As claims supervisor in the workers’ compensation department at VML Insurance Programs (VMLIP), Deborah Briggs helps her adjusters handle their claims with the high standards that VMLIP members have grown accustomed to.
“We expect the best quality and customer service for our members,” says Briggs. “We focus on quality claims handling.”
Briggs has been handling claims for VMLIP since 1995 as an employee of Hastings-Tapley. In 1999 Briggs joined Robin Duvall as a VMLIP employee and claims adjuster.
“I used to handle all of the Northern Virginia territory,” said Briggs.
Her typical day would involve reviewing first reports and her new claims, working the mail, checking e-mails, making phone calls and handling any reporting that needed to be done.
Today she supervises three indemnity and three medical-only claims adjusters, as well as a claims technician.
“At VMLIP our adjusters handle the claims from start to finish – the only time we change adjusters is if the claim moves from medical-only to lost-time, and even then it’s going to an adjuster right down the hallway,” said Briggs. “This allows our adjusters to get to know their claims because they are involved with it along each step of the process.”
In addition to navigating EDI and Medicare reporting requirements, today’s adjusters handle claims that are becoming more and more complicated. Even small injuries can become complicated when the injured employee has pre-existing unrelated medical issues.
VMLIP claims adjusters keep a three-point contact when working a claim – one with the injured worker, another with the member contact, and a third with the medical doctor or nurse.
“We work very closely with nurses,” said Briggs. “Things can get very complicated especially if the injured employee has prior medical issues. Our job is to get them back to baseline before they were injured, and working with nurses helps us determine when we’ve done that.”
VMLIP adjusters maintain a manageable claims count so that each case can be handled with quality and keeping the best outcome for the employee, employer, and pool in mind.
“As a supervisor, I enjoy helping my adjusters manage their claims,” said Briggs. “I also enjoy being more involved with litigation that helps me stay up to date on workers’ compensation laws, which helps me grow as a supervisor.”
Briggs has worked in insurance since she started paying health, dental and vision claims for Teamsters Insurance in the 1980’s. Since then she’s worked for Corvell, Maryland Insurance Group, AIG, Liberty Mutual, and Hastings-Tapley before becoming a VMLIP employee.
She’s worked in bill review, first reporting and transcription, handled medical-only claims and lost-time claims. In 2005 she obtained her Associates In Claims (AIC) designation and in 2006 she obtained her Associate In Insurance (AIS) certification.
Briggs has a son and daughter in their 30’s and a 21-year-old stepdaughter. After volunteering at Innsbrook After Hours for 18 years, she now spends most of her free time with her six-year-old granddaughter Teaghen.
She expects to stay with VMLIP until she retires to ensure that the next generation of claims adjusters and supervisors maintain VMLIP’s reputation for superior service and claims management.
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