Management or Consultant or Insurance claims

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Management, Consultant, Insurance claims with 26 years experience looking for a Executive position.

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Stephen Palmer 21 Mission Drive San Mateo, CA 94402 Home: 510-910-3435 [email protected] Objective To find a challenging professional opportunity that allows me to use my extensiv e claims management experience. Work Experience Consultant: Full Circle Consulting October 2009 to present Currently self employed as a Professional Liability Insurance Consultant, workin g directly with attorneys and other vendors who do business with Insurance Carri ers, including jury consultants, copy services, court reporters , to name a few . Essentially I give them an opportunity to sit down with the equivalent of a m anagement level decision maker at the insurance carrier and then guide the clien t towards the best outcome possible. My vendor consultations revolve around hel ping them understand how to best market their services to insurance carriers. Assistant Claims Manager May 1, 1984 to Sep 23, 2009 Employer: Medical Insurance Exchange of California, Oakland CA Responsibilities included : Negotiating extremely large loss, multi-party claims in litigation, including a mass tort with over 700 plaintiffs and 10 defendant health care providers that u ltimately was resolved for over 450 million dollars All facets of claims management, personnel development, coverage determination, settlement authorization up to policy limits. Client development, claims present ations to insureds and prospective insured groups. Close working relationship with Risk Management personnel to assist them in und erstanding how to identify risk and help physicians understand how to limit thei r risks. Attended and participated as a speaker in numerous risk management semi nars. SIU compliance officer responsible for tracking all potential fraudulent claims pursued against physicians and the insurance carrier, as well as potential fraud ulent requests for coverage by insured physicians. Conducted audits of other insurance carrier's claims files. Was the liaison for all audits being performed by re-insurers at MIEC. Responsible for overseeing all premises related liability claims pursued against physicians and medical groups for personal injury and property damage claims an d suits. Responsible for managing professional liability claims and suits involving medic al products and health care services liability. Initial case assessment, reserve determination and coverage analysis. Employee related challenges, which is a somewhat ambiguous way of saying that wh en necessary, I would put on a variety of hats to handle the endless situations that come up when you have 30 or so people working together and at times " at od ds with each other" while keeping them focused on the mission of the claims depa rtment. . Set up and manned the MIEC booth at numerous conventions and seminars. In this r ole, I was a company presence available to answer any question that a current or prospective insured might have about the company or any medical malpractice rel ated issue or concern. Regulatory compliance with Department of Insurance policies and procedures Identified new business opportunities with medical groups of varying size, up to six hundred physicians, then prepared and presented proposals for them. Developed and implemented attorney litigation guidelines which were requirements that we communicated to all defense counsel as a prerequisite for defending ins

ured health care providers. Responsible for all vendor related contract issues and pricing. i.e Medical reco rd copying fees and quality of service review and vendor selection. Vetting of potential new law firms to handle defense of cases. Vetting of potential Court R eporting agencies and negotiation of rates I was deeply involved in the creation of a paperless office claims handling sys tem at MIEC. I trained all the claims staff in the most advanced negotiation str ategies currently available. Was the initial resume screener for all potential n ew claims employees and then conducted scores of interviews with applicants for claims positions. I was responsible for setting up new systems within the claim s department to take advantage of emerging technologies as they pertained to the claims process. Independent duty hospital corspman May 12, 1979 to Apr 12, 1984 Employer: United States Navy Oakland Naval Hospital, Portsmouth Naval Hospital, Naval Regional Medical Center San Diego Responsibilities: Navy medical advanced training working at various hospitals and remote clinical settings in direct patient care. Education Bachelors Social Work curriculum , Oct 1, 1971 to May 6, 1976 Utah State University GPA: (Major) 3.6 (Overall) 3.2 Other Information Superior medical knowledge, professional liability expertise that only 25 years of experience can bring. Vast knowledge of all the plaintiff and defense attorne ys and venues, arbitrators and complete understanding of the missions and mindse ts of all the other insurance carriers that end up sharing elements of risk in a ny litigated/arbitrated situation . Directly responsible for the decisions to se ttle or litigate the most significant cases in MIEC's history, including a mass tort case in Redding involving numerous physicians and Redding Medical Center. Completed a comprehensive Claims Law course which covered all aspects and discip lines of insurance. Completed numerous skill specific insurance courses, related to insurance covera ge, leadership training, negotiation training ( Karass courses)

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