Briginette Alfonso, CWC

Experience

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  Walt Disney World

  Feb 2011 - Aug 2011

  Intern

  Guide families and facilitate a safe and happy environment for them.Provide customer service by attending to their questions.Keep guests safe by making sure that no one was on the parade route by the time the floats would pass by.

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  THE ADVOCATE PROGRAM

  May 2013 - Aug 2013

  Intern

  Made sure to file all the cases properly, called clients to verify addresses, input clients on database, Assist in court and help clients sign up properly for the program

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  Gallagher Bassett

  Mar 2015 - Jul 2019

  Senior Resolution Manager/MDCPS

  Being a Claims Resolution Specialist, I supervised the entire cycle of processing for workers compensation claims, including the investigation, evaluation, disposal, and settlement process. Elaborating on this role, I scrutinized, determined, and assessed the coverage, liability, and damages of the proper reserves for Miami Dade County Public Schools. Furthermore, I supported the outcome of the claim files while driving efficient management of full case load with a minimum of 180+ claims- Oversaw claims reserve and settlement authority for liability costs and workers’ compensation claims. Incumbents at this level typically hold claims reserve and settlement authority of up to $50,000 liability and/or $100,000 workers compensation or greater.- Alleviated cost of claim while strategically controlling claims settlement and analyzing claims exposure to establish proper course of actions. - Fostered robust collaborative relationships with internal and external stakeholders by providing effective claims resolution. - Enforced strict compliance to SOPs, policies, and best practices for claims handling, including statutory, regulatory, and ethics requirements. - Guaranteed accurate, timely, effective, and complete documentation and communication of the entire claims-related activities. - Utilized knowledge in claims and insurance regulations while exercising proper judgment and decision making to settle applicable claims. Show less

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  DHL

  Jul 2019 - Jul 2022

  Risk Management Specialist

  As a Risk Management Specialist, I played a crucial role in the optimization of medical costs and outcome improvement while overseeing several worker’s compensation programs. - Deliver operational oversight to an average of 400+ claims and drive successful mitigation of lost time per claimant to only 30 to 45 days while also containing the costs. This role typically hold claims reserve and settlement authority of up to $150,000 workers compensation.- Originate an innovative methodology for medical management in accordance with specific set of injuries and unique work conditions. - Manage monthly phone correspondence with key business partners to provide claim status and notify on ongoing cost-reducing tactics. Show less

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  Gallagher Bassett

  Jul 2022 - now

  Lead Resolution Manager

  Being a Lead Resolution Manager, I supervise the entire cycle of processing for workers compensation claims, including the investigation, evaluation, disposal, and settlement process. Elaborating on this role, I scrutinized, determined, and assessed the coverage, liability, and damages of the proper reserves for Miami Dade County Public Schools. Furthermore, I support the outcome of the claim files while driving efficient management of full case load with a minimum of 180+ claimsInvestigates, evaluates, disposes and settles the most complex claims and highest exposures with minimal supervisionIncludes the investigation, determination and evaluation of coverage, liability and damages, and the setting of proper reservesHold claims reserve and settlement authority of up to $50,000 workers compensation or greaterExercises proper judgment and decision making to analyze the claims exposure, to determine the proper course of action and to appropriately settle the claimInteracts extensively with various parties involved in the claim processAble to clearly communicate concise action plans, and present plans for moving the case to conclusionWill demonstrate complete knowledge of the claim file process through presentation of actions and responses to client questionsProcesses claims consistent with clients' and corporate policies, procedures and "best practices" and also in accordance with any statutory, regulatory and ethics requirementsDemonstrated ability to comply with carrier reporting and threshold requirementsAble to recognize and pursue excess insurance recoveriesMentor new trainees Show less