I advocate directly for the account regarding claim exposures. I daily assist accounts in managing their workers' compensation claims to an optimal outcome at the earliest opportunity. I work with carriers on behalf of the account to aggressively resolve the open inventory and explore alternative options to bring about win-win for all parties involved.

I managed a claim unit administrating claims for the entire nation for owner operators and their helpers and casual laborers. Claims are a mix of Occupational accident for the owner operator and workers' compensation for the helpers and laborers as well as providing protection for the motor carrier when improperly named as the employer.I provide oversight and direction for quality outcomes working towards the best outcome at the earliest opportunity throughout the entire nation. 90% of the claims are administered directly in house and the remainder of the claims through TPAs with service agreements and contracts. I provide mentoring and education for my direct and indirect reports, creating and improving workflows based on business needs. I work with our vendors to verify compliance and best practices are being achieved and I have implemented tracking of cost savings programs with vendors to confirm compliance and verification of services provided. I verify that the TPA is following servicing contracts and providing the appropriate oversight on claims in areas not managed in house to bring early resolution at the best outcome for all parties.

I manage a workers' compensation claims unit administrating claims from the Illinois workers' compensation Assigned Risk Pool. These claims range from minor injuries to catastrophic losses. I also oversee and validate quality outcomes as confirmed through NCCI audits to achieve a the highest claim rating of a commendable score as identified by NCCI in an external audits. As part of my job roles, I verified best outcomes with our vendors in medical management, surveillance and law firm confirming that compliance and best practices are being achieved during the entire course and life of a claim file. I tracked and initiated cost savings programs with vendors to confirm appropriate usage and verifiable savings with our medical partners.

Managed a team of workers’ compensation claim representatives, nurses and claim assistants to start up a claim office in the Chicago region. The typical open pending ranged from 350-450 and was in multiple jurisdictions. The cases included severe catastrophic, survivor, and long term cases. Through management of the team, all aspects of claim management was done including, litigation management of a panel of defense attorneys, vendor management of nurse case managers and private investigation firms. When specifically needed, other activities included field investigation for subrogation and AOE/COE issues. Through management of the staff, I provided direction, training, and over-site for all aspects of the claim including settlement authority. Routinely completed account file reviews to agencies and insured’s on a regular basis, and in addition, I provided training to staff regarding the necessary outcome at a claim review.Jurisdictions: Illinois, Indiana, Iowa, Wisconsin, Michigan with backup support for another claim office handling, Missouri, Minnesota, Kansas, Nebraska and Kentucky.Secondary roles and responsibilities: Completed claim compliance requirements as mandated through corporate policies and procedures as outlined under the Sarbanes Oxley filings. Supported national training over the course of my employment of national claim initiatives including new claim systems, and outcome driven initiatives. As part of the initial start up team, was responsible for the hiring of claims personnel, including support staff, in house nursing staff, and investigation staff. Also established legal partnerships with panel law firms and worked within corporate compliance policies to obtain best outcomes.

AOE/COE investigation to conclusion of case, focusing on severe catastrophic, survivor, and long term medical care. During the course of the claim, activities included but were not limited to directing all aspects of the claim including special outside, and private investigations, and subrogation investigations.