1. Mariam Amirani
1395 Spectrum
Irvine, CA 92618
714.397.3774
m1amirani@yahoo.com
-Objective
To obtain a position as a Senior Claims Examiner to administrate and manage Workers’
Compensation claims and utilize my experience as well as advance in my career
-Profile
 17 years experience in handling Workers Compensation Claims
 Ability to direct complex claims from inception to conclusion
 A goal-oriented individual with strong leadership capabilities
 An organized, highly motivated, and detail-directed problem solver
 Ability to work in unison with staff, co-workers, and management
-Employment:
Senior Claims Examiner , Gallagher Bassett Services, Aliso Viejo, CA
12/29/2009 – present
 Dedicated Claims Examiner for Wholefoods Market .; Return To Work unit.
 Effectively manage a case load of litigated and non litigated claims, including very complex
claims.
 Initiate and conduct through investigation, determine compensabilityof claims and
administer benefits, based upon state law and in accordance with established services
instructions and company guidelines.
 Manage medical treatment in accordance with ACOME guidelines.
 Consult , interface, and mange providers for services such as legal counsel, MSA,
Field/Nurse Case Managers.
 Establish claims reserves levels and verify documentation for accuracy, prepare and present
reserve analysis.
 Maintain diary system for case review and documents file to reflect the status and work
being performed on the file.
 Resolve and/or finalize all cases and obtain authority per service instructions.
Senior Claims Examiner
Tristar Risk Management, Santa Ana 2007-2009 (Santa Ana Location)

2. TriStar Risk Management /CSSR, 10/2001-05/2006(County account)
 Experienced with salary continuation or Labor Code 4850
 Effectively managed a caseload of workers’ compensation insurance cases and files
 Determined compensability of claims and administer benefits accordingly.
 Managed medical treatments as appropriate.
 Communicated with claimants, providers and attorneys regarding issues case specific.
 Set reserves within company guidelines
 Maintained diary system for case review and documents file to reflect the status and work
being performed on the files.
Senior Claims Examiner , Gallagher Bassett, Anaheim, 1997-1999
 Analyzed and processed workers’ compensation claim to determine benefits due, and the
exposure on the claim
 Handled all aspects of Workers, Compensation claims with focus on resolution and early
closure of claims
 Negotiated settlement of claims up to designated authority level
 Calculated and assigned timely and appropriate reserves to claims and monitored reserve
adequacy throughout the life of the claim.
 Prepared cover letters to AME/DQME, AOE/COE evaluations. Negotiateoutstanding
liens.
-Education/Degree:
University Of West Los Angeles, CA 1993
Bachelors of Science degree in paralegal with concentration in pre-law and Real Estate
-PROFESSIONAL LICENSES AND CERTIFICATES:
 Self-Insurance Administrator Certificate
 Insurance Claims Professional Certificates
 Current with required hours of training/education
-Relevant Experience & Accomplishments
 Team/Unit Lead
 Working experience handling case files for Clients in the private and public sector