Objective
I would like to either manage, in house, Jones Act, Longshore & Texas Worker's compensation claims or work as an independent handling the investigation aspect of these claims. I currently have a call out service which consists of statement taking / investigation and transportation to and from the medical facility once an employee comes in from offshore.
Experience
Detailed Work History:
September 2008 – January 29, 2010
Sea Bright Insurance Company - Houston, TX
Job Title: Claims Examiner
•Successfully maintained a large case load of complex USL&H, Texas and Louisiana state comp claims from inception to conclusion.
•Successfully negotiated settlements of Longshore claims below authority for best possible outcome for carrier and insured.
•Successfully managed attorneys on litigated claims to ensure the best outcome for the carrier and employer.
•Excellent identification of claims with subrogation potential and ensuring that subrogation counsel was kept abreast of all activity involving subrogation efforts.
•Successfully completed three point contacts within best practices guidelines
•Timely established reserves based on exposure and experience.
•Ensured timely documentation of claim database.
•Successfully managed claimant return to work through nurse case management and staying in close contact with physicians as well as utilizing Independent Medical Exams when appropriate, saving thousands of dollars in indemnity payments for the carrier / insured. .
•Timely and initiated payments, so as to avoid penalties and late fees.
December 2007- September 2008
F.A. Richard & Associates -Corpus Christi, TX.
Job Title: Worker’s Compensation Adjuster
•Successfully maintained a large case load of complex Jones Act liability, USL&H, Texas and Louisiana state comp claims from inception to conclusion.
•Successfully negotiated settlements of Liability claims below authority for best possible outcome for carrier and insured.
•Successfully completed three point contacts within best practices guidelines
•Timely established reserves based on exposure and experience.
•Ensured timely documentation of claim database.
•Excellent identification of claims with subrogation potential and ensuring that subrogation was pursued and funds were recovered.
•Successfully managed claimant return to work through nurse case management and staying in close contact with physicians as well as utilizing Independent Medical Exams when appropriate, saving thousands of dollars in indemnity payments for the carrier / insured. .
•Timely initiated payments, so as to avoid penalties and late fees.
March 2007 – December 2007
Infinity Claims Services- Portland, TX
Job Title: Owner / Independent Adjuster
•Successfully marketed my services to other adjusting firms and companies.
•Ensured transportation and medicals needs were taken care of when employees came in for medical treatment from offshore drilling rigs. .
•Obtained excellent recorded statements from claimant and witnesses that resulted in diminishing liability for the client. .
•Established excellent rapport with claimant during call outs, which allowed client to maintain control of the claimant without legal representation.
•Provided timely updates to the employer and carrier, while ensuring that proper medical attention was provided to the claimant.
May 1999 – February 2, 2007
Shuman Consulting Services Houston, TX
Job Title: Staff Adjuster
•Successfully maintained a large case load of complex Jones Act liability and Texas state comp claims from inception to conclusion.
•Successfully negotiated settlements of Liability claims below authority for best possible outcome for carrier and insured.
•Successfully completed three point contacts within best practices guidelines
•Timely established reserves based on exposure and experience.
•Ensured timely documentation of claim database.
•Successfully managed claimant return to work through nurse case management and staying in close contact with physicians as well as utilizing Independent Medical Exams when appropriate, saving thousands of dollars in indemnity payments for the carrier / insured. .
•Timely initiated payments, so as to avoid penalties, late fees and claimant representation.
1989 – February 1999
Gulf King Services Aransas Pass, TX
Job Title: Claims Coordinator
•Assisted claims adjuster in Investigation of Texas Worker’s Compensation and Jones Act claims resulting in extensive knowledge of legal issues affecting personal injury claims.
•Communication with claimants, doctors, adjusters and attorneys.
•Provided settlement authority and instructions to adjusters.
•Monitored reserves and loss run for self insurance program.
•Updated management with regards to claim status.
•Assisted litigation and discovery.
Education
Associate in Arts - Criminal Justice
Certification
Licensed Texas Worker's Compensation Adjuster
Skils
I have excellent oral / written communications skills as well as excellent customer service skills. I have expert investigative and claims handling skills as well as negotiation and time management skills. I am proficient with the computer as well.
Most of my experience with claims has been in the offshore drilling and energy sector. I have handled claims for many of the larger drilling and production companies as well as handling claims for offshore crew and work boat companies and catering companies. I have also managed claims in the shrimping dredgin industries.