Sheldon Durham
Atlanta,GA
Summary
To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills.
Overview
13
13
years of professional experience
Work History
Workers Compensation Manager
Barbour Orthopaedics
08.2022 - 07.2024
- Managed patients worker's compensation claims on a daily bases.
- Confirmed workers compensation claim detail with worker's compensation adjuster or with the patient's attorney, (i.e Claim details, billing info, authorized body parts, patient demographics)
- Established/created new patients account/profile in SalesForce or updated currently treating patient''s chart/profile with the updated claim details obtained if treatment was not previously authorized.
- Confirmed appointment details with the patient, adjuster, nurse case manager and the patient's legal assistant or attorney
- Uploaded treatment plans, work status along with treatment referrals once completed and signed by the provider
- Verified and drafted workers compensation 205 attachment for surgical or injection recommendation referred by the authorized treating physician.
- Forwarded daily patient appointment notes, work status, and referral through email or fax correspondence once al necessary paperwork has been finalized.
- Communicated daily with managing adjuster or nurse case manager on pending authorization status for for surgeries/injections, imaging and/or procedures,
- Would facilitate referrals to outside providers, and assisted scheduling patients for follow up appointments or scheduling changes if necessary
Legal Assistant/ Workers Compensation Claims Manager
Rolnick & Associates
01.2017 - 07.2022
- Self-driven, task oriented hard worker who seeks to provide the most efficient and effective assistance to Attorneys, Adjusters, Third Parties and clients
- Daily management of approximately 99 Workers Compensation claims in various stages of the clients claim
- Providing update to date and conscious communication to all parties involved
- Provided clients updates of their workers compensation rights and any benefits if entitled to receive and requested such rights by drafting Letter of Representation, filling hearing notice of any benefits denied or dispute
- Drafting pleadings, notices, gathering medical records, interviewing clients and potential witnesses in preparing the clients file for trial
- Negotiating settlement with adjusters and opposing counsel to resolve clients claim
- Proofreading legal documents for the attorney, creating memos, and organizing files
- Scheduling meetings and appointments and manage deadlines for the attorney
- Daily multi-tasking and the ability to change directions if need in order to finish a project by a specific deadline
- Updating the attorneys court calendars and scheduling depositions and mediations
Claims Manager
Goldfein Claims Management
01.2017 - 01.2018
- Client focused atmosphere negotiating diminished value claims
- Handling a caseload on average of 100 cases throughout the life of each claim
- Drafted and submitted demands for settlement with adjuster in attempts to settle the claim prior to litigation
- Worked with Attorneys and maintained organized documents to be utilized throughout the litigation process
- Flexible and able to effectively manage multiple priorities and adapt to constantly changing priorities
- Excellent organization skills, with the ability to prioritize the completion of multiple responsibilities and time management
Legal Assistant
The Fitzpatrick Law Firm LLC.
01.2014 - 01.2017
- Drafted open records request, post certifications, notices to preserve, discovery material and motions
- Investigated facts to obtain relevant issues necessary to determine causation, damages, and extent of injuries of the clients
- Strong oral and written communication skills
- Greeted clients and assisted them with initial intake process and paperwork
- Interacted with clients daily and provided with claim status updates, answered any legal questions regarding their claim
- Ability to work independently in a fast-paced environment
- Prepared and interpreted complex legal documents including pleadings, motions, briefs, interrogatories, responses, letters of protection, agreements and legal memoranda
- Independently developed litigation plan to track and control legal expenses
- Negotiated with insurance adjusters and outside counsel to reach a fair settlement for clients within specified limits
- Prepared and filed civil suits on behalf of clients
Intern
Grady Hospital Systems
01.2014
Assistant Store Manager/ Operation Manager
The Home Depot
01.2012 - 01.2013
Education
Juris Doctor -
John Marshall Law School
Atlanta, GA01.2016
Bachelor of Science -
Middle Tennessee State University
Murfreesboro, TN01.2006
Associate of Arts -
Mississippi Gulf Coast Community College
Perkinston, MS01.2002
Skills
- NextGen
- Sales Force
- CareCloud
- Lexis Nexis
- Westlaw
- Research and analysis
- Microsoft Office Suite
- Scheduling
Timeline
Workers Compensation Manager
Barbour Orthopaedics
08.2022 - 07.2024
Legal Assistant/ Workers Compensation Claims Manager
Rolnick & Associates
01.2017 - 07.2022
Claims Manager
Goldfein Claims Management
01.2017 - 01.2018
Legal Assistant
The Fitzpatrick Law Firm LLC.
01.2014 - 01.2017
Intern
Grady Hospital Systems
01.2014
Assistant Store Manager/ Operation Manager
The Home Depot
01.2012 - 01.2013
Juris Doctor -
John Marshall Law School
Bachelor of Science -
Middle Tennessee State University
Associate of Arts -
Mississippi Gulf Coast Community College
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