Paul Dean
Chesapeake,VA
Summary
Dynamic Workers' Compensation Claims Examiner with extensive experience at the U.S. Department of Labor, excelling in claims processing and data verification. Proven ability to enhance departmental productivity through effective communication and analytical skills, consistently achieving timely resolutions and maintaining high-quality standards in complex claims management.
Overview
17
17
years of professional experience
Work History
Workers' Compensation Claims Examiner
U.S. Department of Labor, OWCP
11.2019 - Current
- Reviewed Settlement Applications jointly filed by parties under Section 8(i) of the Longshore & Harbor Workers' Act, Defense Base Act, or Non-Appropriated Instrumentalities Act, and issued Compensation Order, if approved, and denial letter, if benefits denied.
- Conducted Informal Telephonic Conferences between Claimant's counsel and Employer/Carrier counsel and rendered benefit recommendations based upon same.
- Processed appeal requests to Office of Administrative Law Judges (OALJ) and deferred deficient appeal requests.
- Managed caseloads effectively while maintaining high-quality work standards and meeting strict deadlines consistently.
- Utilized analytical skills to evaluate medical bills for accuracy and appropriateness of charges before approving payments as part of the claims process.
- Conducted thorough investigations of complex claims, gathering relevant documentation and interviewing witnesses when necessary.
Workers' Compensation Claims Assistant (WCA)
U.S. Department of Labor, OWCP
06.2017 - 11.2019
- Utilized advanced software tools for efficient tracking and management of claim cases from inception to closure.
- Maintained strong relationships with service providers for seamless coordination during claim resolutions.
- Transmitted case files between offices.
- Boosted departmental productivity by cross-training on various roles within the claims team, providing backup support as needed.
- Prepared files, letters and notices.
- Minimized risk exposure by conducting detailed fraud investigations on suspicious claim submissions.
- Reduced claim resolution times with thorough investigation and prompt communication with involved parties.
- Provided administrative support to a Senior Claims Examiner by proofreading recommendations for accuracy, editing same, and providing telephone support in answering claimants' questions.
Contact Representative
U.S. Department of Labor, OWCP
09.2011 - 06.2017
- Reviewed and typed Section 8(i) Settlement Orders for ultimate signature by District Director.
- Provided vocational rehabilitation program payment services including administrative records-keeping on payments to rehab providers.
- Conducted thorough research on complex inquiries, delivering informed solutions to customers'' unique challenges.
- Managed a high volume of inbound calls daily, maintaining composure under pressure while providing top-notch service to clients.
- Investigated and resolved customer inquiries and complaints quickly.
- Answered questions from claimants and medical providers calling in regards to their respective 18(b) medical bills pending payment.
Mail Handler
U.S. Postal Service, USPS
05.2008 - 09.2011
- Utilized physical strength to move mail and packages of varying sizes and weights.
- Followed safety protocols while handling and sorting mail for personal safety purposes.
- Inspected mail for damages and took appropriate action to deliver in good condition.
- Unloaded and sorted mail from incoming FedEx air shipping containers, and moved mail to next operation.
- Operated automated sorting equipment to expedite mail processing.
Education
Bachelor of Science - Legal Studies
South University
Virginia Beach, VA12-2016
Skills
- Claims processing
- Verbal communication
- Microsoft Office Suite
- Data verification
Accomplishments
Successfully completed a 3 month legal externship in 2016 in the U.S. Department of Labor's Office of Administrative Judges (OALJ) office in Newport News,VA with a favorable recommendation from supervising judge, Judge Paul Johnson, Jr., Chief Judge.
Languages
French
Limited Working
Timeline
Workers' Compensation Claims Examiner
U.S. Department of Labor, OWCP
11.2019 - Current
Workers' Compensation Claims Assistant (WCA)
U.S. Department of Labor, OWCP
06.2017 - 11.2019
Contact Representative
U.S. Department of Labor, OWCP
09.2011 - 06.2017
Mail Handler
U.S. Postal Service, USPS
05.2008 - 09.2011
Bachelor of Science - Legal Studies
South University
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