Experienced and talented Claims Adjuster pro-active in handling, processing and resolving Michigan Auto PIP claims with effective use of cost controls, company and customer focus.
Evaluated and processed complex Personal Injury Protection files, for Order of Priority, relatedness and appropriateness of treatment based on the injury in question, determined proper reserves and made referrals to Subrogation and SIU departments as needed. Reviewed medical reports and paid medical bills appropriately. Resolved coverage conflicts. Mentored and trained newer staff.
Managed staff of 7 PIP Representatives and 3 claims support while assisting in setting up the present Medicare Review program. Worked with IT and mail departments to set up the current paperless claims system. Ensued staff to supply proper documentation for reimbursements from MCCA past withholdings with good success. Oversaw all large litigated claims and MCCA claims with specialized adjusters.
Managed staff of 8 PIP Adjusters and assisted/coached their training; conducted interviews for new office staff, oversaw 1200 caseload through diary and reserve reviews, as well as individual and team meetings. Worked with MCCA to set up filing system of threshold claims for reimbursement. Involved in all litigation files for best outcome of disputes. Budgeted adjuster's work functions to ensure the 40-hour work week as required by Bristol West.
Please see above AAA Michigan "experience" description.
Completed 3 years of college following high school when I began working at AAA Michigan. Attended PIP Claims- related training programs at AAA Michigan, including PIP Adjuster training, Medical Terminology training, as well as, various seminars discussing work loss benefits, case management, fraud and investigation, and catastrophic claims. Member of the Michigan Adjusters Association for over 30 years Furthermore, I have taken an addition business classes at Macomb College. Throughout my career, I have availed myself to several vendor presentations for various injury claims-related topics.
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