Open To Work
Tina Adams
Gastonia,NC
Summary
Experienced Senior Workers' Compensation Claims Analyst with extensive experience at Atrium Health, excelling in problem-solving and client engagement. Proven track record in negotiating settlements and enhancing claim accuracy, while fostering strong relationships with stakeholders. Known for reliability and adaptability, ensuring smooth operations even under high pressure conditions. Skilled in effective communication and task management, fostering collaborative and efficient work environment. Organized and dependable candidate successful at managing multiple priorities with a positive attitude.
Overview
29
29
years of professional experience
Work History
Workers' Compensation Claims Analyst - Senior
Atrium Health
03.2008 - 10.2025
- Evaluated complex workers' compensation claims to ensure compliance with regulations and company policies.
- Communicated effectively with injured employees regarding claim status and benefit entitlements.
- Conducted thorough investigations into claims, gathering evidence to support decision-making processes.
- Examined claims forms and other records to determine compensability.
- Conducted day-to-day administrative tasks to maintain information files and process paperwork.
- Analyzed information gathered by investigation and reported findings and recommendations.
- Conducted comprehensive interviews of witnesses and claimants to gather facts and information including recorded statements.
- Maintained contact with claimants and attorneys to determine treatment status.
- Documented information gathered in field and uploaded data to company database for efficient processing using Riskonnect and David.
- Directed claims negotiations within allowable limit of $50,000 and supported successful litigations for advanced issues.
- Maintained claims data in system to complete the NC Dept. of Labor Statistics Surveys and NC Dept. of Labor Public Sector Surveys.
- Update return to work days and lost days for OSHA, Risk Management and Safety departments.
- Supported scheduling and coordination of appointments for efficient medical treatment of injured workers.
- Trained new staff on operational procedures and workplace safety protocols.
- Worked fast to complete tasks and meet daily deadlines.
- Established strong working relationships with clients through excellent communication skills, fostering long-term partnerships built on trust.
- Coordinate in person and online Continued Education classes for multiple states.
- Cultivated positive relationships with vendors to deliver timely and cost-effective supply of services and materials.
- Resolved discrepancies in claim submissions, improving accuracy of processing outcomes.
- Utilized claims management software to track and manage case status efficiently.
- Claim closure in a timely manner by settlement, mediation or rating and release from medical care.
Workers' Compensation Claims Adjuster
Atrium Health
08.2000 - 03.2008
- Managed complex workers' compensation claims, ensuring compliance with state regulations and company policies.
- Evaluated medical records and documentation to determine claim validity and appropriate compensation levels.
- Collaborated with medical professionals and legal teams to facilitate resolution of disputed claims.
- Trained junior adjusters on best practices for claims assessment and dispute resolution processes.
- Conducted regular audits of claims files to ensure accuracy and adherence to internal standards.
- Delivered exceptional customer service to policyholders by communicating important information and patiently listening to issues.
- Maintained claims data in systems.
- Verified accuracy of return to work days and days away from work to maintain accuracy of records database.
- Negotiated mediated settlement agreements to resolve disputes.
- Complete and submit claims forms and other records to governing workers compensation commissions.
- Maintained contact with claimants and nurse case managers to determine treatment status.
- Review medical records and bills for payment.
Claims Assistant / Medical Only Adjuster
Atrium Health
07.1996 - 08.2000
- Resolved customer inquiries, ensuring timely and accurate responses to enhance satisfaction.
- Collaborated with clients and stakeholders to gather necessary documentation for efficient claim processing.
- Conducted thorough investigations of complex claims, employing negotiation skills to reach equitable settlements.
- Managed complex service issues, coordinating with teams to deliver effective solutions.
- Manually entering injury reports to claims system and assign to adjusters.
- Trained new staff on company policies and customer service protocols for consistent performance.
- Improving overall team efficiency and response time.
- Transcribing recorded statements.
- Completing and submitting forms to the NC Industrial Commission.
- Entering and submitting payments for vendors.
Education
Associate of Arts - Associate in Claims
Insurance Institute Of America
Charlotte, NC10-2002
Associate of Arts - Business Administration
Gaston College
Dallas, NC05-1989
Skills
- Customer service
- Problem-solving
- Attention to detail
- Client engagement
- Conflict resolution
Work Preference
Work Type
Full TimeLocation Preference
HybridRemoteOn-SiteTimeline
Workers' Compensation Claims Analyst - Senior
Atrium Health
03.2008 - 10.2025
Workers' Compensation Claims Adjuster
Atrium Health
08.2000 - 03.2008
Claims Assistant / Medical Only Adjuster
Atrium Health
07.1996 - 08.2000
Associate of Arts - Associate in Claims
Insurance Institute Of America
Associate of Arts - Business Administration
Gaston College