Workers Compensation Claims Adjuster
Content
Mercedes McMicheal 1554 Highland Blvd. [email protected] 9454 510-688-3212 Objective: To obtain a permanent Workers Compensation Examiner position.
Hayward, CA
Work Abilities: 20 years of administering workers compensation claims for both public and priva te sectors 10 years of administering workers compensation benefits to monolingual Spanish speaking workers from Central Valley throughout Bay Area 3 years supervised administrative support within the workers compensation indus try Employment History: Essential Staffing/Tuell & Associate 7/08-present Temporary Assignments; Chevron , ICW Group, CCMSI. Tristar Risk Management: 7/4/06 to 05/08 Handle San Francisco School District split alpha from A-C. Adjusting workers compensation claims; consisting of temporary disability, perma nent disability payments, litigation; claimant contact; occasional recorded stat ements; negotiate settlements. Maintain contact with client from beginning to en d of claim while also providing status of claims. Keenan & Assoc. 05/05 03/06 Handled caseload of Self Insured, Eight School Districts in the Santa Clara area from the beginning to the end of claim. Provide claim status for early return t o work to modify or alternative position. Quarterly file reviews on all open cla ims. Excess reporting and handled 80% of the litigation. Professional Search 12/04- 3/31/05 Senior Claims Examiner * Handle high caseloads of complex dual jurisdiction Federal (Longshore) and Sta te claims. * Claim responsibility from date of injury to settlement to include all aspects of benefits administration. * Paperless Claims Workstation for Zurich NA. * Senate Bill 899 Legal Update 11/02-11/04 AIG Insurance, San Ramon, CA Senior Claims Examiner * Handled high caseloads of complex, litigated Workers Compensation claims files on a diary system to result in timely administration of benefits, plan implemen tation strategies and case resolution * Evaluated claims by reviewing exposure of liability, setting timely reserves t o adequately reflect potential value of the claim 3/26/01-10/30/02 Kemper Insurance Group, Concord, CA Senior Claims Examiner * Handled Del Monte account and use my skills as a Bi-lingual examiner. * Make benefits payments, establish and review reserves for adequacy, provide be nefits such as vocational rehabilitation, rate for permanent disability and sett le claims
Professional: Cigna Casualty-E.S.I.S, Examiner Trainee Program, I.E.A Certificat ion , San Francisco, CA, WCCP, S.I.P. Nov 2006, U.S. Long Shore and Harbor Cert ification Act 1998, MS Word, Lotus 123.
Hayward, CA
Work Abilities: 20 years of administering workers compensation claims for both public and priva te sectors 10 years of administering workers compensation benefits to monolingual Spanish speaking workers from Central Valley throughout Bay Area 3 years supervised administrative support within the workers compensation indus try Employment History: Essential Staffing/Tuell & Associate 7/08-present Temporary Assignments; Chevron , ICW Group, CCMSI. Tristar Risk Management: 7/4/06 to 05/08 Handle San Francisco School District split alpha from A-C. Adjusting workers compensation claims; consisting of temporary disability, perma nent disability payments, litigation; claimant contact; occasional recorded stat ements; negotiate settlements. Maintain contact with client from beginning to en d of claim while also providing status of claims. Keenan & Assoc. 05/05 03/06 Handled caseload of Self Insured, Eight School Districts in the Santa Clara area from the beginning to the end of claim. Provide claim status for early return t o work to modify or alternative position. Quarterly file reviews on all open cla ims. Excess reporting and handled 80% of the litigation. Professional Search 12/04- 3/31/05 Senior Claims Examiner * Handle high caseloads of complex dual jurisdiction Federal (Longshore) and Sta te claims. * Claim responsibility from date of injury to settlement to include all aspects of benefits administration. * Paperless Claims Workstation for Zurich NA. * Senate Bill 899 Legal Update 11/02-11/04 AIG Insurance, San Ramon, CA Senior Claims Examiner * Handled high caseloads of complex, litigated Workers Compensation claims files on a diary system to result in timely administration of benefits, plan implemen tation strategies and case resolution * Evaluated claims by reviewing exposure of liability, setting timely reserves t o adequately reflect potential value of the claim 3/26/01-10/30/02 Kemper Insurance Group, Concord, CA Senior Claims Examiner * Handled Del Monte account and use my skills as a Bi-lingual examiner. * Make benefits payments, establish and review reserves for adequacy, provide be nefits such as vocational rehabilitation, rate for permanent disability and sett le claims
Professional: Cigna Casualty-E.S.I.S, Examiner Trainee Program, I.E.A Certificat ion , San Francisco, CA, WCCP, S.I.P. Nov 2006, U.S. Long Shore and Harbor Cert ification Act 1998, MS Word, Lotus 123.
