Experience

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  K and b Publications

  • Baltimore, Maryland Area

  • Workers Compensation operations/specialist

    • Dec 2017 - Apr 2023
    • Baltimore, Maryland Area

    Provide technical advise and assistance on workers' compensation administration processes and procedures. Claims adjusting and claim auditing.

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  WC Contractor

  • Workers' Compensation Specialist

    • Jan 2009 - Jun 2011

    Independent contractor for workers compensation claim processing and operation activities.

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  URDC

  • Baltimore, Maryland Area

  • Mentor

    • Jan 2009 - Mar 2011
    • Baltimore, Maryland Area

    Using the game of chess as a tool we teach young kids to play and intergrate the life skills from chess into their daily lives. Helping to develop critical thinking, logic, reasoning stratgetic thinking.

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  Baltimore City Schools

  • Workers' Compensation Specialist

    • May 2004 - Dec 2008

    Contract administration and analyze incident reports/claims to determine extent of school systems liability, make approval or denial decisions and negotiate settlements with case review committee and claimants in accordance with self-insurance provisions. Collaborate with third-party administrator and interview claimants to correct errors, rectify omissions and investigate questionable issues. Recommend RTW options.Outcomes:Completed more than 1,300 claims throughout tenure. Provided optimum service to school Board, and identified fraudulent claims.Achieved the highest number of timely reporting of incidents in 2007. Surpassed goal by averaging 75% reporting on time claims. Selected by supervisor to assist with file closures; resolve complex claims-processing issues; participate in quality-control audits; and monitor claim status updates.Maintained a superior quality rating of 94% in file handling and claims resolution.Received good Performance ratings (2005, 2006) and excellence rating (2007).

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  City of Baltimore

  • Workers Compensation Claims Processing Supervisor

    • Nov 1991 - May 2004

    Supported claims adjusters in processing hundreds of first- and third-party workers' compensation insurance claims. Contract administration and analyze incident reports/claims to determine extent of school systems liability, make approval or denial decisions and negotiate settlements with case review committee and claimants in accordance with self-insurance provisions. Collaborate with third-party administrator and interview claimants to correct errors, rectify omissions and investigate questionable issues. Recommend RTW options. Analyzed and determined completeness and validity of claims. Assisted stakeholders in a busy call-center environment. Outcomes:Accompanied adjusters and nurse case managers in the field to investigate claims and determine cause and extent of damages and recommendation for Return to Work.Worked with investigation to uncovered fraudulent claims; provided evidence leading to the recovery of thousands of dollars in insurance overpayments.Developed a strong understanding of insurance policies and legal issues through completion of a series of in services classes coupled with in-depth, multi-disciplinary claims training with in house risk committees.

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  IWIF

  • Towson, Maryland

  • Claims Unit Supervisor

    • Jan 1987 - Jan 1991
    • Towson, Maryland

    Supervise the processing and audit of workers' compensation benefits by Claims Division

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  State of Maryland-Workers' compensation Commission

  • Baltimore, Maryland Area

  • Fiscal Associate II

    • Jul 1974 - Jan 1987
    • Baltimore, Maryland Area

    Oversight of Subsequent Injury Fund accounts payable/receivable unit in Accounting Division and Agency Personnel activities