I have over five years of experience handling workers' compensation claims, including reviewing medical records, assessing claim validity, and determining appropriate compensation. I am proficient in state-specific workers' compensation laws and have successfully managed high-volume caseloads while maintaining accuracy and compliance. My experience also includes collaborating with medical providers, legal teams, and employers to ensure timely and fair claim resolutions.

I stay updated on state and federal workers' compensation laws through continuous education and industry resources. I meticulously review claims to ensure adherence to regulations, maintain detailed documentation, and conduct regular audits. Additionally, I collaborate with legal and compliance teams to address any discrepancies and implement corrective actions to mitigate risks and maintain compliance.

When handling disputes, I first gather all relevant documentation, including medical records and witness statements. I then communicate with all parties involved to understand their perspectives and work toward a resolution. If necessary, I escalate the matter to mediation or legal teams while ensuring compliance with regulations. My goal is to resolve disputes fairly and efficiently while minimizing delays and costs.

I have extensive experience using claims management software such as Guidewire, Mitchell, and Riskonnect. These tools help streamline claim processing, track deadlines, and generate reports. I also use Microsoft Excel for data analysis and reporting. My proficiency with these tools allows me to manage caseloads efficiently, ensure accuracy, and provide timely updates to stakeholders.

I prioritize claims based on urgency, complexity, and deadlines. I use organizational tools like task management software and calendars to track progress and ensure timely resolutions. I also delegate tasks when appropriate and maintain open communication with team members to address bottlenecks. By staying organized and proactive, I effectively manage high volumes of claims without compromising quality or compliance.