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yyyyyy x. yyyyyy 0000 xxxxxx xxxx , xxxx , xxxxx 00000
xxx-xxx-xxxx
objective
productive, quality-oriented claims professional eager to assist a progressive organization
by contributing strong business talents in optimizing sales and retention goals in the
insurance brokerage or private employer sectors.
career profile
ø more than 30 years of claims management, with 13 years as claims team leader, handling multi-million-dollar accounts in over ten states, including federal compensation programs.
ø in-depth experience in managing investigation/evaluation, negotiation and litigation; possess background working in remote dedicated offices as well as in call center environments.
ø led dedicated team for levi strauss, a 25-year customer, in receiving 90% and above audit results for seven years, and also accomplished 90%+ audits with excess carriers and state audit groups.
ø above results were due to exhibiting excellent account management skill sets, developing strong one-to-one relationships, providing immediate response to concerns and continually striving for process improvement as well as claim and cost containment.
ø provide diligent on-site accident investigation and close interaction with injured employees and local contacts.
ø developed risk mitigation techniques for adia manpower management team, resulting in claims costs reduction.
ø for jacksonville shipyards, assisted with reduction of indemnity/medical costs by proactively negotiating, resolving exposure and participating in claims defense at dol hearings.
ø self-driven, effective team player with strong decision-making and training skills.
professional certifications
licensed in texas, oklahoma and kentucky
professional experience
ace/esis 1996 - 2010
claims specialist & team leader, dallas, tx (2003-2010)
between 2/08 and 12/10, was assigned accounts such as abm industries, beck, dow chemical, ritz carlton, trueblue and waste connection; excellent broker audits of 95% on 12/09.
tasked with dedicated management of levi strauss account (2006-2008) for ky, ga and tx; determined compensability/payments and issue resolution.
during 2005-2006, managed lockheed martin contract team of on-site representatives, claims center representatives and case management nurses in overseeing workers compensation claims in tx.
additionally during 2005-2006 posted successful broker review for levi strauss account with results of 90%.
during 2003-2005, directed remote team of workers compensation representatives, claims assistants and network representatives dedicated to handling levi strauss concerns in ar, ga, ky, ms, nc, tn, va and tx.
results from successful excess carrier audit (3/07) provided positive feedback; additionally had successful self-insured audit (2006) and broker audit in 2009 resulted in 92%.
remote team leader, knoxville, tn (1996-2003)
oversaw activities of remote team of nine personnel handling workers compensation issues for levi strauss in ar, ga, ky, ms, nc, tn and va.
yyyyyy x. yyyyyy
page two
held management responsibility over technical team for providing investigation, evaluation, negotiation and claims conclusion in a timely manner.
additionally, oversaw operations management to assure timely claims registration, prompt payment of benefits as well as bills, and providing overall customer service.
was charged with interviewing, hiring, training and evaluating performance of claims representatives/assistants; utilized department goals as basis for determining unit objectives.
over four-year period, led team in successful broker audits, receiving positive feedback and scoring 90% or higher.
cigna property/casualty, jackson, fl 1990 c 1996
senior claim representative
held responsibility for timely investigation, evaluation, negotiation and claims for such major accounts as ashland oil, budget rent-a-car and chevron, among others, providing on-site investigation of incidents, compensation determination and benefits payment.
was able to reduce some claims costs due to implementing early return-to-work programs.
successfully prevailed in settling projects for adia, ashland oil, borden inc. and fleming inc.
served in team management role in absence of designated team leader, training coordinator for compensation center.
prior experience
prior to 1990, served in field as a supervisor/specialist for aetna life & casualty investigating, evaluating, negotiating and resolving longshoremen, harbor worker, aafes and jones act cases, determining compensability, coordinating benefits for shipyard explosions and bridge construction accidents, collaborating with/preparing defense counsel at department of labor hearings, supervising accounts for such clients as aafes, jacksonville shipyards, misener marine, boeing, barrett banks and dillard s, and recruiting, training and developing team members.
have traveled extensively throughout state of florida, performing on-site investigation, attending litigation activities and meeting with medical providers to coordinate medical treatment. additionally, was involved with lockheed-martin at space center in melbourne, fl, overseeing all claims exposure. have handled claims for longshore/harbor workers act regarding federal compensation
education
florida state university, tallahassee, fl
bachelor of science, cum laude graduate, 1975
marketing major, business administration minor
dean s list student for majority of tenure at fsu
3.57 gpu
member, mu kappa tau marketing sorority
associate in claims (aic) designation, 2002
cpcu program, continuing classes
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