JANUARY 2015 – PRESENTCLAIMS SPECIALIST, LINE CONSTRUCTION BENEFIT FUNDHired to implement new processes for Medicare, non-work-related injuries, payment collection, and subrogation for a self-administered welfare benefit plan. This includes medical, dental, vision, life and disability benefits for members of the IBEW.Subrogation Manager• Thorough legal and ERISA knowledge.• Analyze, processes and manages complex first and third party liability claims by investigating and gathering information from team members.• Asses liability and resolves claim within evaluation.• Pays benefits due; approves and makes timely claims payments and adjustments. • Coordinates benefits with other carriers of various lines of insurance carriers.• Manages litigation, and assigns to appropriate adjuster.Coverage specialist • Manages assigned caseload of short term disability cases.• Maintains high level customer focus and provides service deliverables on time.• Makes accurate claim payments in accordance with the terms of the policy.• Timely and accurate adjudication of STD claims requiring medical intervention. Broad knowledge of disability contracts, policies, and products and continued understanding of medical issues.• Responsible for timely and accurate claims review, initiation, and completion of claims. • Ability to interact effectively and professionally with claimants, employers, medical resources, attorneys, and union leadership.• Well versed in medical record interpretation and a broad spectrum of medical conditions. • Transitions members to Medicare status utilizing broad knowledge and experience with the Medicare system.

Environmental and asbestos claims from acceptance to resolution. This includes coordinating the clean-up of environmental disasters. • General liability, Excess and umbrella policy specialist.• Mass litigation claim experience of moderate to high exposure and complexity.• Knowledge of the insurance industry, claims, and the insurance legal and regulatory environment. • $500,000 reserve authority.