews of claimants to gather facts and information.
• Improved claim resolution times by efficiently managing a caseload of 250-300+ claims per month.
• Provided exceptional customer service, addressing concerns, and answering questions promptly.
• Delivered exceptional customer service to policyholders by communicating important information and patiently listening to issues.
• Researched claims and incident information to deliver solutions and resolve problems.
• Analyzed information gathered by investigation and reported findings and recommendations.
• Conducted day-to-day administrative tasks to maintain information files and process paperwork.
• Maintained contact with claimants and attorneys to determine treatment status.

• Delivered exceptional customer service to policyholders by communicating important information and patiently listening to issues.
• Conducted day-to-day administrative tasks to maintain information files and process paperwork.
• Conducted comprehensive interviews of witnesses and claimants to gather facts and information.
• Analyzed information gathered by investigation and reported findings and recommendations.
• Read over insurance policies to ascertain levels of coverage and determine whether claims would receive approvals or denials.
• Reviewed medical treatment records to determine extent of liability.
• Identified suspicious losses and contacted manager for investigative assistance.
• Worked with private attorneys on preparation of evidence, witness statements, and other documentation in preparation for settlement negotiations.
• Negotiated settlement agreements to resolve disputes.

• Reduced workplace accidents by effectively coordinating safety training programs for all employees.
• Timely reported and communicated to insurance company injury reports.
• Review of lost runs. Correction of errors and omissions.
• Streamlined emergency response plans, resulting in faster response times and minimized risk to personnel during critical situations.
• Enhanced workplace safety by conducting thorough risk assessments and implementing necessary control measures.
• Collaborated with cross-functional teams to identify potential hazards, leading to safer work environments for team members.
• Worked with attorney to properly implement the first cases using FMLA in the workers comp arena.
• Established policies regarding workplace safety and wellness.
• Taught and maintained creditials of onsite emergency response team.
• Taught orientation of mandatory and non mandatory benfits.

Assisted on site physician with pre-hire physical.

Maintained and coordinated on site wellness programs

Trained onsite first responders in First Aid and CPR.

Reported workplace injuries to insurance company.

Maintained, established and monitored restricted duty policies.

Ergonomics

Taught orintation on mandatory and non mandatory health benefits.

Assisted Safety Coordinator with OSHA.

Assisted physician with patient care.

Phlebotomy, hematology, EKG & test results

Administered vaccinations and medicine.