Veronica Devault

Background

About Veronica Devault

Medical Claims Adjuster experienced in Workers' Compensation and skilled in Healthcare, Computer Literacy, Microsoft Office, Data Entry, Case Management, Interpersonal Communication, Analytical and Critical Thinking, Customer Service, Privacy, and Confidentiality. Recently hired as Workers' Compensation Claims Adjuster MO at Gallagher and Bassett. Successfully passed TX Property and Casualty Insurance All Lines Adjuster. I am licensed in the following states: AL, AR, CA, CT, DE, FL, GA, IN, KY, LA, MI, MN, MS, NC, NH, OK, RI, SC, TX, UT. While also having experience in the following states: CO, IA, IL, KS, MA, MD, NE, NJ, PA, SD, TN, VA, WI. Manage medical only claims to include authorizing medical treatment and processing appropriate medical bills consistent with best practices and state regulations. interact with injured workers, clients, and vendors to gather necessary info, schedule appointments, ensure timely payment of all benefits and complete state filling forms. Evaluates claims for purpose of setting reserves and sending for bill review. Set up new claims, establish and maintain proper coding per best practices and client requirements. Previously worked as a Medical Claims Adjuster at The Loomis Company processing claims and maintaining pended customer service logs. Performing file reviews as required and handling member advocate issues (i.e. PPO discrepancies, assist with claims issues, research/obtain additional needed information). Responding to client emails that relate to sharing requests and assist with maintaining the priority mailbox. Assisting Client Service Account Managers with plan problems and questions. Collaborating/communicating with other departments within the company (i.e: plan build, provider services, etc.). The position I held at Comprehensive Diagnostic Center was IME Coordinator. I worked alongside insurers, case managers/administrators and attorneys; mainly defense, to assist them with their workers' compensation claims and liability cases. This also entailed working with physicians who would be performing the IME. I ensured they understood each case in its entirety and had all pertinent medical records for review to insure they author a complete and comprehensive report. Prior to this I worked as a Certified Nursing Assistant in Genesis nursing homes. After 9 years, with extensive knowledge of rehabilitation and the medical field, I needed a change of pace and began to look for a career that would offer a full time position with a set schedule and allow me more time with my family.