Carla Maldonado

Sr. Claims Adjuster at Next Level Administrators, LLC
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Contact Information
us****@****om
(386) 825-5501
Location
Richardson, Texas, United States, US
Languages
  • English Full professional proficiency
  • Spainsh Native or bilingual proficiency

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Experience

    • United States
    • Claims Adjusting, Actuarial Services
    • 1 - 100 Employee
    • Sr. Claims Adjuster
      • Sep 2022 - Present

    • United States
    • Insurance
    • 1 - 100 Employee
    • Sr. Claims Representative
      • Oct 2020 - Apr 2023

    • United States
    • Insurance
    • 700 & Above Employee
    • Sr.Claims Representative
      • Nov 2014 - Oct 2020

      Non Subscriber Texas & Oklahoma Non Subscriber Texas & Oklahoma

    • Insurance
    • 1 - 100 Employee
    • Sr. Adjuster Multi.States
      • Mar 2014 - Nov 2014

    • Temp Contractor
      • Sep 2013 - Mar 2014

      General adjusting duties, and technical support to the Austin, Tx office during implementation and roll out of new claims system. General adjusting duties, and technical support to the Austin, Tx office during implementation and roll out of new claims system.

    • Claims Consultant
      • 2004 - 2013

      Sr. Adjuster handling lost time claims for multiple jurisdictions which include Texas, Oklahoma, Arkansas, Colorado, Kentucky, Florida,Georgia and various other states. Investigate to include three point contact to tie down injuries & identify potential third party for subrogation. Maintain professional contact with Insured, injured worker, and other internal and external contacts. Calculation of indemnity payments and state form filings. Prepare large loss reports to excess carriers and request reimbursements. Maintain quarterly status reports on claims for reporting to Insured, Brokers and Agents. Show less

    • Sr. WC Administrator
      • Oct 2000 - Oct 2002

      Investigate and determine compensability on Texas lost time claims. Obtain recorded statements from injured employee and witnesses. Indentify potential subrogation and pursue recovery. Maintain professional contact with Insured, claimant, and all other internal and external contacts. Investigate and determine compensability on Texas lost time claims. Obtain recorded statements from injured employee and witnesses. Indentify potential subrogation and pursue recovery. Maintain professional contact with Insured, claimant, and all other internal and external contacts.

    • Claims Consultant III
      • Sep 1999 - Oct 2000

      Sr. Adjuster handling lost time claims to include supplemental income benefits in Texas. Complete 3 point investigation to include recorded statements, identify 3rd party exposure and pursue collection of subrogation. Interact with in-house early return to work specialist, insured and injured worker and treating doctor to reduce indemnity cost. Sr. Adjuster handling lost time claims to include supplemental income benefits in Texas. Complete 3 point investigation to include recorded statements, identify 3rd party exposure and pursue collection of subrogation. Interact with in-house early return to work specialist, insured and injured worker and treating doctor to reduce indemnity cost.

    • Sr. Work Comp Adjuster
      • Mar 1993 - Sep 1999

      Handling of lost time & medical only state workers comp claims for Texas and Oklahoma. Attended Benefit Review Conferences and Contested Case Hearings. Investigation to include 3 point contact determine compensability & payment of indemnity benefits. Identify third party exposure for potential subrogation. Responsible for non-subscriber claims to include rollout of program and review of ERISA documents. Audited employer's who managed their own non-subscription programs and helped develop better standards and practices within their own organization. Show less

Education

  • Princeton High School
    High School Diploma
    1979 - 1982

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