
Ieisha Dyer
@ieishadyer
Workers' compensation claims professional at Selective Insurance reviewing medical records and authorizing payments.
What I'm looking for
At Selective Insurance, I manage workers' compensation claims, review medical records and treatment plans, and determine claim eligibility and benefit authorization.
In my current role as a Workers' Compensation Claims Representative I, I review coverage, authorize medical payments, and coordinate with providers, employers, injured workers, attorneys, and vendors to resolve claim issues.
As a Workers' Compensation Complex Medical Only Adjuster, I investigated claims involving causality issues, denials, medical claim petitions, and coverage determinations. I reviewed provider billing and medical documentation, processed payments within my authority, and evaluated claim exposure.
I began at Selective Insurance as a Workers' Compensation Claims Technician, verifying coverage, reviewing provider invoices, and processing claim documentation. I'm seeking to apply my claims and reimbursement experience in a remote revenue cycle, medical billing, insurance follow-up, denials management, or accounts receivable role.
Experience
Work history, roles, and key accomplishments
Workers' Compensation Claims Representative I
Jan 2025 - Present (1 year 8 months)
Manage a caseload of workers' compensation claims, review medical records, and authorize payments in compliance with state regulations. Investigate claim issues and coordinate with stakeholders to resolve complex claims.
Investigated complex medical-only claims involving causality issues, denied claims, and coverage determinations. Reviewed medical documentation and provider billing to evaluate compensability and authorize payments.
Verified insurance coverage, investigated claims, and communicated with stakeholders to resolve claim issues. Reviewed provider invoices and approved medical bills for compensable work injuries.
Education
Degrees, certifications, and relevant coursework
North Carolina Central University
Bachelor of Science, Recreation Administration
Bachelor of Science in Recreation Administration with a minor in Management from North Carolina Central University.
Tech stack
Software and tools used professionally
Availability
Location
Authorized to work in
Salary expectations
Job categories
Skills
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