Michelle Mosley

Experience

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  BJ's Restaurants, Inc.

  Sept 2009 - Oct 2013

  Regional Trainer

  Identified and interpreted guest needs through interpersonal communication, resulting in increased guest retention and revenue.Successful achievements in multiple, cross-promotional sales engendering increased guest loyalty and record team sales.Supported and enacted procedures to satisfy guests with server considerations to meet overall management objectives.Worked effectively in team leadership and participation roles to meet team and company sales goals. Consistent errorless independent money management Cultivated passion for corporate standards of service through effective training and development of new team members.Managed knowledge of multiple stations, excellent multitasking abilities. Successfully diffused high pressure situations with an objective approach. Show less

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  Institution Solutions

  Oct 2013 - May 2017

  • Devised and implemented continuous training programs for CSR’s, including a structured system with quick reference materials to get trainees on the phones in three or less days rather than previous average of five days; Fueled by expertise in the principles and processes for providing customer support and personal services, both in person and on the phone;• Constructed and executed a reporting structure for call volume and length to establish a basis for quality, consistency, and efficiency within the call center; Show less •Cultivated relationships with partner administrators and clients to ensure consistent development of customer relations and to improve data retention with technology driven processes;•Assisted in multi-departmental projects, habitually exceeding expectations and deadlines set;•Assumed obligations and responsibilities of a vacated position with a committed approach to fulfill immediate needs, while maintaining outstanding expectations of duties in the current position; •Coordinated with clients directly on enrollment, billing, and reporting for multiple products and programs. Show less

  • Member Services Team Lead

    Oct 2013 - May 2017

  • Operations Manager

    Oct 2013 - May 2017
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  Sedgwick

  May 2017 - Sept 2022

  To analyze complex or technically difficult workers' compensation claims to determine benefits due; to work with high exposure claims involving litigation and rehabilitation; to ensure ongoing adjudication of claims within service expectations, industry best practices and specific client service requirements; and to identify subrogation of claims and negotiate settlements.

  • Claims Team Lead

    Jan 2022 - Sept 2022

  • Claims Examiner

    May 2017 - Jan 2022
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  CNA Insurance

  Sept 2022 - now

  Workers' Compensation Specialist

  Manages an inventory of moderate to high complexity and exposure commercial claims by following company protocols to verify policy coverage conduct investigations develop and employ resolution strategies and authorize disbursements within authority limits. Provides exceptional customer service by interacting professionally and effectively with insureds claimants and business partners achieving quality and cycle time standards providing regular timely updates and responding promptly to inquiries and requests for information. Verifies coverage and establishes timely and adequate reserves by reviewing and interpreting policy language and partnering with coverage counsel on more complex matters estimating potential claim valuation and following company's claim handling protocols.Conducts focused investigation to determine compensability liability and covered damages by gathering pertinent information such as contracts or other documents taking recorded statements from customers claimants injured workers witnesses and working with experts or other parties as necessary to verify the facts of the claim Show less