Summary
Overview
Work History
Education
Skills
Certification
Kudos
Timeline
Generic

Jennifer Hirth

Helena,MT

Summary

Accomplished Senior Claims Examiner with a proven track record in processing and evaluating workers' compensation claims. Efficiently handles multiple cases to ensure accurate and timely resolutions, showcasing exceptional customer service and analytical skills. Possesses a keen eye for detail when investigating liability, leveraging extensive expertise in the Montana Workers Compensation Act and statutes. Skilled in training and supporting new adjusters to compile, code, categorize, and audit information for seamless claims processing.

Overview

12
12
years of professional experience
1
1
Certification

Work History

Claims Examiner II

Montana State Fund
09.2020 - 07.2025
  • Active caseload of around 115 workers’ compensation claims along with successful management of claims involving both medical and legal complexities, demonstrating a strong understanding of the medical knowledge and legal framework and regulations to ensure accurate resolution and ongoing compliance with applicable laws while providing fair and equitable resolution to both the policyholder and injured workers.
  • Mentored new employees, providing comprehensive guidance to help them become proficient in claims handling, adhering to best practices, current guidelines, and available resources.
  • Initiated and established a team chat that fostered and interactive space for fellow examiners to discuss claim-related questions, share insights and collaborate effectively, enhancing team communication and knowledge sharing.
  • Demonstrated expertise in compliance with the Montana Workers’ Compensation Act ensuring all claims processing activities aligned with legal regulations and organizational standards.
  • On-going collaboration with medical professionals, legal teams and policyholders as needed to ensure effective claims handling and communication to optimize claim outcomes and resolution.

Claims Examiner I

Montana State Fund
09.2019 - 09.2020
  • Demonstrated expertise in compliance with the Montana Workers’ Compensation Act ensuring all claims processing activities aligned with legal regulations and organizational standards while managing an active caseload of around 115 claims
  • Demonstrated exceptional proficiency in indemnity claims management, leading to a swift promotion to Claims Examiner II within one year of hire, showcasing adaptability, expertise, and a strong commitment to delivering high-quality claims services.
  • On-going collaboration with medical professionals, legal teams and policyholders as needed to ensure effective claims handling and communication to optimize claim outcomes and resolution.
  • Participated in continuous training and professional development activities to stay updated with industry trends, regulations, and best practices in claims handling.

Claims Associate

Sedgwick Claims Management Services Inc.
10.2015 - 04.2019
  • Specialized in medical only claims handling, demonstrating a focused approach to mastering the intricacies of claims while adhering to Montana State Law and client contracts.
  • Actively managed over 400 litigated asbestos claims in relation to the applicable occupational disease laws, prepare information as needed to attorneys and Medicare.
  • Provided expert clerical support to over 10 internal staff and management by handling wide range of routine and special requirements.

Compliance Technician

Department of Labor & Industry
10.2013 - 10.2015
  • Input of over 900 insurance carriers’ quarterly reports including, Quarterly Expenditure reports, Surcharge reports and Assessment payments totaling more than $3,000,000.00.
  • Implemented scanning database to reduce cost of documentation storage saving over 7 hours a week of filing.
  • Answered questions regarding workers’ compensation coverage requirements and approving reciprocal agreements.
  • Processed applications and approved payments for the Subsequent Injury Fund.

Education

Nursing - Nursing Science

Front Range Community College
Westminster, CO
06.2013

Skills

  • Certified claims specialist
  • Advanced investigative skills
  • Medical case management
  • Claims cost analysis
  • Claims management and resolution
  • Efficient task organization
  • Mentoring team members
  • Collaborative teamwork

Certification

  • Certified Montana Claims Examiner -04/2-18
  • Certified Nurse Aide, 12/2012
  • ISO 9001:TS 16949 Lead Auditor, 05/2006

Kudos

Personal Thank you from Governor Bullock for outstanding customer service while employed at Department of Labor & Industry

Timeline

Claims Examiner II

Montana State Fund
09.2020 - 07.2025

Claims Examiner I

Montana State Fund
09.2019 - 09.2020

Claims Associate

Sedgwick Claims Management Services Inc.
10.2015 - 04.2019

Compliance Technician

Department of Labor & Industry
10.2013 - 10.2015

Nursing - Nursing Science

Front Range Community College

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Jennifer Hirth