Renata McCoomer
Grayson,GA
Summary
Highly skilled and proactive professional with a proven track record in claims management, customer relations, and team leadership. Possessing strong analytical abilities and extensive experience in workers' compensation, I aim to leverage my expertise to drive efficiency and achieve optimal outcomes.
Overview
30
30
years of professional experience
1
1
Certificate
Work History
Sr. Claims Specialist
GAIC/Strategic Comp
Alpharetta, GA
01.2013 - 01.2024
- Managed workers' compensation claims for multiple clients, ensuring timely resolutions and cost-effectiveness through proactive strategies.
- Conducted thorough investigations to determine compensability and oversaw subrogation recoveries.
- Directed settlement negotiations and guided defense counsel to align with client objectives.
- Maintained quality assurance programs and fostered positive client relationships through regular communication.
- Demonstrated strong leadership by managing vendors, providing technical support, and serving as a second-level appeal for claim-related issues.
- Drafted project progress reports for upper-level management review.
- Collaborated with vendors to negotiate contracts for necessary services or products.
- Facilitated communication between departments to resolve issues quickly.
- Resolved customer complaints promptly while upholding company standards.
- Enhanced team performance through effective collaboration and training.
- Organized team-building events to promote a positive work environment.
Claim Adjuster
Georgia Administrative Services
Duluth, GA
11.2012 - 01.2013
- Managed workers' compensation claims for a government agency, ensuring compliance with statutory requirements and delivering quality service to clients.
- Oversaw investigations, identified mitigating factors, and facilitated settlement negotiations in alignment with client goals.
- Managed file coding, data quality, and EDI filings to maintain accuracy and efficiency in claims processing.
Claims Supervisor
Matrix Absence Management, Inc.
San Jose, CA
07.2009 - 09.2012
- Led multi-state team in workers' compensation claims management, ensuring regulatory compliance and client satisfaction.
- Implemented quality assurance programs, driving performance improvements and offering technical support.
- Fostered client relationships through effective communication, onsite visits, and cost-saving measures.
- Provided technical guidance on complex claims issues and established check-and-balance systems.
- Managed Claims Team operations, including scheduling and task assignment.
- Collaborated with managers to develop best practices and maintained accurate records.
- Resolved customer complaints promptly and investigated discrepancies for accuracy.
- Analyzed financial data and drafted reports on key metrics.
- Reviewed completed work for consistency and quality.
- Planned and led team meetings to discuss priorities and review results.
Claims Supervisor/ Officer Manager
Cannon Cochran Management Services, Inc
Tucker, GA
06.2008 - 04.2009
- Managed claims processes and provided leadership and training to subordinate staff, driving continuous improvement initiatives.
- Implemented new procedures and policies to enhance efficiency and effectiveness in claims handling.
- Conducted performance evaluations and guided to support staff development and growth.
- Assisted with training new employees on company policies and procedures related to Workers' Compensation.
- Monitored team performance and provided feedback to individual members on their progress.
- Conducted regular meetings with staff to discuss any issues or problems related to claims processing.
- Reviewed, analyzed, and reported on team performance data for management review.
- Provided technical guidance and assistance in resolving complex or difficult claims-related issues.
- Identified areas of improvement within the department and recommended solutions as needed.
- Managed day-to-day operations of the Claims Team including scheduling, assigning tasks, monitoring progress.
Claim Specialist III
Sedgwick CMS
Atlanta, GA
06.2005 - 06.2008
- Managed workers' compensation claims for Georgia Pacific account, overseeing complex files and facilitating timely resolutions.
- Provided detailed status reports to clients and conducted onsite inspections to assess claim status and address safety concerns.
Education
BBA - Business Administration And Management
American Intercontinental University
Atlanta, GA08-2011
Some College (No Degree) - Business Administration and Management
University of Louisville
Louisville, KYSkills
- Decision-Making
- Settlement Negotiations
- Staff Management
- Litigation Management
- Expense Control
- Microsoft Office
- Claims file management processes
- Sourcing and Compiling Information
- Estimate Preparation
- Analytical Skills
- Report and Records Review
Certification
- GA, CWCP
- GA Resident Adjusters License
Timeline
Sr. Claims Specialist
GAIC/Strategic Comp
01.2013 - 01.2024
Claim Adjuster
Georgia Administrative Services
11.2012 - 01.2013
Claims Supervisor
Matrix Absence Management, Inc.
07.2009 - 09.2012
Claims Supervisor/ Officer Manager
Cannon Cochran Management Services, Inc
06.2008 - 04.2009
Claim Specialist III
Sedgwick CMS
06.2005 - 06.2008
BBA - Business Administration And Management
American Intercontinental University
Some College (No Degree) - Business Administration and Management
University of Louisville
References
References available upon request.
References
References available upon request.
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