Susan C Anderson
Assigned Risk Solutions
Holt,MI
1
Certification
6
years of professional experience
Seasoned Workers Compensation Insurance Specialist with excellent planning and problem-solving abilities. Offering over 24 years of experience and a willingness to take on any challenge. Organized, driven and adaptable with proven history managing high caseloads and projects.
Work History
Provider Panel Coordinator
2 Years 7 Months- Insurance Compliance Documentation
- Verify and validate medical providers
- Create and manage Provider Panel according to state regulation
- Customer service for internal and external customers
Medical Only Claims Specialist/Claim Representative
1 Year 9 Months- Manage case load of Medical Only claims for IL, IN, MI, NV, NY, NC, SC, VA according to Servicing Agreements
- Complete three-point contacts
- Complete investigation to determine compensability
- Manage return to work and monitor work status to full release
- Properly reserves claim files and Plans of Action
- Collaboration with fellow team members to manage high case volumes and coverage
- Assisted with training and mentoring needs within the department
- Collaborated with fellow team members to manage high claim volumes
Business Operations Specialist II / AF Specialty
- Manage AF Specialty email box for Fronting Agreements
- Research utilizing AF Specialty First Document and Fronting Tool data, state websites for Workers Compensation and Department of Transportation DOT Search.
- Forward emails to appropriate Front and all company brands
Medical Only Claims Specialist
- Managed case load of Medical Only claims for State of TN, KY, MI, MS, TX
- Experienced in TN (Certified), KY MO, IN, V,A, OK MI, MS, TX (Licensed) and AR
- Managed full investigations to determine compensability
- Evaluated pending claims to identify and resolve problems blocking auto-adjudication.
- Managed return to work and monitors work status to full release.
- Managed reserves on claim files
Business Documentation Analyst
1 Year- Developed Business Quality and Workflow materials Enterprise wide
- Responsible for standardizing documentation for Service Center Operations that includes quality initiatives enterprise wide
- Identified and implemented methods to increase organizational effectiveness of quality framework for Service Center Operations enterprise wide
- Supported the development of work standards and establishment of performance metrics.
- Exchanged information with staff, managers and business leaders regarding multi-functional operational needs
- Assisted in the development of user acceptance testing, training cases, and activities
- Performed peer reviews for quality documentation standards
- Maintained SharePoint Site for documentation management and controls
- Issued Monthly Service Center Newsletter for monthly Service Center updates, team initiatives and announcements
Education
Certified Workers Compensation Professional
Completed AICPCU/IIA courses 33 & 34
- Business
Skills
Strong Verbal and Written Communication Skills
Problem-Solving Skills
Multi State Workers Compensation Experience
Insurance Claims Management
Experience in process and procedure development and cross functional workflow development
Applied and accepted to Emergent Markets D & I Mentor/Mentee Program
Certification
- Certified Authority on Workers Compensation
- National Insurance Crime Bureau, Workers' Compensation Fraud Awareness Certificate of Completion
- Licensed: TX
- Certified Adjuster: TN
Timeline
Business Operations Specialist II / AF Specialty
05.2024 - 03.2024Read More
Provider Panel Coordinator
03.2024 - CurrentRead More
Medical Only Claims Specialist/Claim Representative
Assigned Risk Solutions
08.2022 - 05.2024Read More
Medical Only Claims Specialist
The Accident Fund
08.2022 - 08.2022Read More
Business Documentation Analyst
The Accident Fund
08.2020 - 08.2021Read More
Lansing Community College and Baker College
from Business
Read More
Read More
Certified Workers Compensation Professional
Read More
Section name
- Susan C Anderson
- 2240 Samper Ln # 11
- Holt, MI 48842
- 517-930-3824
- Susan4523@yahoo.com
- 5030 Great Lakes Drive, Apt D
- (Cell) 517-930-3824
- Email: susan4523@yahoo.com