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TAMMY R. KOHL 4173 Nipigon Drive, Columbus, Ohio 43207 H: (614) 497-2251 [email protected]
SUMMARY OBJECTIVE
I am extremely organized and ambitious with 15+ years in the worker’s compensation and legal environments. I am also a self-starter with outstanding phone etiquette, and able to work independently or as part of a team. My career goal is to secure a challenging position with an outstanding employer offering stability, growth and opportunity for advancement.
AREAS OF EXPERTISE
Detail-oriented Legal research
Highly organized Worker’s Compensation
Microsoft office proficient Composition of legal documents
Exceptional communication skills Risk Management
Medical terminology & Coding Team player
WORK HISTORY FROM 1987 to PRESENT
MEDICAL CLAIMS EXAMINER AT HEALTH MANAGEMENT SOLUTIONS, INC. Columbus, Ohio
Process treatment requests from provider and advise injured worker, provider and employer of decision.
Collaborate with providers to obtain updates regarding treatment plan and return-to-work status.
Manage claims through well-developed action plans to resolve each claim in a timely manner.
Frequently communicate with all appropriate parties involved with the claim.
Staff cases with R.N. Team Manager to determine referrals to vocational rehab, physical therapy or exam.
MANAGER OF CARE P.T. INC. (Chiropractic Therapy) Columbus, Ohio Responsible for the administration of office policies, procedures, employee training and performance.
Processed all billing on a monthly basis; prepared letters for collection accounts when necessary.
Recorded procedure/ICD-9 codes in system for worker’s compensation, health insurance, Medicare claims.
Assisted patients with billing issues such as treatments and the duration covered under their insurance.
FRAUD RESEARCH SPECIALIST AT GAP INC., DIRECT Grove City, Ohio Responsible for checking/monitoring fraud for each order before releasing to be shipped.
Contacted the financial institutions to verify that the customer did place the online order.
Processed online returns and/or corrections to customer’s order.
Reviewed red flagged international orders for fraud. Educated customer regarding sales on merchandise, gift cards, future releases and upcoming benefits
KNISELY, WILHELM AND KNISELY LAW OFFICES Columbus, Ohio Organized files for hearings by obtaining evidence and prepared argument summary for attorney. Reviewed medical reports and diagnostic results to pursue additional allowances for client. Discussed concerns pertaining to temporary total, wage loss and permanent partial issues with client. Assisted attorney with negotiation of settlements for indemnity and medical claims.
CLAIMS EXAMINER TO LITIGATION SPECIALIST AT COMPMANAGEMENT, INC. Dublin, Ohio Reviewed medical for potential handicap claims and settlements to control client(s) reserve.
Contacted employers regarding group rates and discussed claims affecting their experience period.
Compiled information for hearing files and assigned tasks to the state fund claims dept.
Processed and made decisions on all orders and complex claims.
Reviewed files to determine if treatment was excessive to warrant a file review or exam.
Managed claims through action plans and continued until the statute of limitations expired.
Prepared a large volume of files on a weekly basis for upcoming worker’s compensation hearings
Assisted the State Fund department with check lists for information necessary to argue at the various hearing levels, as well as weekly meetings for questions or concerns and to advise of any changes or updates within the BWC guidelines.
LAW FIRM OF JEFFERY G. WILLIAMS Lima, Ohio
Provided support to three attorneys and private investigator.
Prepared legal documents for civil, criminal, domestic, probate via transcription.
Scheduled meetings, depositions and hearing dates.
Assisted investigator with transcripts regarding interviews and depositions for cases.
EDUCATION AND TRAINING
High School Diploma and Certificate for completion of 2-year Business Administration
Completion of courses in Time Management Customer Service and BWC guidelines
Received Certificates for above average scores on exams for Human Anatomy and Medical Terminology
MEMBERSHIP AFFILIATIONS
Member of the Fraternal Order of Police Association, Lodge #5 from 2007 – present
Notary Public from 1987 - present
