Risk Management/Hr
Staff Works Group
Southfield, Michigan
● Managed multi state Workers’ Compensation, Disability, and Unemployment claims, investigations, hearings; collaboration with adjusters on IME authorizations.● Managed lost time and medical expenses, transition to work placements, wage statements, job descriptions, reserve increase approvals, and claim reviews to achieve claim resolution.● Managed insurance policy renewals, certificates of insurance, and work comp code classifications requests.● TPA and vendor management: Assurance, Chubb, Cincinnati Insurance, York Risk Services, Captive Resources, West Bend Insurance, Gallagher Bassett, CBCS, ADP, Thomas and Company, BWC, CareWorks, Concentra, Medcor, Odell Studner, and Zurich. ● Maintained logs of accident reports and workers’ compensation. Performed closed file reviews to determine whether claims were processed in an effective manner; identified areas of improvement including reserving and leakage control.● Worked closely with staff and outside defense counsel in managing litigated files according to established litigation management protocols.● Investigated new claims by reviewing first report of loss and supporting materials; communicate with claimant, policy holder/customer, and witnesses, etc. Participated in monthly Quality Review process with insurance carriers.● Carrier policy audit preparation and submission. Quarterly client payroll reporting and submission to insurance carriers.