Accomplished federal employee with a proven track record with the government, enhancing operational efficiency and team performance. Expert in time management and customer service, I've led significant process improvements and mentored staff to achieve excellence. Skilled in quality assurance and communication, my leadership drives results and fosters a collaborative environment.
Overview
15
15
years of professional experience
Work History
Supervisory Claims Examiner
DOL-Office Of Workers' Compensation Programs
Kansas City
06.2022 - Current
Led team meetings and one-on-one coaching sessions to continuously improve performance.
Conducted monthly quality reviews of compensation payments, claim adjudication actions, schedule award payments, periodic entitlement review actions, disability management actions, and written and verbal communication to claimants, government agencies, attorneys, and legal representatives.
Conducted quarterly performance evaluations, providing feedback, and coaching for team development.
Maintained up-to-date records of employee attendance, payroll information, vacation requests.
Mediated conflicts between employees and facilitated effective resolutions to disputes.
Reviewed employee performance and provided ongoing feedback and coaching to drive performance improvement.
Interviewed prospective employees and provided input to HR on hiring decisions.
Enforced customer service standards and resolved problems to uphold quality service.
Coached, mentored and trained team members in order to improve their job performance.
Provided leadership, insight, and mentoring to newly hired employees to supply knowledge of various agency rules and procedures.
Reviewed all completed work by new employees to verify consistency, quality, and conformance.
Provided leadership during times of organizational change or crisis situations.
Scheduled interviews for potential candidates and conducted reference checks prior to hire.
Implemented process improvements, resulting in an increase in operational efficiency.
Claims Examiner
DOL-Office Of Workers' Compensation Programs
Kansas City
02.2018 - 06.2022
Managed caseload effectively, ensuring timely review and resolution of claims.
Analyzed information from claimants, witnesses, and medical professionals to make informed decisions.
Maintained up-to-date knowledge of regulatory changes affecting claims processing.
Handled and processed a variety of traumatic injury claims, occupational disease claims, and extended occupational disease claims.
Participated in quality assurance activities such as peer reviews and audits of payments.
Delivered exceptional customer service to clients by communicating information and actively listening to concerns.
Developed a detailed understanding of the company's policies and procedures related to claim processing and payment determination.
Tracked progress of pending cases through manual follow-up or automated systems.
Investigated discrepancies in claims and resolved issues with customers via telephone or written correspondence.
Provided guidance to other staff members regarding claim processing rules and regulations.
Processed claims payments, and scheduled awards and denials in accordance with agency procedures.
Legal Administrative Specialist
Social Security Adminstration
Kansas City
05.2010 - 02.2018
Answered questions and responded to inquiries to deliver a high level of service to claimants.
Reviewed and processed retirement and disability claims.
Reviewed monthly benefit amounts for accuracy, and corrected them when needed.
Provided support and guidance to colleagues to maintain a collaborative work environment.
Helped answer questions and train four coworkers.
Education
Bachelor of Arts - Business Administration
Ottawa University
Ottawa, KS
05-2009
Skills
Customer service
Conflict resolution
Team leadership
Employee training
Mentoring staff
Performance evaluation
Quality assurance
Communication skills
Time management
Investigative skills
Verbal communication
Accomplishments
I have won many Department of Labor Performance and Information-Sharing Awards including: Adjudication Quality in July 2021; Periodic Entitlement (PER) Quality in January 2021; Pay Timeliness in September 2020; PRM Timeliness in August 2020; & Pay Quality in April 2020. Additionally, I was selected for a $3,000 Quarterly Information Sharing Presentation Award in September 2020 based on my performance in the employee recognition program’s monthly awards where I created a presentation for all employees on payment and PRM Timeliness.
Timeline
Supervisory Claims Examiner
DOL-Office Of Workers' Compensation Programs
06.2022 - Current
Claims Examiner
DOL-Office Of Workers' Compensation Programs
02.2018 - 06.2022
Legal Administrative Specialist
Social Security Adminstration
05.2010 - 02.2018
Bachelor of Arts - Business Administration
Ottawa University
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Edwin E. FloresEdwin E. Flores
Claims Examiner (GS-12) at Department Of Labor - Office Workers CompensationClaims Examiner (GS-12) at Department Of Labor - Office Workers Compensation