Tracy Jurgella
Fond Du Lac
Summary
Dynamic Senior Workers' Compensation Claims Adjuster at Society Insurance with a proven track record in claims management and exceptional customer service. Adept at critical thinking and problem-solving, I excel in analyzing complex claims and collaborating with teams to drive organizational growth and enhance client satisfaction.
Overview
31
31
years of professional experience
1
1
Certification
Work History
Senior Workers' Compensation Claims Adjuster
Society Insurance
05.2015 - Current
- Examined claims forms and other records to determine insurance coverage for various levels of claims.
- Delivered exceptional customer service to policyholders by communicating important information and patiently listening to issues.
- Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
- Read over insurance policies to ascertain levels of coverage and determine whether claims would receive approvals or denials.
- Analyzed information gathered by investigation and reported findings and recommendations.
- Conducted comprehensive interviews of witnesses and claimants to gather facts and information.
- Reviewed police reports, medical treatment records, and other forms of documentation to determine extent of benefits and coverage.
- Identified suspicious losses and contacted manager for investigative assistance.
- Maintained contact with claimants and attorneys to determine treatment status.
- Directed claims negotiations within allowable limits and supported successful litigation.
Occupational Therapist
Various Employers
05.1994 - 05.2015
- Documented patient progress accurately and efficiently, ensuring compliance with regulatory requirements.
- Provided interventions and treatments to improve patient abilities to perform daily activities, manage symptoms and prevent injury.
- Worked in a variety of setting providing therapy services including outpatient rehab, inpatient rehab, industrial rehab, subacute and homecare settings.
- Collaborated with interdisciplinary team members for comprehensive patient care and optimal results.
- Participated in continuing education opportunities to stay current with industry trends and best practices in occupational therapy.
- Coordinated discharge planning efforts alongside case managers to ensure seamless transitions between care providers upon leaving facility.
- Mentored occupational therapy students during clinical rotations, fostering professional growth and development.
- Conducted thorough evaluations to assess patient needs, functional limitations, and potential for improvement.
- Adapted environments by making changes to patient homes, workplaces and school environments to promote safety, independence and participation.
- Meticulously reviewed records and referrals to determine and implement best treatment methods.
- Led team of occupational therapy assistants, overseeing their work and facilitating professional development through mentoring.
Education
Bachelor of Science - Occupational Therapy
University Wisconsin Milwaukee
Skills
- Organizational growth
- Critical thinking
- Continuous learning mindset
- Analytical mindset
- Medical terminology proficiency
- Claims management
- Teamwork and collaboration
- Customer service
- Problem-solving
- Time management
- Multitasking
- Reliability
Certification
- OTR - Occupational Therapist Registered
- Licensed Adjuster - Texas
Timeline
Senior Workers' Compensation Claims Adjuster
Society Insurance
05.2015 - Current
Occupational Therapist
Various Employers
05.1994 - 05.2015
Bachelor of Science - Occupational Therapy
University Wisconsin Milwaukee
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