Denee Nichole Johnson

About Denee Nichole Johnson

Holding years of experience in the insurance industry, I have proven to be flexible and…

Experience

1. Claims Examiner

   Sedgwick

   Nov 2018 — Present · New Orleans, LA, US

   Analyzes and processes complex or technically difficult workers\' compensation claims by investigating and gathering information to determine the exposure on the claim; manages claims through well-developed action plans to an appropriate and timely resolution. Negotiates settlement of claims within designated authority. Calculates and assigns timely and appropriate reserves to claims; manages reserve adequacy throughout the life of the claim. Calculates and pays benefits due; approves and makes timely claim payments and adjustments; and settles clams within designated authority level. Prepares necessary state fillings within statutory limits. Manages the litigation process; ensures timely and cost effective claims resolution. Coordinates vendor referrals for additional investigation and/or litigation management. Uses appropriate cost containment techniques including strategic vendor partnerships to reduce overall cost of claims for our clients. Manages claim recoveries, including but not limited to: subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets. Reports claims to the excess carrier; responds to requests of directions in a professional and timely manner. Communicates claim activity and processing with the claimant and the client; maintains professional client relationships. Ensures claim files are properly documented and claims coding is correct. Refers cases as appropriate to supervisor and management. Supports the organization\'s quality program(s).

Education

• Southeastern Louisiana University

  Bachelor of Science (B.S.)

  2011 — 2015

• Jackson State University

  Master of Business Administration (M.B.A.)

  2016 — 2017