Tandy Lyon
Mabank ,TX
Summary
Accomplished Senior Workers' Compensation Claims Adjuster with a proven track record at Sedgwick CMS, adept in strategic decision-making and critical thinking. Expert in claims management and fraud detection, achieving over 100% closing ratio. Fostered strong client relationships, excelling in heavy litigation and multi-jurisdictional claims handling.
Overview
19
19
years of professional experience
Work History
Senior Workers' Compensation Claims Adjuster
Sedgwick CMS
03.2016 - Current
- Interviewed claimants and witnesses to gather factual information.
- Investigated and processed Worker's Compensation insurance claims for policyholders.
- Examined photographs and take recorded statements.
- Trained other claims staff members on proper handling and evaluation of injury claims.
- Maintained contact with claimants and attorneys to determine treatment status.
- Investigated and handled death claims as well a catastrophic injuries.
- Identify and handle Subrogation claims
- Handle Worker's Compensation claims for the state of Texas, Oklahoma and Kansas
- Experience in handling and setting reserves on multi-million dollar claims.
- Maintain Carrier reporting as required
- Heavy litigation experience
- In person File Reviews as required
- Exceed 100% closing ratio
- Identify and review all medical to ensure proper payment of medical.
- File Reviews as required by the client
- Maintain a professional and close relationship with all clients as well as staff.
Senior Workers' Compensation Claims Adjuster
Gallagher Bassett Services Inc.
05.2005 - 03.2016
- Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
- Conduct complete investigations, including recorded statements.
- Established productive working relationships with multiple clients.
- Identify Subrogation
- Maintained suspicious claims database and prepared reports for supervisors.
- Handles multiple accounts and jurisdictions
- Handle heavy litigation
Education
GED -
Mesquite
Mesquite, TX05.2004
Skills
- Strategic Decision-Making
- Critical thinking abilities
- Fraud detection techniques
- Claims Management
- Coverage Assessment
- Settlement Negotiations
Timeline
Senior Workers' Compensation Claims Adjuster
Sedgwick CMS
03.2016 - Current
Senior Workers' Compensation Claims Adjuster
Gallagher Bassett Services Inc.
05.2005 - 03.2016
GED -
Mesquite
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