Chris Kiefer Lahey
Work Comp Adjuster
Lee's Summit,MO
Summary
Dedicated and conscientious Workers Compensation Claims Adjuster with a goal of providing high client satisfaction . Experienced in obtaining optimal outcomes for legitimate injury claims across a wide variety of industries while continuing to meet business goals. Knowledgeable in an array of injury-specific medical options for individual claims cases. Well versed at juggling multiple tasks and working under pressure.
Overview
36
36
years of professional experience
Work History
Workers Compensation Claims Adjuster - Return to Work
Travelers Insurance
01.2022 - Current
- Actively manages 150 open workers compensation claims in KS, MO, NE, IA and MN with minimal supervision;
- Makes timely contact with all parties;
- Determines coverage, compensability and assess for subrogation;
- Sets expectations with all parties involved and emphasizes communication is key throughout the life of the claim;
- Establishes initial and ongoing claim serves to reflect claim exposure;
- Manages and authorize payment of medical and lost time benefits, monitors claims for continuation of benefits and terminates payments when appropriate;
- Prepares letters to medical providers to address prevailing factor or causation of medical treatment;
- Successfully conducts quarterly claims reviews with insured to provide claim status;
- Maintains contact with claimants and attorneys to determine treatment status;
- Conducts negotiations for settlement of claims
- Collaborates with legal counsel on litigated claims;
- Contact Medical Providers for medical records and billing information;
- Reviews all medical billing for approval or denial.
Fraud Investigator
Charter Communications
08.2019 - 07.2021
- Independently leveraged appropriate resources to support the identification and initiation of complex fraud or abuse investigations;
- Appropriately collected, analyzed and documented information;
- Brought resolution to fraudulent claims by employing tools that detect and disrupt fraud schemes.
- Listened to recordings of incoming calls as soon as they were captured, made an immediate fraud determination, took the appropriate action and advised management of my findings
- Utilize defined metrics for tracking and reporting.
- Proactively identified and presented opportunities for improved training and operational procedures inside and outside of the department to team leaders and managers on an ongoing basis;
- Assisted other investigators in difficult or complex situations and handled escalation calls whenever necessary.
Revenue Officer/Program Analyst
Internal Revenue Service
03.1988 - 07.2019
- Conducted investigations and interviews at individual taxpayer residences and/or business locations;
- Interviewed 3rd parties on a regular basis, verified assets via local county assessor and registrar of deeds visits;
- Calendared and maintained a high inventory caseload;
- Provided case oversight, set deadlines for requested actions and monitored compliance.
- Coordinated and worked in cooperation with all stakeholders to ensure continuity of scheduled tasks.
- Conducted selective investigations that became the catalyst for a recommendation to initiate specific procedures to avoid fraud in electronic filing;
- Performed in-depth research and analysis on programs such as Offer in Compromise and Innocent Spouse.
- Conducted the research and provided the analysis and evaluation of Taxpayer Assistance Orders for the National Taxpayer Advocate Annual Report to Congress.
Education
Associate of Applied Science - Paralegal
Johnson County Community College
Overland Park, KS05.1989
General
University of Kansas
Lawrence, KS08.1986
Skills
- Quick study, organized with great attention to detail;
- Experienced researcher and investigator skilled in both oral and written communication, analysis and problem solving;
- Skilled multitasker who effectively manages time, resolves problems;
- Computer proficiency in MS Office Suite (Word, Excel, and PowerPoint), and readily adapt to new programs and technologies
Timeline
Workers Compensation Claims Adjuster - Return to Work
Travelers Insurance
01.2022 - Current
Fraud Investigator
Charter Communications
08.2019 - 07.2021
Revenue Officer/Program Analyst
Internal Revenue Service
03.1988 - 07.2019
Associate of Applied Science - Paralegal
Johnson County Community College
General
University of Kansas
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