ANGELA HELPER, CWCP

2444 North Main Street NW• Atlanta, GA 30318 • (C) 678.480.1483 • arhelper10@gmail.com

CLAIMS ADJUSTER

Well respected professional who blends strong managing benefits management which include workers’

compensation, FMLA, LTD and STD. Seventeen years of medical experience. Exceptional aptitude for hands on tasks along with maximizing time management to maintain day to day work flow.

Areas of Strengths Include

● Superb Written and Oral Communication ● Analytical and Innovative Thinker

● People Soft Knowledge ● Outstanding Analytical Skills ● Relentless Attention to Detail ● Performance Management ● Excellent Planning ● HIPPA & JCAHO Compliance

● Flexible and Adaptable ● Budgeting and Forecasting ● Problem Solver ● HRIS Proficiency

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PROFESSIONAL EXPERIENCE

The Claims Solution 10/2015-Present Contract Claims Adjuster, Workers Compensation and General Liability Adjuster

Participation in budget preparations for each claim manages reserve expenses per claim

Implement workers’ compensation policies along with providing current MCO posting for Georgia

employees

Perform data entry functions for workers compensation claims for multistate claims

Provide weekly and monthly claims spread sheet of open claims with reserves for claims review.

Interface with physician offices, attorneys and vendors

Cross reference each workers’ compensation claim with other benefits applicable to employee

First point of contact for department heads

Provide all authorization for initial medical treatment

Provide accurate wage statements for partial and total disability benefits.

Participate in claims settlement and negotiations

Settle Customer Service and Property Casualty Claims

Monitor post-accident drug screen with the authority to proceed to controvert claims.

Oversee and ensure medical records are obtained

Maintain knowledge of all employee work status

Follow union law for Illinois Claims

Extensive knowledge of medical and technical terminology

Angela Helper

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American Employer Group, Knoxville, TN 7/2014-10/2015

HR/Workers’ Compensation Coordinator/ Certified Workers’ Compensation Multi States

Oversee employee matrix and auditing

Provide all authorization for initial medical treatment

Onboarding and employee orientation

Conduct new talent interviews

Family Medical Leave Act preparation for internal employees

Ensure Federal/State Law workers’ compensation

New enrollment benefits

Unemployment benefit hearings

Performance counseling, evaluations and terminations

Attention to detail, excellent planning, organizing and time management skills

Perform data entry functions for workers compensation claims for internal and external employees

Communicate effectively with operations, risk management

Implement workers’ compensation policies along with providing current MCO posting for employee in various states

Obtain supervisor, employee and witness statements upon work related incidents

Provide accurate wage statements for partial and total disability benefits for workers compensation

Monitor reserves set by third party administers, post-accidental drug screen with the authority to

controvert claims with positive drug screens, or claims that arise out of the scope of employment.

Ensure the maintenance of reporting loss runs along with full compliance with multistate workers’

compensation laws.

Oversee obtaining all records maintain for each claim

Interface with physician offices, attorneys and third party administrator vendors

Direct all incoming medical record and medical bills to the assigned adjuster and monitor the length of time it takes for the bills to be paid.

Maintain knowledge of all employee work status

Offsite Accident scene investigations

Cross reference each workers’ compensation claim with unemployment benefits

Monitor claims and trends to and produce incentives for staying safe in the work environment

Provide weekly and monthly claims spread sheet of open claims with reserves for claims review to the

Human Resources Director

Participate in claim reviews to determine reserves, settlement negotiations for catastrophic claims

Bridge the gap between the claimants, medical providers and adjusters

Angela Helper

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Participation in budget preparations as it pertains to deductible and per claim fees as well as reserve

expenses per claim.

Extensive knowledge of medical and technical terminology

EARLY CAREER: Worked as a Certified Medical Assistant for seventeen years assisting Multi Physician Practices.

This included Internal Medicine, Infectious Disease, Anesthesiology, Orthopedics and Psychology clinics. Most recent positions were:

LSU Medical Center Orthopedics Department, LA 1/2012-5/2014 Office Assistant/Medical Assistant,

Served as a member of a healthcare team for a large orthopedic practice. I was assigned to a Trauma Surgeon and provided assistance multiple Physicians, Residents and Medical Students.

Establish and implement administrative policies and procedures Obtained and maintained relationships with case managers, workers compensation adjusters, physical therapist, and

Veterans Affairs nurse and case managers for prior authorization and treatment continuation. Casting and splinting fractures, suture removal, injections, wound cultures, prior authorization for surgeries, physical therapy and diagnostic testing.

Southern Pain Center, Mandeville, LA 04/2007-11/2012

Medical Assistant

Served as a key a member of interdisciplinary healthcare team for a busy Interventional Pain

Management office and surgical center. I assisted one Medical Doctor as well as a Physician Assistant in ensuring optimal patient care and smooth daily functioning of the office. Counseled patients on medication management as well as interventional pain management and spinal cord stimulators.

Assisted with the effective coping skills, scheduled referrals for inpatient and outpatient behavioral health and substance abuse facilities for simultaneous treatment. Knowledge of pharmacology, spinal cord stimulators, and intrathecal pump monitoring.

TRAINING AND EDUCATION

University of Phoenix Bachelor’s Degree Psychology ● Certified Workers’ Compensation Professional

Collaborative Institutional Training Initiative Certification (CITI) in the following area;

Health Information Privacy and Security and Accountability (HIPPA)

GCP Course for Clinical Trials Involving Investigational Drugs

OSHA Blood Borne Pathogens

Social and Behavioral Research

Bryman College Certified Medical Assistant, Phlebotomy Tech