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UNITED STATES的国旗
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James C.

@jpcarey23

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Insurance claims professional & expert witness

Executive with claims consulting firm who is available to review and work as an expert witness or review/audit claims files for best practices and give advice to employers, brokers, attorneys, medical providers or claimants to successfully navigate the workers' compensation system. Independent adjuster licensed in 14 states across all lines of business, personal & commercial. Also, experience and expertise working with database administration & design, complex mathematics, algorithm development, project management, extensive writing experience and vast technical knowledge.

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经验

Owner

C4 Analytics
1月 2016 - 现在
• Consulting practice that assists brokers, employers, claims administrators and insurance carriers with complex litigation and case management issues • Perform claims audits for retained clients in defense or prosecution of bad faith claims handling litigation • Attend hearings to represent the interests of a retained client (insured, applicant or provider) • Expert witness for insurance litigation • Independent adjusting services for all lines, personal & commercial

Vice President, Claims

RiskSolutions Inc.
12月 2011 - 12月 2015 (4 年)
• Management of all aspects of a claims department including client/broker relationships, carrier/TPA relationships and act as liaison for all complex issues • Design an algorithm and Web application to identify high risk claims at claim's inception (US Patent Office Application No. 61735486). • Prepare training seminars • Lead claims reviews • Work with adjusters in all U.S. jurisdictions • Assist brokers in managing high deductible policies, including reserve analysis & approval

Senior Claims Examiner

Corvel Corporation
8月 2011 - 1月 2012 (5 个月, 1 天)
• Review and adjust claims to maintain compliance with the Labor Code. • Make decisions in regards to compensability of claims. • Pay benefits, settlements, and medical bills timely and accurately. • Analyze and review all claims while maintaining a diary to move each case towards finalization and closure. • Field phone calls from employers, employees, attorneys and medical providers. • Manage claims from inception to closure, ensuring that the claims are handled effectively, timely and pursuant to best claims practices. • Work as lead examiner for a highly active group of self-insured employers. • Provide training to other examiners and assistants as needed. • Experienced in high exposure, high cost, legally complex, and medically complex claims.

教育

Bachelor of Arts

University of California, Irvine, United States 1995 - 1999
(4 年)

资质

Independent Adjuster

Dept. of Insurance - various states
2020
Licensed independent adjuster in California, Arizona, New Mexico, Texas, Louisiana, Mississippi, Georgia, West Virginia, Michigan, Montana, Utah, Idaho, Oregon & Washington.

Self-Insured Administrator

Division of Workers' Compensation, Self-Insured Programs
2004

Experienced Adjuster Designation

California Department of Insurance
2004
Certified experienced workers' compensation claims adjuster with CE hours current through 2016

出版物

Sport Compact Car

McMullen Argus
Editor and contributing writer for auto enthusiast magazine from 2001-2003.

Honda Tuning

McMullen Argus
Editor and contributing writer for Honda enthusiast magazine 2001-2003.

Sport Compact Car

McMullen Argus
Editor and contributing writer for auto enthusiast magazine.

Import Tuner

McMullen Argus
Video game and consumer electronics columnist for import enthusiast magazine from 2001 through 2008.

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