Tracy Milligan
San Diego,CA
Summary
Experienced Senior Workers' Compensation Claims Adjuser with 21 year career assessing work-place injuries, determining liabilities and negotiating settlements. Detail-oriented, observant and knowledgeable with excellent interpersonal and documentation skills. Efficiently handle high case volumes with accuracy and care.
Overview
22
22
years of professional experience
Work History
Senior Workers' Compensation Claims Adjuster
State Compensation Insurance Fund, SCIF
Santa Ana, California
05.2002 - 12.2023
- Determined liability, compensability and benefits due on each claim.
- Reviewed police reports, medical treatment records, medical bills and physical property damage to determine extent of liability.
- Analyzed medical records to determine compensability of claims.
- Reviewed benefit payments to ensure accuracy and compliance with applicable regulations.
- Investigated fraud allegations related to workers' compensation claims.
- Handled complex workers' compensation claims, including those involving multiple jurisdictions and laws.
- Negotiated settlements with claimants, attorneys, and other parties involved in the claim process.
- Facilitated communication between injured employees, employers, insurance carriers, attorneys, physicians, rehabilitation providers, and other stakeholders throughout the claims process.
- Ensured compliance with all relevant federal and state laws pertaining to workers' compensation benefits.
- Delivered exceptional customer service to clients by communicating information and actively listening to concerns.
Skills
- Critical thinking abilities
- Strategic Decision-Making
- Claims Management
- Decision-Making
- Settlement Negotiations
- Liability Determination
- Claims Evaluation
- Team Collaboration
- Claims Processing
- Time Management
- Problem-Solving
- Payment Processing
- Claims Investigation
- Organizational Skills
- Multitasking
- Claims Investigation Expertise
Timeline
Senior Workers' Compensation Claims Adjuster
State Compensation Insurance Fund, SCIF
05.2002 - 12.2023
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