William Simon Email & Phone Number

Nashville, Tn, Us

Nashville, Tennessee, United States

Investigate and manage incidents and events resulting from marine group operations to identify the proximate cause and access potential liability on the part of the organization.Claims may involve personal injury/illness, Property damage, Cargo damage, and other types of claims.Interface with vessel associates, operations managers, customer service representatives, contractors, insurance carriers, medical providers, in-house and outside counsel, and others as required, to investigate and effectively process claims, as well as manage liability exposure. Consult with claimants and medical providers to obtain pertinent medical information to manage claims.Maintain accurate records and notes on all aspects of claims, such as taking statements, obtaining medical records, hiring surveyors, establishing reserves, monitoring expenditures, and approving payments.Partner with in-house and outside counsel to formulate litigation strategy and achieve favorable results for the organization.Initiate and monitor various requested Coast Guard documents (such as 2692 forms)

Nashville, Tennessee, United States

Adjudicate occupational injury claims by reviewing policies, verifying coverage, and administering appropriate medical and indemnity benefits based upon language in policy with nationwide transportation providers.

Franklin, Tennessee, United States

Receive and manage lost-time claims and confirm policy coverage and acknowledgment of the claimDetermine the validity and compensability of the claim.Establish reserves and authorize payments within reserving authority limitsServe as mentor to less experienced adjustersCommunicate claim status with the customer, claimant, and clientAdhere to client and carrier guidelines and participate in claims review as needed

Clarksville, Tennessee, United States

Monitored and evaluated samplings of inbound and/or outbound calls and other contact methods including chat and email for compliance.Reported results of the evaluation to appropriate Quality/Operations stakeholders. Provided feedback and identified staff training and developmental needs.Maintained knowledge and understanding of client products, services, and/or program strategies. Participated in internal quality audits designed to improve overall call quality and recommend changes. Participated in quality task forces with management and clients. Responsible for meeting departmental productivity requirements

Los Angeles, California, United States

Determined validity and compensability of the claim. Established reserves and authorized payments within reserving authority limits. Handled both litigated and non-litigated claims. Ensured compliance with rules and regulations governing Workers’ Compensation benefits and self-insurance administration.Reviewed, evaluated, and interpreted established laws of Workers’ Compensation programs.Communicated claim status with customers, claimants, and clients.Adhered to client and carrier guidelines and participated in claims review as needed