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Tyneshia Matthews

@tyneshiamatthews

I am an experienced workers' compensation claims adjuster delivering accurate case management and regulatory compliance.

United States

Message

What I'm looking for

I seek a claims or risk-management role where I can apply my workers' comp expertise, support a collaborative team, and continue growing professionally.

I am a seasoned workers' compensation claims professional currently functioning as a Senior Claims Adjuster, managing a high-volume caseload of approximately 250 medical-only, lost-time, and litigated claims while ensuring regulatory compliance and timely action. I focus on prompt contact with injured workers, accurate reserve-setting, and diligent claims lifecycle management.

I earned promotions from Claims Intake Specialist to Adjuster and then to Senior Adjuster by driving results — timely EDI filings, mediation participation, full washout settlement proposals, excess reporting for high-exposure claims, and successful subrogation recoveries. I regularly collaborate with defense counsel, nurse case managers, vendors, and internal teams to optimize outcomes and control costs.

I bring strong office and technical skills (MS Word, Excel, PowerPoint, Outlook, Access), excellent customer service, and a proven ability to adapt and learn quickly. I am dependable, detail-oriented, and committed to resolving claims efficiently while supporting team development and continuous improvement.

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Experience

Work history, roles, and key accomplishments

Current

Senior WC Claims Adjuster

Current

City of Jacksonville

Jan 2024 - Present (1 year 10 months)

Promoted to Senior Workers' Compensation Claims Adjuster managing a high-volume caseload of ~250 claims and driving resolution through settlements, mediations, and excess reporting. Ensured regulatory compliance via timely EDI filings and optimized reserve and medical payment management.

Claims Management EDI Reserve Management Litigation Support Medical Billing Case Management

Workers' Compensation Claims Adjuster

City of Jacksonville

Sep 2020 - Jan 2024 (3 years 4 months)

Handled medical-only and complex lost-time claims during the pandemic, managing appointments, reserves, vendor assignments, and state reporting to avoid fines. Advanced claims to resolution, coordinating with nurse case managers and defense counsel when needed.

Claims Management Vendor Management Medical Case Management

Claims Intake Specialist

City of Jacksonville

Mar 2013 - Sep 2020 (7 years 6 months)

Served as Claims Intake Specialist and receptionist, scanning and auditing claim files, distributing caseloads equitably to adjusters, and supporting departmental operations. Improved file accuracy by reviewing documentation and processing check images into claim records.

Document Scanning Data Entry File Management

Library Clerk

Jacksonville Public Library

Jan 2013 - Mar 2018 (5 years 2 months)

Performed circulation duties including check-in/out, new patron registration, shelving, and customer assistance while supporting event promotion through flyer creation. Recognized for customer service with a certificate of recognition and five-year service pin.

Customer Service Event Promotion Data Entry

Clerk II

Clerk of Courts

Jan 2008 - Jan 2013 (5 years)

Provided clerical support in misdemeanor and appeals departments, handling data entry, indexing, billing, record building, and judge/trial clerk assistance. Created a prep fee billing sheet adopted by the Appeals Department and cross-trained across divisions.

Data Entry Indexing Billing Case Preparation

Cashier

Target

Jan 2007 - Jan 2008 (1 year)

Started as a seasonal cashier and was retained permanently; handled transactions, returns, guest services, and cross-store inventory requests while promoting Red Card benefits to save customers money.

Point of Sale Customer Service Returns Processing Inventory