Terrie Diggan
Wellington,NV
Summary
Objective: To secure a responsible and challenging position that allows me to use my experience, knowledge and expertise to the advantage of my employer and our clients/customers. I am currently retired and preferably seeking part time employment.
I am a loyal and dedicated employee eager to learn new skills. Always interested in taking on new tasks as assigned. Over 40 years of experience in customer service that includes contact with clients, injured workers, medical providers, etc. Heavy computer experience including Microsoft Word, Microsoft Outlook, Excel and Valley Oak Systems (VOS). Experience in medical terminology, ICD9, ICD10, CPT codes, medical billing and medical terminology.
Overview
10
10
years of professional experience
1
1
Certification
Work History
Senior Claims Examiner
Corvel Corporation
07.2013 - 12.2023
Managed Workers' Compensation claims for third party administrator (CA Workers' Comp). Paid indemnity/permanent disability benefits, medical benefits and future medical claims. Retired 12/31/2023.
Combined 35+ years experience in CA Workers' Compensation claims with various third party administrators (TPA's) from July 1988 - December 2023. Experience with data entry, medical terminology, claimant/client contact, defense and applicant counsel contact and medical bill paying.
Prior to workers' compensation, experience in retail that included sales associate at Mervyns Department store and clerical work for Brueners Home Furnishings store (1970's - 1980's).
Education
Associate of Arts - Natural Resources
San Joaquin Delta College
Stockton, CA06-1977
Skills
- Claims analysis
- Coverage evaluation
- Investigation techniques
- Policy interpretation
- Litigation management
- Reserves management
- Claim resolution
- Claims processing
- Verbal communication
- Microsoft Office Suite
- Disability claims process
- Coding systems
- Disability processing
- Investigative skills
- Teamwork
- Customer service
- Problem-solving
- Insurance policy knowledge
- Time management
- Attention to detail
- Problem-solving abilities
- Multitasking
- Claims investigation
- Reliability
- Excellent communication
- Computer skills
- Customer service and support
- Organizational skills
- Team collaboration
- Decision-making skills
- Active listening
- Adaptability and flexibility
- Verbal and written communication
- Claims
- Decision-making
- Workload prioritization
- Teamwork skills
- Claims adjustment
- Claims evaluation
- Task prioritization
- Report and records review
- Coverage determination
- MS office
- Payment processing
- Settlement negotiations
- Denied claims identification
- Records review
- Case management
Certification
Self-Insured Administrator's Certificate (CA Workers' Comp) obtained in November 2000.
Workers' Compensation Claims Professional Certificate (CA Workers' Comp) obtained in December 2004.
Timeline
Senior Claims Examiner
Corvel Corporation
07.2013 - 12.2023
Associate of Arts - Natural Resources
San Joaquin Delta College
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