1. Desiree R. McAllaster
2341 Sand Ridge Road, Placerville, CA 95667
(530)391-0696
dizzy_742001@yahoo.com
Objective: To obtain a position with achieving my full potential while learning more information every day and
being a team player
SKILLS:
 Customer Service
 Claims handling
 Problem solving
 40 wpm
 10-key 8000 spm
 MS Office (Word, Excel and Outlook)
 Lotus
 ClaimZone claims network
 SIMS/Systema claims network
 ABS Claim System
 Knowledge of CPT, HCPC, ICD-9, ICD-10 codes
 Knowledge of Medical terminology
 Multiple phone lines
 Self-motivated to work alone
 Works well within a team while bringing new ideas
 Handles high paced/stress work environment
EmploymentHistory:
12/2015-2/2016 Health Net Federal Services via Kelly Services, Inc. Supervisor: Dawn Lawrence
2025 Aerojet Road (916)353-6711
Rancho Cordova, CA 95670 Claims Examiner I – Ops – Temporary
*Duties: Initializing the first process of all claims eligible or ineligible for payment accurately, with services quality, while
keeping up with production standards and specification; processing claims to determine for typeand amount of benefit
payable; determining levels of reimbursement for claims based on the provided criteria, provider contract, plan and
employer group provisions; matching authorizations to claims while maintaining current desk procedures, protocoland
reference materials; reviewing audits, appeals and complaints and researching any missing or required information;
responding in writing to providers, members, or other company departments to process and resolve theclaim issue; being
consistent with applicable policies, procedures and department guidelines; knowledge of related information systems,
including: Microsoft Office: Word, Outlook, Excel and ABS Claim System
6/2015-7/2015 Athens Administrators via Essential Staffing, Inc. Supervisor: Tricia Kelly
1765 Challenge Way (916)514-4802
Sacramento, CA 95815 Medical Claim Examiner/Assistant -Temporary
*Duties: Processing new claims in compliance with client’s Service Agreement; issuing all indemnity payments and awards
on time; processing all approved provider bills timely; contacting employer for return to work status or availability of
modified work; contacting injured workers at initial set up of claim; sending DWC notices timely; issuing TD, PD and SJDB
notices timely; updating information on computer, issue TD/mileage, and sending medical files; scheduling interpreter for
appointments, depositions, etc.;requesting Employer’s Report, DWC-1, Doctor’s First Report if needed; file and serving
documents on attorneys, WCAB, doctors; requesting PD ratings from DEU; drafting Stipulated Awards and C&R’s;
processing checks – stop payment, cancellations, voids, journal payments;completing referrals to investigators; working
collaboratively with Senior Claims Examiners, Nurse Case Managers and other Assistant Claims Examiners; contacting
with clients, injured workers, attorneys, doctors, vendors and other parties;knowledge of workers’ compensation laws,
policies and procedures; medical and legal terminology; mathematical computer processing skills; operating standard office
equipment; working knowledge of related information systems, including: Microsoft Office: Word, Outlook, Excel and
Systema/SIMS
7/2014-4/2015 York Risk Services Group Supervisor: Tracie Goggin
1107 Investment Blvd. (916)934-0812 ext. 16170
El Dorado Hills, CA 95762 Claims Examiner
*Duties: Investigating claims to determine an injured worker’s entitlement to Workers’ Compensation benefits; completing
3-point contact on new claims within 24 hours in order to obtain information necessary to make a compensability decision
on the claim; administering indemnity and medical benefits for valid Workers’ Compensation claims; managing a caseload
of claims from inception to closing; establishing appropriatereservelevels based on financial exposure and updates reserves
upon receipt of new information; properly payingindemnity benefits and awards; issuing state-mandated benefit notices
within therequired timeframes; annotating, categorizing and addressing incoming mail on a daily basis; responding to
questions and requests from the client; prioritizing multiple tasks and meet deadlines; portrayingexcellent written and verbal
skills and excellent customer service skills; knowledge with Workers’ Compensation law, policies and procedures;
knowledge with medical and legal terminology; mathematical computer processing skills; operating standard office
equipment; working knowledge of related information systems, including: Microsoft Office: Word, Outlook, Excel and
ClaimZone

2. 5/2008-7/2014 York/Avizent/Frank Gates Supervisor: Catrina Allen
1107 Investment Blvd. (916)934-0812 ext. 16101
El Dorado Hills, CA 95762 Claims Assistant
*Duties: Providing clerical support to thetechnical claims staff in an effort to maintain compliance with both State law and
internal procedures; assumes responsibility for the accurate and timely completion of assigned administrative tasks to
support quality claims handling by thetechnical claims staff; complete diary instructions to include by not limited to benefit
letters, form letters file and serves, status call, payment transfers and State form preparation;paying bills; proficient in
Microsoft Office; initiate and maintain a good rapport with internal and external customers; prioritizeand organize assigned
work; work with technical staff to ensure work is completed timely and accurately; communicate to management any
workflow problem, issues or backlog immediately; assist with special projects and assignments as necessary; mathematical
computer processing skills; operating standard office equipment; working knowledge of related information systems,
including: Microsoft Office: Word, Outlook, Excel and ClaimZone
11/1999-1/2010 G&O Body Shop, Inc. Manager: Gary Cooper, Jr.
5821 MotherlodeDrive (530)622-9211
Placerville, CA 95667 Dispatcher/Office Assistance
*Duties: Answering multiple, busy phonelines; dealing with emergency situations;dispatcher to over 20 tow truck drivers;
updating and status reports on all drivers; prioritizing calls; dealing with law enforcement on the phoneand in person for
tow calls or vehicles in thetow yard; dealing with theirate public at times; assisting the owner/boss with cliental situations;
accounting, billing, and statistics;computer programming for billing, data entry;remote computer skills for AAA
dispatching; working knowledge of related information systems, including: Microsoft Office: Word, Outlook and Excel;
DMVpaperwork for all company vehicles, training new employees; operating standard office equipment
4/2005-1/2010 Midnight Exchange Owner: Ted Cooper
5821 MotherlodeDrive (530)295-4311
Placerville, CA 95667 Operator/Dispatcher
*Duties: Multiple, busy, switchboard phonelines; dealing with emergency situations with crisis lines; prioritizing phone
calls; dispatching tow trucks, taxis and EID techs; updating where drivers and clients locations are; performing multiple
tasks all at one time; taking messages for clients dealing with irate, confused and/or distressed customers; filing and
updating info for present and/or futureday(s); basic computer operations; working knowledge of related information
systems, including: Microsoft Office: Word, Outlook and Excel; typing;faxing; accounting; billing and statistics;data entry;
and training new employees
4/2001-12/2003 Gold Country Exchange Owner: Chuck Holland
191 Placerville Drive (530)622-6500
Placerville, CA 95667 Operator/Dispatcher
*Duties: Multiple, busy, switchboard phonelines; dealing with emergency situations with doctors, hospitals, and crisis lines;
prioritizing phonecalls; dispatching tow trucks, taxis, and EID techs; updating where drivers and clients locations are;
performing multiple tasks all at one time; taking messages for clients dealing with irate, confused and/or distressed
customers and/or patients;filing and updating info for present and/or future day(s);basic computer operations; working
knowledge of related information systems, including: Microsoft Office: Word, Outlook and Excel; typing;faxing;
accounting; billing and statistics;dataentry;and training new employees
7/1997-12/1999 City Answering Service Owner: Bobbi Westcott
2986 Coloma Street (530)621-0400
Placerville, CA 95667 Operator/Dispatcher
*Duties: Multiple, busy, switchboard phonelines; dealing with emergency situations with doctors, hospitals, chaplains, and
crisis lines; prioritizing phone calls; dispatching tow trucks, taxis, limos, & EID techs; updating where drivers and clients
are; monitoring and dispatching alarms for multiple companies; performing multiply tasks all at one time; taking messages
for clients dealing with irate, confused and/or distressed customers and/or patients;welfare checks on elderly clients by
phone; filing and updating info for present and/or futureday(s); basic computer operations;typing;faxing; accounting;
billing and statistics;dataentry;and training new employees
Education:
1989-1992 El Dorado High School *Graduated with Diploma
561 Canal Street, Placerville, CA 95667
2008-2011 Insurance Education Association
Classes completed: CA-10 Intro to WC
CA-14 Return to Work
CA-12 Medical Coordination of WC
CA-11 WC Claims Advanced
CA-16 PD Rating
**Received my W.C.C.A. certificate on 8/31/2011.**
5/27/2016