Tomasina Albarado
Tucson
Overview
19
19
years of professional experience
1
1
Certification
Work History
Senior Claims Examiner
Keenan And Associates
07.2015 - Current
- Reduced claim resolution time by conducting thorough investigations and timely decisionmaking.
- Negotiated settlements with claimants, balancing fairness with fiscal responsibility to the company.
- Collaborated with legal counsel on complex claims, ensuring compliance with regulatory guidelines.
- Maintained up-to-date knowledge of industry trends and legislative changes, ensuring accurate claim evaluations.
Workers’ Compensation Claims Examiner
Tristar Risk Management
12.2015 - 07.2016
- Administer 200 Indemnity Workers’ Compensation files with County of Los Angeles
Workers’ Compensation Claims Examiner
Metro Risk Management
05.2013 - 08.2014
- Investigated & ascertained claim compensability, in addition to attending continuing education workshops
- Worked with defense attorneys to coordinate claim strategies & the reduction of claim litigation volume
- Utilized effective cost containment practices to reduce litigation expenses
- Administered disability payments, coordinated care with medical provider offices & processed necessary referrals with panel vendors
- Prepared claims for periodic client file reviews and internal best practice audits
Workers’ Compensation Claims Examiner
AIG Domestic Claims
10.2007 - 04.2013
- Administered mixture of litigated and non-litigated claims, caseload of 180 files, self-insured
- Issuance of timely benefits and letters, AOE/COE investigations, recorded statements, negotiate liens, telephonic and on site file reviews with clients
- Administer about 130-150 Indemnity Workers’ Compensation files
- Review all medical, diagnostic, and specialist reports in order to determine whether the claim will be accepted, denied or delayed benefits
Claims Examiner
Broadspire
11.2005 - 10.2007
Education
Bachelor of Arts - Business Management
California State University Fullerton
Fullerton, CA01-2003
Associate of Arts - General Education
Associate of Arts
Costa Mesa05-1998
Skills
- Claims processing
- Verbal communication
- Data verification
- Disability claims process
- Microsoft Office Suite
- Claims investigation
- Benefits review
- Litigation management
- Liability determination
Certification
WCCP
Languages
Spanish
Native or Bilingual
Timeline
Workers’ Compensation Claims Examiner
Tristar Risk Management
12.2015 - 07.2016
Senior Claims Examiner
Keenan And Associates
07.2015 - Current
Workers’ Compensation Claims Examiner
Metro Risk Management
05.2013 - 08.2014
Workers’ Compensation Claims Examiner
AIG Domestic Claims
10.2007 - 04.2013
Claims Examiner
Broadspire
11.2005 - 10.2007
WCCP
Bachelor of Arts - Business Management
California State University Fullerton
Associate of Arts - General Education
Associate of Arts
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