Christopher Chavez Email & Phone Number

Los Angeles County, California, United States

Long Beach

• Directly supervises highly technical, quasi-judicial, and complex administrative management and personnel. Perform quality claim reviews every 90 days to ensure adequate file documentation and regulatory compliance for.
• Provide technical claims handling assistance to six direct reports, delegate client specific projects and ensure recommended action for specific claims is completed timely to promote client satisfaction
• Identifying trends and issues and reporting to Compliance Manager Contributing feedback during monthly program leadership meetings.
• Enforces regulations, governing procedures and practices stated by the State of California.
• Acting as second level of appeal for client and claimant issues. Complete reserve release requests for team per Self-Insured Best Practices

Long Beach, California, United States

• Managed caseload upwards of 150 indemnity high exposure files by developing proactive legal and settlement strategies to minimize cost exposure.
• Consistently and adequately updated action plans and reserves per Self Insured Best Practices while maintaining over 85% on regulatory audits
• Completion of Settlement Authority Requests (SARs) above $150K
• Subject Matter Expert: Submit and Non-Submit Medicare Set-Asides

Rancho Cordova, California, United States

• Conducted stationary and mobile surveillance assignments on claimants involved in potential Workers Compensation Fraud (Sub-rosa)
• Completed comprehensive daily reports detailing surveillance activity and database search information pertaining to claimants