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Edison Ward
Compensation Adjuster
Summary
Highly skilled and experienced Compensation Adjuster with a proven track record of success in managing and analyzing workers’ compensation claims. Demonstrated expertise in adjudicating claims, evaluating medical records, negotiating settlements, conducting investigations, and applying workers’ compensation laws and regulations to ensure accurate and timely claim processing. Strong understanding of medical terminology and ability to collaborate effectively with medical professionals. Proven ability to manage a high volume of active claims and resolve issues promptly and effectively.
Education
Bachelor’s degree
August 2018
Skills
- IDA Claims Platform
- Workers’ Compensation
- Claims Management
- Settlement Negotiation
- Policy Analysis
- Medical Terminology
Work Experience
Compensation Adjuster
- Applied knowledge of workers compensation laws and regulations to ensure accurate and timely claim processing
- Collaborated with medical professionals to interpret medical findings and assess impairment ratings
- Prepared and issued detailed claim reports, including medical summaries, reserve evaluations, and settlement proposals
- Managed a caseload of over 100 active claims, resolving issues promptly and effectively
Compensation Adjuster
- Managed and analyzed workers compensation claims for major insurance carriers, ensuring compliance with state and federal regulations
- Adjudicated claims, evaluating medical records and determining benefit eligibility, to process payments and facilitate claim closures
- Negotiated settlements with claimants and their attorneys, resulting in cost savings for employers and insurers
- Conducted comprehensive investigations to determine causation and liability, interviewing witnesses and gathering evidence
Accomplishments
- Successfully implemented a new automated claims processing system, streamlining the adjustment process and reducing turnaround time by 20%.
- Developed and implemented a comprehensive training program for new adjusters, ensuring consistent application of adjustment practices and adherence to regulatory requirements.
- Negotiated a favorable settlement in a major bodily injury case, achieving a significant reduction in the companys potential liability.
- Conducted a thorough analysis of the companys claims data, identifying trends and developing recommendations to improve claims handling efficiency.
- Successfully resolved a highvolume of claims during a major natural disaster, ensuring timely and fair settlements for policyholders.
Awards
- Received the Exceptional Achievement in Compensation Adjustment award for consistently exceeding performance targets and demonstrating exceptional judgment in resolving complex claims.
- Honored with the Outstanding Contribution to the Insurance Industry award for developing innovative approaches to claims resolution, resulting in improved customer satisfaction and reduced litigation costs.
- Recognized for Excellence in Claims Management for successfully resolving a highprofile and complex property damage claim, saving the company over $1 million.
- Recipient of the Top Performer Award for consistently surpassing individual adjustment performance goals and maintaining the highest levels of customer service.
Certificates
- Certified Workers’ Compensation Professional (CWCP)
- Certified Insurance Counselor (CIC)
- Associate in Insurance Services (AIS)
- Certified Claims Professional (CCP)
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How To Write Resume For Compensation Adjuster
- Highlight your experience and skills in managing workers’ compensation claims.
- Showcase your ability to interpret medical records and apply workers’ compensation laws and regulations.
- Quantify your accomplishments, such as the number of claims managed or the amount of cost savings achieved.
- Use industry-specific keywords to optimize your resume for search engines.
- Proofread your resume carefully for any errors.
Essential Experience Highlights for a Strong Compensation Adjuster Resume
- Managed and analyzed workers’ compensation claims for major insurance carriers, ensuring compliance with state and federal regulations.
- Adjudicated claims, evaluating medical records and determining benefit eligibility, to process payments and facilitate claim closures.
- Negotiated settlements with claimants and their attorneys, resulting in cost savings for employers and insurers.
- Conducted comprehensive investigations to determine causation and liability, interviewing witnesses and gathering evidence.
- Applied knowledge of workers’ compensation laws and regulations to ensure accurate and timely claim processing.
- Collaborated with medical professionals to interpret medical findings and assess impairment ratings.
- Prepared and issued detailed claim reports, including medical summaries, reserve evaluations, and settlement proposals.
Frequently Asked Questions (FAQ’s) For Compensation Adjuster
What is the role of a Compensation Adjuster?
A Compensation Adjuster is responsible for managing and analyzing workers’ compensation claims, ensuring compliance with state and federal regulations, adjudicating claims, negotiating settlements, conducting investigations, and applying workers’ compensation laws and regulations to ensure accurate and timely claim processing.
What are the key skills required for a Compensation Adjuster?
Key skills for a Compensation Adjuster include strong knowledge of workers’ compensation laws and regulations, ability to interpret medical records, negotiation skills, investigative skills, and excellent communication skills.
What are the career prospects for a Compensation Adjuster?
Compensation Adjusters with experience and expertise can advance to roles such as Claims Manager, Risk Manager, or Underwriter.
What is the average salary for a Compensation Adjuster?
The average salary for a Compensation Adjuster varies depending on experience, location, and employer, but it typically ranges from $50,000 to $80,000 per year.
What are the educational requirements for a Compensation Adjuster?
Most Compensation Adjusters have a bachelor’s degree in a related field, such as business, economics, or finance.
What are the certification requirements for a Compensation Adjuster?
There are several certifications available for Compensation Adjusters, such as the Associate in Claims (AIC) designation from the Insurance Institute of America (IIA) and the Certified Professional in Workers’ Compensation (CPWC) designation from the Workers’ Compensation Institute (WCI).