Workers Compensation Service Specialist
Resume:
Ronnie Gary
*************@******.***
WORK EXPERIENCE State of Ohio Bureau of Workers Compensation Columbus, OH January 1983 – December 2018 Claims Service Specialist Nov. 2004 – Dec. 2018
● Independently managed caseloads of lost-time claims for workers compensation benefits
● Reviewed, approved and denied compensation for injured workers based on supporting documentation and files received from medical providers and employers
● Assisted with medical authorization for injured workers, such as but not limited to, medical treatment for injuries incurred on the job
Medical Claims Specialist Jan. 1999 – Oct. 2004
● Worked with managed care organizations and medical providers to determine approval and denial for injured workers
● Assisted with caseloads for medical only claims
● Successfully processed and reviewed 30-40 medical claims per day Workers Compensations Claims Representative Apr. 1985 – Dec. 1998
● Developed a robust and thorough understanding of the complete Workers Compensation process
● Fielded incoming calls from injured workers, medical providers, employers, attorney representatives, managed care organizations and the general public on how to file claims, receive compensation and request medical benefits
● Worked with other internal departments throughout the agency to provide ancillary information to third parties Clerk (Level 2) Nov. 1983 – Mar. 1985
● Collaborated with various departments to source and collate claims files
● Gathered any other pertinent information claims representatives needed to answer and address customer inquiries Clerk (Level 1) Jan. 1983 – Oct. 1983
● Served as a liaison between internal departments to retrieve claims from the primary file room and to alleviate lag in addressing customer claims
● Purged files when necessary and upon request to ensure accurate record keeping for the agency LEADERSHIP EXPERIENCE State of Ohio Bureau of Workers Compensation Office Liaison Columbus, OH January 2014 – December 2018
● Cross-referenced Ohio Bureau Workers Compensation claims with the State of Ohio Job and Family Services Department unemployment claims to ensure accuracy of benefits for beneficiaries
● Served as the only liaison for the Columbus office of approximately 80 claims specialists State of Ohio Bureau of Workers Compensation V3 Coordinator Columbus, OH January 2011 – December 2015
● Acquired special knowledge of how to identify errors and mitigate risks associated with catastrophic lost-time claims’ benefits
● Corrected errors with claims, such as overpayments, duplicative payments and lack of payments, to ensure injured workers received appropriate compensation
● Served as one of four representatives for the agency’s Columbus office AWARDS
● State of Ohio Governor’s Award for 36 Years of Service
● Employee of the Month
● External Letters of Accommodation
● Customer Service Awards
SKILLS
● Excellent customer service
● Attention to detail
● PowerPoint proficient
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