Michael Ashworth

About Michael Ashworth

I am a multi-faceted professional in the insurance and healthcare space with extensive training (Registered Nurse (RN), MBA w/ Focus on Leadership), Legal Nurse Consultant (LNC), and Associate in Claims (AIC). With over 30 years of experience, I specialize in translating complex medical data into actionable business strategies that mitigate risk and drive down claim costs. Throughout my career, I have succeeded at the intersection of medical necessity and financial stewardship. Whether managing high-dollar workers\' compensation claims exceeding managing highly litigated claim, or navigating the nuances of Medicare Set-Asides (MSAs), my focus remains the same: providing clarity in high-pressure environments. Core Competencies & Impact:~ Strategic Leadership (MBA): Proven ability to optimize operations, such as successfully reducing a vendor network from over 150 to fewer than 20 through stringent quality and reporting standards.~ Clinical & Legal Insight (RN/LNC): Leveraging deep medical knowledge and recent Legal Nurse Consultant training (11/2024) to uncover defense and subrogation opportunities within complex records.~ Technical Insurance Mastery (AIC): Expert in managing multi-jurisdictional claims across 11+ states, including OH, IL, MN, MO, and WI, ensuring compliance with shifting statutory requirements.~ Cost Mitigation: A track record of identifying savings by completing 2-3 Medicare Set-Asides daily and providing expert advice on medical cost containment. A Career Built on Results:From my current role as a Senior Resolution Manager at Gallagher Bassett to my tenure supervising headquarters-level claims for The Cincinnati Insurance Companies to time spent as an Occupational Nurse at an onsite manufacturing facility and my role as a self-insured administrator, I have dedicated my career to improving outcomes for both the carrier and the claimant. I am passionate about mentoring teams, developing best practices, and using data-driven insights to expedite claim resolutions. Let’s Connect: I am always open to discussing workers\' compensation trends, medical-legal consulting, or leadership strategies in the claims industry.

Experience

1. Senior Resolution Manager

   Gallagher Bassett

   Sep 2024 — Present

   Analyze claims exposure and resolve claims efficiently, ensuring compliance with policies and regulations.• Provide exceptional customer service to claimants, demonstrating empathy and effective communication.• Document claim activities accurately and timely to support claim file outcomes.

Education

• Franklin University

  Master of Business Administration - MBA, Business Administration and Management, General

  2002 — 2004

• Sinclair Community College

  ADN, Nursing

  1989 — 1991

• Wright State University

  BSN, Nursing

  1996 — 1998

Skills

• Recruiting
• Program Management
• Research
• Customer Service
• Event Planning
• Training
• Volunteer Engagement
• Workers Compensation
• Claim
• Youth Leadership
• Internal Communications
• Civic Engagement
• Youth Engagement
• Leadership
• Project Planning
• Youth Mentoring
• Medical / Workers Compensation Claims Administration
• Volunteering
• Medical Billing
• Healthcare
• Employee Benefits
• Workers' Compensation Claims
• Insurance
• Claims Management
• Team Building
• Management
• Physical Security
• Medical Claims Managment
• Community Service
• Nonprofits