Royce Williams
Hendersonville,TN
Summary
My objective is to work to exceed customer and employer expectations by delivering second-to-none service. Build a great report with customers in all initiatives and interactions by always putting the customer first while still focusing on and honoring the company’s interest and image.
Overview
10
10
years of professional experience
Work History
Case Manager
Morgan and Morgan
05.2023 - Current
- Assist the attorney in developing settlements, preparing documents and correspondence as needed
- Cases include Auto bodily injury, Premises, General Liability and Workers Compensation
- Daily interaction with existing and potential clients via telephone and in person
- Order medical records from providers and communicate with clients and providers during the course of treatment
- Interact with insurance carriers and healthcare providers to secure records and account balances
- Negotiate case settlements with insurance carriers and negotiate a deduction of outstanding medical balances with providers.
Claims Examiner
United Auto Insurance Company
06.2022 - 10.2022
- Analyze and determine liability in a timely fashion
- Interview customers, claimants, and witnesses
- Set and manage reserves
- Communicate with customers written and verbally
- Managed vehicle repairs
- Negotiated liability with customers and other insurance carriers.
Workers Compensation Claims Examiner
Sedgwick
04.2021 - 04.2022
- Analyze complex or technically difficult workers' compensation claims to determine benefits due; Work with high exposure claims involving litigation and rehabilitation; Ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; Identify subrogation of claims and negotiate settlements
- Licenses in Georgia, North Carolina, and South Carolina.
Claims Resolution Coordinator
Kemberton
05.2019 - 03.2021
- Responsible for the management and resolution of insurance denials for hospitals and physician practice groups
- Communication between co-workers and hospitals
- Communicate with patients via phone calls and certified letters
- Responsible for finding creative ways to resolve complex denials for workers compensation, general liability, auto liability, and medical claims.
Claims Examiner
Progressive
05.2017 - 05.2019
- Determine liability in a timely fashion
- Interview customers, claimants, and witnesses
- Communicate with customers written and verbally
- Collaborated with appraisers and estimators to manage vehicle repairs
- Negotiate with customers and other insurance carriers.
Disability Specialist
Sedgwick
08.2014 - 08.2015
- Responsible for ongoing clinical assessment and evaluating the need for alternative treatment
- Coordinating medical treatment and length of disability with providers and employers
- Creating case management plans to ensure quality and appropriate service delivery of the case management process Responsible for managing disability and leave of absence claims
- Contacted claimant via phone and email throughout claim
- Responsible for analyzing supporting documents to support disability
- Approved and denied claim based on the documentation provided
- Worked with medical codes
- Reported to claimant's employer with denials and approvals
Education
Diploma -
Harper Woods High School
Harper Woods, MI06.2002
Skills
- Management
- Outlook
- Microsoft
- Leadership
- Customer Service
- Negotiation
- Liability
- Decision Making
- Problem-Solving
- Case Management
- Case Documentation
- Organization and Multitasking
- Documentation And Reporting
- Relationship Building
- Conflict Resolution
- Email and Telephone Etiquette
- Records Management
- Case Management Tracking
- Medical Records Management
- Performance Tracking
Timeline
Case Manager
Morgan and Morgan
05.2023 - Current
Claims Examiner
United Auto Insurance Company
06.2022 - 10.2022
Workers Compensation Claims Examiner
Sedgwick
04.2021 - 04.2022
Claims Resolution Coordinator
Kemberton
05.2019 - 03.2021
Claims Examiner
Progressive
05.2017 - 05.2019
Disability Specialist
Sedgwick
08.2014 - 08.2015
Diploma -
Harper Woods High School