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Claims Representative Resume

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Detroit, MI

TECHNICAL SKILLS:

  • Excel PowerPoint OmniForm Lotus Notes
  • Word Outlook Typing (50 wpm) Mediation
  • Access WordPerfect Project Management GroupWise
  • Windows Quicken Web - based Databases Research
  • Adobe Acrobat Customer Service Records Management Litigation
  • Case Management Title Searching Docketing Scheduling
  • Procurement Data Entry Contract Formulation QuickBooks
  • ABBYY FineReader Project Publisher Tax Preparation

PROFESSIONAL EXPERIENCE:

Claims Representative

Confidential, Detroit, MI

Responsibilities:

  • Initiate contact with applicants who are requesting information regarding benefits administered by the Railroad Retirement Act (RRA), the Railroad Unemployment Insurance Act (RUIA) and Medicare.
  • Conduct interviews to obtain information about an applicant’s eligibility and entitlement to benefits under the retirement, survivor, disability, sickness and unemployment programs.
  • Conduct investigations, including sensitive and difficult interviews, to obtain additional information regarding possible fraud against the agency.
  • Prepare reports, correspondence and other written materials in accordance with established regulations and guidelines under the RRA and RUIA.
  • Review applications and evidence to verify whether or not procedure was followed.
  • Adjudicate applications for benefits and make appropriate entitlement decisions.
  • Receive and review applications, documents, forms and evidence for omissions and inconsistencies.
  • Reject evidence that was not in compliance with agency standards and other applicable laws, rules and regulations.
  • Enter pertinent information into various electronic/automated tracking systems and databases ensuring all data entry is complete, accurate and complies with agency standards and procedure.
  • Maintain contact with other Federal, state and local governmental agencies, private agencies and organizations and officials and employees of carriers and labor organizations in order to assist applicants in obtaining the appropriate benefit.

Confidential,Detroit, MI

Veterans Service Representative

Responsibilities:

  • Granted or denied complex and sensitive applications for veterans’ benefits based on electronic and paper applications.
  • Independently researched, interpreted and analyzed federal law and regulations, case law and procedure from various sources to make initial determinations as to an applicant’s eligibility for benefits.
  • Inputted and retrieved data from various electronic/automated systems to process applications to adjudicate and finalize eligibility decisions of benefit claims ensuring all federal rules, regulations and policies were followed.
  • Determined the necessity for and type of medical examinations, reexaminations or opinions needed to evaluate disabilities resulting from diseases or injuries.
  • Developed comprehensive requests for examinations or opinions to ensure appropriate evidence was received.
  • Utilized various computer systems for inputting and retrieving data related to claims adjudication and award processing.
  • Explained the full range of benefits and all related programs to applicants verbally and in writing.

Compensated Work Therapy Program Volunteer

Confidential, Ann Arbor, MI

Responsibilities:

  • Interviewed clients to obtain pertinent medical, mental, employment and educational information for preparation of a variety of intake forms.
  • Safeguarded veterans’ medical and financial information in accordance with VA policy and procedure.
  • Recorded meeting notes and entered notes into the Computerized Patient Record System ( CPRS ) .
  • Logged travel pay into the Veterans Health Information Systems and Technology Architecture (VISTA) database.
  • Provided job - related counseling and drafted résumés for veterans for potential job opportunities.
  • Communicated effectively with veterans, visitors and callers answering questions and inquiries and providing essential information.

Contract Specialist

Confidential, Ann Arbor, MI

Responsibilities:

  • Cradle-to-grave procurement of supplies and services adhering to procedures outlined in the Federal Acquisition Regulations (FAR), VA Acquisition Regulations (VAAR), Public Laws and VA policy.
  • Gathered information from various sources to prepare a variety of purchase orders, BPAs and sole source justifications for the procurement of supplies, equipment and services.
  • Ensured documentation contained all legal requirements and contractual language complied with federal regulations and guidelines.
  • Identified errors and omissions in Statements of Work, contracts and purchase orders.
  • Maintained the confidentiality of internal correspondence and communications regarding market research and acquisition planning for contracts.
  • Relayed inquiries and information to supervisor on progress of market research and status of completion of contracts.
  • Prepared purchase requests and conducted market research to procure supplies and services to meet agency and veterans’ needs.
  • Performed reporting requirements to include gathering and interpreting data, statistical analysis and formulation of reports for both internal and external sources.
  • Inputted information into various databases to draft contracts and purchase orders.
  • Created technical and non-technical documentation to assist in training new contract specialists.
  • Guided, mentored and provided job-related training to new contract specialists on how to prepare purchase orders and contracts.
  • Preserved positive and professional working relationships with vendors and customers by regularly communicating the status of purchase requests, delivery of supplies, payment on orders, award of contract and responding to routine communications and inquiries.

Confidential, Detroit, MI

Case Manager

Responsibilities:

  • Reviewed and analyzed legal documents for accuracy and acceptability in accordance with applicable federal rules and regulations in preparation for trial.
  • Assisted law clerks with trial notebook preparation ensuring all relevant legal documents and evidence, such as exhibits, affidavits, electronic media, depositions, etc., were properly prepared and assembled.
  • Provided support to the U.S. Marshals Service, U.S. Attorneys, private attorneys and judges answering requests for information related to court orders, policy, procedure and scheduling.
  • Examined and processed search and seizure warrants and wiretap requests.
  • Drafted orders, other legal and formal correspondence and documentation and prepared accurate and complete statistical reports.
  • Attended court proceedings and conferences taking accurate minutes and succinctly summarizing court hearings and conferences.
  • Maintained and managed the court’s calendar of active cases by calendaring matters, monitoring deadlines, monitoring filing of pertinent documents and timely responses to judicial orders and regulating case movement.
  • Reviewed case files and reports for any necessary actions and overdue deadlines.
  • Scheduled and coordinated meetings, conference calls, hearings, scheduling conferences, trials and other proceedings with attorneys, interpreters and in pro per clients.
  • Served as liaison between the court and the U.S. Marshals Service, U.S. Attorneys Office, clerk’s office, the bar and the public to facilitate exchange of information and to ensure that cases proceeded smoothly and efficiently through the court system.
  • Processed legal documents to include orders, pleadings, judgments and minute entries as directed by federal court policy and procedure.
  • Reviewed the quality of electronically filed documents ensuring that all orders and automated entries were appropriately and accurately inputted into the case management system.
  • Developed training material and trained new staff on docketing, scheduling and courtroom policy and decorum.

Confidential, Detroit, MI

Associate Attorney

Responsibilities:

  • Interpreted and applied regulatory material, state law, rules and guidelines to cases.
  • Conducted in-depth interviews of clients and others in jail and in court to ascertain why defendants were in violation of the court’s order and inputted a record of their statements into the court’s database.
  • Gathered, assessed and prepared background information and other evidence on defendants for case preparation and litigation ensuring all information was complete and accurate.
  • Made convincing oral presentations to judges and the public clearly and logically presenting findings of fact, the law and arguments by accurately describing defendants’ payment history, bench warrant history and custodial parent complaints.
  • Used independent judgment to determine whether to take defendants to court or dismiss bench warrant and evaluated and prepared recommendations regarding bond or custody.
  • Assessed the validity of information received from different sources to compare and contrast data received from defendant and information in databases.
  • Prepared statistical reports on the total amount of child support ordered versus the amount of money collected.
  • Designed universal order for use by entire litigation department for commitment of defendants for contempt of court thereby improving the workflow of the office.
  • Created Excel spreadsheet to maintain and update case files and records in order to identify trends in defendants’ payment of support and to identify those defendants who posed a high risk of continued noncompliance with the court’s orders.
  • Evaluated and improved the security of bench warrant attorneys to avoid conflict and tension between attorneys and defendants and their family members.
  • Established and maintained positive and professional working relationships with upper level management, judges, defense counsel, deputies and staff to ensure an efficient court-call.
  • Collected and disbursed over $30,000.00 in overdue child support for the benefit of custodial parents and children.

Judicial Research Attorney

Confidential, Detroit, MI

Responsibilities:

  • Utilized a variety of legal databases to independently research, interpret, analyze and apply an extensive spectrum of federal and state case law, statutes, court rules, legislative history and regulations to develop solutions to a variety of complex factual legal issues.
  • Interpreted and applied information from various sources to render sound decisions of bench trials providing fact finding analysis, legal interpretations and logical conclusions of law.
  • Drafted multiple opinions of the court, recommendations, orders and other legal documentation.
  • Researched and assessed specific case law to draft legal memoranda assigned by the judge.
  • Provided legal support to judge on motions after reviewing case law, court rules and statutory authority.
  • Identified underlying legal issues in motions and developed alternative analysis and solutions to various legal questions whenever requested.
  • Presented formal briefings on motions, both orally and in writing, providing persuasive arguments and defensible summaries.
  • Served as point-of-contact for litigants, attorneys and the public on case-related issues.
  • Trained and supervised the legal writing and research of law interns.
  • Processed routine legal paperwork, developed form letters and prepared documents and other official correspondence for judge’s approval and signature.

Judicial Research Attorney

Confidential, Detroit, MI

Responsibilities:

  • Used Westlaw, LexisNexis, Michigan Bar Online and ICLE to research, identify and interpret case law, statutes, procedures and administrative guidelines relative to the disposition of a particular legal issue.
  • Synopsized research material to draft recommendations for court on the appropriate action to be taken by the court regarding a variety of legal subjects.
  • Reviewed evidence to determine whether or not it was acceptable to the judge.
  • Researched court motions related to interstate child custody questions and other legal matters identifying legal issues involved and utilizing applicable statutes and case law.
  • Independently applied court rules, practices and procedures to investigate, examine and adjudicate claimants’ petitions for relief.
  • Communicated and worked effectively with the general public and others informing them of court policy and procedure and their legal rights and responsibilities.
  • Conducted preliminary reviews and evaluations of submitted evidence to ascertain the sufficiency, authenticity and validity of a petitioner’s claim.
  • Interviewed petitioners to elicit truthful statements, assess applicant’s credibility and analyze information gained to identify facts and considerations to determine whether petitions should be granted or denied.

Domestic Relations Specialist

Confidential, Detroit, MI

Responsibilities:

  • Interviewed clients to develop, analyze and evaluate all facts and evidence to assess violations of court orders and to determine the appropriate course of action available.
  • Examined cases to make recommendations and decisions to modify child support orders, ensuring the proper administration of and compliance with state guidelines, rules and regulations.
  • Exercised independent and sound judgment and discretion in making written recommendations and in other decision making processes.
  • Generated financial reports by interviewing litigants and gathering financial and other pertinent data from a variety of sources.
  • Researched verification of earnings and background information of litigants using internal and external databases, contacting employers, locating absent parents and working with outside agencies.
  • Reviewed the accuracy and veracity of information and documentation submitted by litigants for child support valuations.
  • Collected, analyzed and evaluated information, data and complex facts to formulate and present well-documented recommendations for judges, referees, attorneys and litigants regarding child support, parenting time and child custody.
  • Cross-referenced several databases to identify incomplete or inconsistent data and requested additional information from appropriate party.
  • Compared and correlated information from staff and other sources when inconsistencies were found in case files in order to reconcile and correct discrepancies in information.
  • Used tact and caution while negotiating resolutions and mediating disputes between parties regarding child custody and parenting time.
  • Articulated information, both orally and in writing, with people from diverse backgrounds explaining their legal rights and responsibilities, court policy and procedure, court orders and other case-related matters.
  • Dealt respectfully and professionally with litigants regarding contentious issues, such as who would have sole custody versus parenting time and how much child support would be ordered.
  • Established and maintained rapport with clients to elicit accurate and complete information for child support reviews.
  • Provided support and advice to judges and referees regarding state guidelines, case and account information.
  • Created tables, charts and graphs in Excel to prepare statistical reports, maintain statistical data on case files and to track multifaceted workload.
  • Assigned to special project to accomplish six-month backlog of 700 cases overdue for review while effectively managing current caseload.

Confidential, Detroit, MI

Investigation Clerk

Responsibilities:

  • Investigated criminal activity and developed plans to close drug houses by instituting seizure and forfeiture proceedings.
  • Identified, located and intervened with legal owner of property to eliminate drug activity and to begin procedures to forfeit property when necessary.
  • Referred addresses for intensified drug enforcement by police.
  • Recommended seizure of property from owner for confirmed drug activity.
  • Provided support to prosecutor in preparation of pursuing seizure and forfeiture of property.

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