Summary
Overview
Work History
Education
Skills
Timeline
Generic

Lucille Pakay

Hillarys,WA

Summary

Case Manager/Claims Officer with expertise in managing workers compensation claims from beginning to end including management of complex claims.

Experience in the interpretation of relevant provisions of the Workers Compensation and Injury Management Act 1981 and apply appropriate action.

Proactive, using own initiative in providing quality services to clients in accordance with the organisation’s policies, legislation and regulations for effective management of claims with the main goal of successfully returning injured workers to work;

Overview

17
17
years of professional experience

Work History

Claims Officer

Insurance Commission Of WA
03.2021 - 01.2023
  • Manage portfolio of workers compensation claims from beginning to end, responsible for assessing and making liability decisions of injured workers claims, which include liaising with treating health providers, employers, other stakeholders and if necessary, investigate claims for potential Common Law, fraud and recoveries
  • Communicate efficiently with clients, internal and external stakeholders in relation to workers compensation entitlements, status of claims and provide advice on interpretation of legislation with evidence-based liability decision
  • Promote proactive support to clients and maintain ongoing communication with stakeholders such as employers, third-party claims administrators, investigators and loss adjusters
  • Negotiation and settlement in progressing claims for timely resolution and cost-effective management, ensure compliance with Workers Compensation and Injury Management Act 1981
  • Perform administrative tasks and complete work in compliance with relevant legislative, regulative or internal policy requirements;
  • Assist phone calls from other teams and answering enquiries direct to clients and external stakeholders

Case Manager

IAG (INSURANCE AUSTRALIA GROUP)
02.2018 - 03.2021
  • Manage portfolio of workers compensation claims from beginning to end, responsible for assessing and making liability decisions of injured workers claims, which include liaising with treating doctors, employers, other stakeholders and if necessary, investigate claims for potential common law, fraud and recoveries
  • Working actively with injured workers, employers, health care service providers to strategically plan, which include providing range of quality case management services to clients to achieve a return to work objective
  • Coordinate and facilitate case conferences with injured workers’ treating GP and Treating Specialist and other stakeholders to establish a return to work programme, to ensure the parties comply with return to work recommendations for swift recovery and successful return to work
  • Coordinate appropriate action which includes lodging of disputes notices at WorkCover which is in accordance with the Workers Compensation and Injury Management Act 1981
  • Negotiate speedy resolution of disputes direct with injured workers or with their legal representatives with or without intervention of WorkCover
  • Perform administrative tasks and complete work in compliance with relevant legislative, regulative or internal policy requirements

Volunteer

Whitford Primary Catholic School
02.2016 - 02.2018

Assisting teachers in setting up games and activities with Kindy and Pre-Primary children, provide assistance and directions to children in their activities, supervising children in the playground to ensure safe playing/minimise disputes, safe use of playground equipment and comfort children who are may be upset;

Support student physical, mental, and social development using classroom games and activities.

Volunteer

Geoje International Kindy Academy
09.2014 - 02.2016
  • Provide assistance to teachers and children who are expats and come from various cultural background and languages, acknowledging different need of children and provide comfort if upset or sad, learning new phrases/language, teaching basic English to children and Teachers’ Aides.

Case Manager

QBE Insurance
05.2007 - 01.2010
  • Responsible for managing portfolio of workers compensation claims
  • Managing claims and work actively with injured workers, employers, health care service providers to strategically plan, which include providing range of quality case management services to clients to achieve a return to work objective
  • Provide leadership, support, direction and co-ordination with stakeholders to solve issues and make decisions based on sound judgement
  • Facilitating necessary treatment to assist in management of injury
  • Managing daily workflow maintaining client customer service standards
  • Provide cost effective, professional customer focused workers compensation claims services for clients
  • Identify indicators for potential fraud, recoveries and common law where applicable

Underwriting Assistant

Gallagher Bassett Services Inc.
03.2006 - 06.2006
  • Responsible for assisting and providing advise to clients with regard to their workers compensation policy and premium payment
  • Liaising with Underwriters, Insurance Brokers and Accountants to obtain information and/or clarify information submitted on behalf of clients.
  • Maintaining and recording of every telephone discussion and action taken for clients
  • Processing request for Certificate of Currency for clients with such request to be completed and provided to clients within 24 hours
  • Providing advise to clients in relation to workers compensation changes in NSW which includes promoting the organisation and its services to clients
  • Following up and liaising with clients in relation to their premium payments and declaration forms

Education

Postgrad Cert Workers Comp Practice & Management - Workers Compensation

Curtin University
Perth, WA
11.2005

Skills

  • Deliver high quality claims management
  • Communicate effectively both verbally and in writing with range of stakeholders
  • Good time management skills, good work plan and ability to work under pressure
  • Work effectively in busy environment, handling multiple simultaneous demands with high level of accuracy
  • Ability to work cooperatively within team and independently as required
  • Proactively and collaboratively work with clients and external stakeholders
  • Produce cost effective, best outcome and timely settlement of claims
  • Provide general administrative support within the policies and best practice to ensure continued delivery of high quality services

Timeline

Claims Officer

Insurance Commission Of WA
03.2021 - 01.2023

Case Manager

IAG (INSURANCE AUSTRALIA GROUP)
02.2018 - 03.2021

Volunteer

Whitford Primary Catholic School
02.2016 - 02.2018

Volunteer

Geoje International Kindy Academy
09.2014 - 02.2016

Case Manager

QBE Insurance
05.2007 - 01.2010

Underwriting Assistant

Gallagher Bassett Services Inc.
03.2006 - 06.2006

Postgrad Cert Workers Comp Practice & Management - Workers Compensation

Curtin University
Lucille Pakay