Karen Roberts

Experience

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  Liberty Mutual Insurance

  Jan 1995 - Jan 1998

  • Claims Specialist

    Jan 1995 - Jan 1998

  • Claims Specialist

    Jan 1995 - Jan 1998
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  Keenan and Associates

  Feb 1998 - May 2000

  Senior Workers Compensation Claims Examiner

  • Managed a large assortment of complex workers’ compensation claims and administered the entire claims process from inception through completion. Recognized as a Workers’ Compensation Claims specialist and assisted in training internal claims support staff.• Analyzed complex claims data; participated in fraud investigations; identified subrogation recovery potentials, managed vocational rehabilitation issues; conducted settlement negotiations; and represented clients at the Workers’ Compensation Appeals Board.• Traveled to client locations to conduct claim reviews; participated in JPA meetings; setup and conducted client training workshops; and worked with clients to develop and implement loss control plans designed to reduce workers’ compensation claims. Show less

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  The Hartford

  May 2000 - Jun 2002

  High Exposure Consultant

  • Successfully managed catastrophic claims and provided business-to-business consultation using extensive insurance industry claims expertise.• Analyzed complex claims involving high exposure; identified and mitigated crucial claims issues; negotiated creative settlements, and worked diligently to quickly resolve claims.• Worked extensively with corporate office consultants to develop strategies to minimize risks, reduce exposure, and secure settlements. Facilitated roundtable discussions designed to troubleshoot claims issues and maximize utilization of existing resources.• Designated Subject Matter Expert regarding Structured Settlements and recognized as a mentor to coworkers. Show less

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  CSAC Excess Insurance Authority

  Jun 2002 - Dec 2006

  Sr. Excess Workers Compensation Claims Examiner

  • Responsible for a large caseload of excess workers’ compensation claims involving TPA and self-administered members.• Duties include analyzing claim issues, assessing appropriate reserves and strategizing resolution plans with claims team as well as payment reconciliation and reimbursement. • Interacting with reinsurers to obtain settlement authority and reimbursements.• Participating in a number of committees involving Workers’ Compensation Trend Identification, Legislative Committee and Claim Review Committees with various member and JPA representatives. • Spearheading special projects including formal Request for Proposals, drafted charter and governing documents, underwriting analysis, and organizational development processes. • Performed as liaison between lobbyist, legislative committee members, and coalition groups. • Strong decision-making abilities and “attention-to-detail” work techniques.• Consistently achieved customer satisfaction goals using creative problem solving skills. Show less

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  Matrix Absence Management

  Sept 2007 - Jul 2013

  Sr. Integrated Claims Examiner

  • Responsible for a large caseload of group self-insured claims from inception to resolution.• Primary duties include initial investigation, subrogation identification and investigation, identification of red flags and appropriate action, management of ancillary services and resources, accurate reserve analysis and critique, and excellent interpersonal skills.• Good rapport building abilities with all participants in the worker’s compensation process to include injured worker, employer, medical and legal providers, and management team. • High proficiency regarding best practices and various software and proprietary programs.• Timely and accurate documentation as well as responsiveness to requests from any source. Show less

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  York Risk Services Group

  Jul 2013 - Jan 2016

  • Successfully managed three direct reports and 18 team members to assure compliance with York Best Practices, quality and audit standards, continuing education and licensing requirements. Created an office environment of celebration, success and teamwork. • Responsibilities included staffing and coordination with human resources on personnel matters. • Business development to include furthering York’s reputation with new prospects and prospective clients. Develop and facilitate client training and education.• Create and implement strategic initiatives which categorize and target claims for resolution.• Monitor outcomes through weekly and monthly progress tracking with weekly client updates. Show less • Successfully manage a nine-member team of motivated claims professionals to assure compliance with York Best Practices, quality and audit standards. • Consistently achieve a minimum of 100% closing and production ratios.• Develop and implement goals and objectives with rewards system to motivate employee participation as well as identify performance issues and coordinate with human resources on corrective action plans. • Recommend and develop client education and training based on identified loss drivers and trends. Building rapport and confidence with client and touch-point contacts. Facilitate WorkComp 101 client education meetings.• Engage ancillary business partners for team collaboration to round table and achieve best outcomes on complex claim issues, finding ways to improve processes and systems. Show less

  • Assistant Vice President, Workers Compensation

    Apr 2015 - Jan 2016

  • Unit Manager, Workers Compensation

    Jul 2013 - Apr 2015
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  Acclamation Insurance Management Services

  Mar 2016 - Nov 2016

  Workers Compensation Claims Supervisor
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  Arcadia Settlements Group

  Nov 2016 - now

  Structured Settlement Specialist

  Let me help you get your California Workers Compensation Claims settled! I make it easy for you from referral to final claim closure! Having done every phase of the California workers compensation claims administration process, I need very little input in order to help you negotiate the final settlement terms and draft all the necessary documentation to achieve resolution and help you shine!