David Chatelain Email & Phone Number

Sandy Springs, Ga

• Experience in reporting, investigating, managing, and resolving workers' compensation claims, demonstrating proficiency in handling compliance-related issues and ensuring adherence to regulatory requirements.• Ability to provide direction and support to insurance carrier claim adjusters and defense attorneys, showcasing effective collaboration with external partners to ensure compliance with insurance regulations and legal requirements.• Skill in identifying claim trends and developing safety recommendations to mitigate workers' compensation costs, demonstrating proactive risk management and compliance efforts to ensure a safe work environment.• Experience in identifying, evaluating, and providing risk management recommendations to minimize business risks and overall cost of risk, highlighting a strategic approach to compliance and risk mitigation.• Experience in filing applicable reports and remitting payments for workers' compensation in monopolistic states, showcasing compliance with state-specific regulatory requirements and reporting obligations.• Responsible for managing and distributing risk management period reports, demonstrating proficiency in data management and reporting for compliance purposes.• Collaboration with accounting for budgeting annual accruals related to claims, showcasing financial planning skills and compliance with accounting standards and regulations.• Proficiency in administering the claims database system and generating reports as needed, highlighting technical skills and compliance with data management and reporting requirements.• Skill in reviewing certificates of insurance for coverage, demonstrating attention to detail and compliance with insurance requirements for contractual agreements.

Norcross, Georgia

" Manage the processing and completion of complex workers' compensation claims for staff who experience minor to severe injuries on the job. Listen closely to each complaint / case, take steps to gather required information, and collaborate and work closely with attorneys to successfully reach a compensation agreement that is satisfactory to all parties involved and meets individual unique requirements and close each case." Utilized in-depth understanding of rules and regulations to develop legal documents including motions, brief inserts, discovery documents, correspondence, and legal memoranda. Ensure that all documentation is complete, accurate, and in compliance with required standards.

• Analyzed claim exposure to assess the appropriate course of action and ensure proper settlement or closure of claims in alignment with state regulations, company policies, and client guidelines.• Cultivated and sustained strong relationships with client contacts to enhance retention and consistently exceed client expectations while adhering to established policies and procedures.• Managed and provided oversight on claim files, including indemnity determination, loss of income calculations, medical relevance assessment, treatment plan evaluation, and return-to-work strategies to ensure timely and accurate payment of all benefits.• Handled legal aspects of claims, including negotiation of settlements, formulation of litigation strategies in collaboration with assigned attorneys, and representation in depositions, mediations, and hearings.• Evaluated claims for reserve adequacy and settlement potential, leveraging knowledge of MSAs (Medicare Set-Asides) and structured annuities where applicable.• Documented all claim activities promptly and effectively, maintaining comprehensive records that support the resolution of each claim. • Interfaced extensively with various stakeholders involved in the claims process to facilitate effective communication and resolution.• Managed Electronic Data Interchange (EDI) requirements in compliance with state and company protocols, ensuring timely and accurate data transmission.• Identified and pursued opportunities for Second Injury Fund (SDF) claims, subrogation, fraud detection, and vocational or field case management involvement as needed.• Conducted regular status reports and claim reviews with clients, traveling as necessary to facilitate in-person meetings and maintain client relationships.• Stayed current with legal statutes and regulations relevant to claims handling, maintaining Continuing Education Units (CEUs) and licensure as required by the state of practice.