Compensation Claims Examiner

Newtown, PA, ***** • ********@*****.*** • 267-***-****

ROBERT KERCHEFF

PROFESSIONAL SUMMARY

Federal Claims Examiner with over 20 years of experience in adjudicating federal workers’ compensation claims, including legal decision writing and lifecycle management. Demonstrates expertise in training, claims auditing, and regulatory compliance, with a proven track record of promotions based on performance. Seeking to leverage extensive experience and skills in a role focused on insurance claims administration or public administration or health care administration and customer service support.

SKILLS

Claims Administration, Federal Claims Adjudication, Litigation, Regulatory Compliance, Staff Leadership, Training, Claims Auditing, Process Optimization, Client Relations, Presentations, EEO Counseling, Governmental Compliance, Healthcare Administration, Public Administration.

EMPLOYMENT HISTORY

FEDERAL CLAIMS EXAMINER 2002 - Present

U.S. Department of Labor – Office of Workers’ Compensation Programs Philadelphia, PA

• Adjudicate federal workers’ compensation claims from initiation through closure.

• Write formal legal decisions on claims including initial determinations, entitlement, and termination of benefits.

• Earned promotions from GS-9 Step 1 to GS-12 Step 10 based on performance.

SENIOR CLAIMS REPRESENTATIVE 2000 - 2001

Chubb Services Corporation Florham Park, NJ

• Handled NY and NJ Workers’ Compensation claims for national accounts, school districts, and municipalities.

• Served as third-party administrator with full claims lifecycle management.

SENIOR CLAIMS REPRESENTATIVE 1999 - 2000

Atlantic Mutual Insurance Companies Morristown, NJ

• Managed high-volume litigation caseload of NY Workers’ Compensation claims.

• Conducted home office and onsite claims reviews and provided reserve analysis to support account retention.

WORKERS’ COMPENSATION CLAIMS ADMINISTRATOR 1996 - 1998

Tower Insurance Company New York, NY

• Led department start-up, developed claim forms, and implemented policy/procedure infrastructure.

• Maintained active claims caseload and ensured low loss ratios for a competitive small-business book.

SENIOR CASE MANAGER 1994 - 1995

Liberty Mutual Insurance Company Lynbrook, NY

• Directed Workers’ Comp unit for mid-sized market accounts.

• Oversaw subrogation and Second Injury Fund recovery.

• Supervised claims examiners and support staff; promoted rapidly based on performance.

CLAIMS EXAMINER 1993 - 1994

Wright Risk Management Garden City, NY

• Managed Workers’ Compensation claims for self-insured school districts under a reciprocal program.

• Communicated results to principals of self-insured entities.

CLAIMS ADJUSTER 1993

Crawford and Company Lake Success, NY

• Sole WC claims adjuster for Lake Success branch, servicing insurance companies and self-insured employers.

SENIOR CLAIMS AUDITOR 1989 - 1992

National Council on Compensation Insurance (NCCI) Boca Raton, FL

• Audited WC claim operations of insurers nationwide for compliance with statutory and national standards.

• Produced detailed audit reports and presented findings to senior management and client principals.

CLAIMS MANAGER 1987 - 1988

Rockwood Insurance Company Richmond, VA

• Directed all branch claims activity and supervised staff.

• Office closed due to corporate consolidation.

EARLIER:

-In 1986-1987 worked as a direct care counselor for Richmond Residential Service, principally at the Ordway Group Home for the MR/DD adult population. Taught independent living skills to residents, worked with state health facilities and families to facilitate the transition of individuals from the institutional setting to the group home setting.

- In 1983-1986, served as Naval Officer and Health Care Administrator at Portsmouth Naval Hospital. Administrative officer for the following departments: Social Work, Radiology, Laboratory, Pastoral Care, Clinical Investigation, Respiratory Therapy, Pharmacy and General Surgical Services.

Also served as Equal Opportunity Counselor/Trainer and Assistant Supply and Fiscal Officer for the Midlantic Region.

- Previously managed prenatal and family planning center in the Tremont area of Bronx, New York from 1982 to 1983 for Maternity Infant Care Family Planning Project c/o Medical Health Resources Association

EDUCATION

MASTER OF PUBLIC ADMINISTRATION (MPA) – HEALTH CARE ADMINISTRATION CONCENTRATION 1982

New York University

BACHELOR OF ARTS (BA) – SOCIAL SCIENCES, HISTORY & EDUCATION 1977

SUNY Oneonta

GRADUATE COURSEWORK (SOCIAL WORK) 1984 - 1986

Virginia Commonwealth University

Completed 2 years

ADMINISTRATIVE RESIDENCY 1982

Greenpoint Hospital / NYC Health & Hospitals Corporation

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