Summary
Overview
Work History
Education
Skills
Timeline
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Larry Stone

Petrie Terrace,QLD

Summary

Dynamic Claims Analyst with extensive experience at Workcover QLD, adept at negotiating settlements and enhancing customer satisfaction. Proven expertise in claims analysis and policy interpretation, coupled with strong interpersonal communication skills. Successfully managed high-volume caseloads while maintaining compliance and confidentiality, driving timely resolutions and fostering positive client relationships.

Overview

26
26
years of professional experience

Work History

Claims Analyst

Qantas Airways
09.2005 - 09.2011
  • Negotiated successful settlements with clients, ensuring a mutually beneficial outcome for all parties involved.
  • Conducted day-to-day administrative tasks to maintain information files and process paperwork.
  • Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
  • Maintained contact with claimants and attorneys to determine treatment status.
  • Directed and coordinated various investigations conducted by field investigation team.
  • Maintained strict confidentiality with all personal data as per company guidelines.
  • Managed high-volume caseloads, prioritizing tasks to ensure timely completion of all claims.
  • Maintained compliance with industry regulations and company policies while managing sensitive client information and claims records.
  • Demonstrated a high level of accuracy and attention to detail in reviewing claim documentation for approval or denial decisions.
  • Enhanced customer satisfaction by resolving complex claims issues in a timely manner.
  • Conducted thorough investigations into each claim, gathering relevant data and documentation to support decision-making processes.
  • Assisted clients throughout the entire lifecycle of their claim, from initial filing to final settlement or denial determination.
  • Mentored junior team members, sharing expertise in claims analysis techniques and fostering professional growth within the department.
  • Examined claims forms and other records to determine insurance coverage.
  • Researched claims and incident information to deliver solutions and resolve problems.
  • Reviewed questionable claims by conducting agent and claimant interviews to correct omissions and errors.
  • Determined liability outlined in coverage and assessed documentation such from police and healthcare providers to understand damages incurred.
  • Conducted comprehensive interviews of witnesses and claimants to gather facts and information.

Claims Analyst

WorkCover Queensland
10.1980 - 02.2000
  • Maintained strict confidentiality with all personal data as per company guidelines.
  • Managed high-volume caseloads, prioritizing tasks to ensure timely completion of all claims.
  • Maintained compliance with industry regulations and company policies while managing sensitive client information and claims records.
  • Demonstrated a high level of accuracy and attention to detail in reviewing claim documentation for approval or denial decisions.
  • Enhanced customer satisfaction by resolving complex claims issues in a timely manner.
  • Interacted with clients and employees, which helped cultivate positive working relationships.
  • Conducted thorough investigations into each claim, gathering relevant data and documentation to support decision-making processes.
  • Participated in ongoing training programs to stay current on industry developments and maintain a strong understanding of relevant laws and regulations affecting the claims process.
  • Maintained strong working relationships with third-party vendors, such as independent adjusters and appraisers, to facilitate prompt resolution of claims.
  • Provided exceptional customer service by promptly addressing inquiries from policyholders, agents, and other stakeholders regarding the status of their claims.
  • Worked closely with legal counsel when necessary during complex cases involving litigation or arbitration proceedings related to disputed claim outcomes.
  • Assisted clients throughout the entire lifecycle of their claim, from initial filing to final settlement or denial determination.
  • Mentored junior team members, sharing expertise in claims analysis techniques and fostering professional growth within the department.
  • Examined claims forms and other records to determine insurance coverage.
  • Researched claims and incident information to deliver solutions and resolve problems.
  • Analyzed information gathered by investigation and reported findings and recommendations.
  • Reviewed questionable claims by conducting agent and claimant interviews to correct omissions and errors.
  • Reviewed police reports, medical treatment records, and physical property damage to determine extent of liability.
  • Collected information from customers to complete claims and legal files.
  • Evaluated original investigation reports and documents to resolve secondary concerns.
  • Identified suspicious losses and contacted manager for investigative assistance.
  • Determined liability outlined in coverage and assessed documentation such from police and healthcare providers to understand damages incurred.
  • Followed up on potentially fraudulent claims initiated by claims representatives.
  • Conducted comprehensive interviews of witnesses and claimants to gather facts and information.
  • Interviewed agents and claimants to correct errors or omissions and investigate questionable claims.
  • Worked with private investigators and attorneys on preparation of evidence, witness statements, and other documentation in preparation for trial.

Education

Brisbane State High
Brisbane, QLD

Skills

  • Claims
  • Claims analysis
  • Interpersonal and written communication
  • Policy interpretation

Timeline

Claims Analyst

Qantas Airways
09.2005 - 09.2011

Claims Analyst

WorkCover Queensland
10.1980 - 02.2000

Brisbane State High

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Larry Stone