Summary
Overview
Work History
Education
Skills
Timeline
Hi, I’m

Michael Bucaro

Volo,United States

Summary

Experienced Senior Claims Adjuster professionally handles minor to complex claims for customers. Adept at working directly with customers and providing guidance throughout the claims process. Committed to successfully managing a complex and diverse caseload and ensuring each party is satisfied with the outcome.

Versatile human resources specialist offers recruitment, policy development and office management expertise paired with outstanding multitasking and communication abilities. Goal-oriented professional with several years of comprehensive experience retaining employee relations. Commended for superior performance and consistently going above and beyond to exceed goals.

Strategic professional in human resources management, known for high productivity and efficiency in task completion. Possess specialized skills in employee relations, compliance with labor laws, and talent acquisition strategies. Excel in communication, leadership, and problem-solving to enhance organizational effectiveness.

Overview

15
years of professional experience

Work History

Department of Labor
Volo, United States

Claims Examiner
07.2022 - 04.2025

Job overview

  • Company Overview: This is a federal job
  • Conducts fact-finding to properly gather, assess, and adjudicate claims of disability and death cases arising under the Act.
  • Reviews evidence, develops facts, and analyzes and evaluates conflicting statements or allegations.
  • Makes initial determinations on a broad range of claims for assigned cases.
  • Applies knowledge of DFELHWC laws, regulations, and policies to assigned cases selected for training and developmental purposes.
  • Receiving continual technical guidance, the incumbent adjudicates and makes determinations on most non-medical issues that arise as well as medical issues for which there are established precedents or where medical opinion clearly supports the claim.
  • Issues include, but are not limited to, compensability, medical authorizations, time requirements, coverage of employees under the Act, wage-loss and other compensation entitlement, disability management and interventions, the extent of disability, and periodic entitlement review in a timely manner.
  • The supervisor or specialist provides specific advice and guidance in the development and adjudication of highly controversial issues.
  • Properly examines medical evidence for claims involving traumatic injuries and primary non-traumatic injuries for factual sufficiency and legal correctness to determine if the compensation claim meets the five basic requirements and basic criteria outlined in established guidelines.
  • The incumbent employs standard investigative approaches to obtain information, evidence, and other documentation related to claims.
  • Reviews and evaluates a variety of evidentiary documents (e.g., narrative medical reports commenting upon the relationships of the disability to the implicated employment factors, history of claimant's disability, specifics of employment felt to be the cause of injury, job descriptions, comments on the veracity of the claimant's statements, claimant's health history, claimant's leave records, etc.) from a variety of sources submitted with or subsequent to the initial claim.
  • If any such information is not included with the claim, the incumbent sends appropriate development letters requesting the necessary information.
  • Prepares correspondence and maintains working relationships with claimants, witnesses, employers, physicians, medical providers, investigators, representatives, attorneys, and other sources to obtain missing or supplemental medical and employment documents, to clarify information, and to secure additional factual and medical information needed to adjudicate the claim.
  • Refers stakeholders to the supervisor or higher-graded specialist to address difficult problems or more complex issues.
  • In cases involving disability, the incumbent makes a determination based on the evidence received, takes appropriate measures to address medical care, and initiates Program disability management protocols.
  • Prepares statements of accepted facts and refers cases for medical opinion to the district medical advisor/independent medical examination those cases that require clarification of medical opinion regarding causal relationship of the disability to employment or degree of permanent impairment.
  • Ensures that the record reflects sufficient medical and factual evidence to justify the opinion requested.
  • Makes final determinations on less difficult claims - ensuring that claims decisions are consistent with established guidelines.
  • Applies lay medical knowledge of physical impairments to make equitable decisions.
  • Cases involving difficult or controversial issues (e.g., formal rejection of a claim, withholding of benefits, establishment of fees for legal representation, etc.) are subject to complete review for adequacy of facts and evidence, accuracy of determinations, and authorization for payment by a supervisor or a higher-graded specialist.
  • For assigned cases, the incumbent identifies and calculates overpayments in accordance with the FECA procedure manual; processes administrative terminations on overpayments within the authorized monetary limits; and processes payments of compensation and schedule awards in accordance with the FECA procedure manual.
  • Determines the amount of compensation, the extent of disability, and the length of time compensation is to be paid for assigned cases.
  • Receiving continual technical guidance, the incumbent sets up initial, continuing, and temporary total disability compensation payments for wage loss.
  • For initial payments, prepares a pay rate memo for review by the supervisor or a higher-grade claims examiner that outlines the appropriate pay elements to be used for compensation purposes (e.g., pay rate, compensation rate, pay rate effective date, etc.).
  • In continuing payments, the incumbent determines the length of time compensation is payable.
  • After appropriate documentation has been obtained and prepared, the incumbent keys the pay elements and period of disability for certification.
  • This is a federal job

85th ARSC
Arlington Heights, United States

Human Resource Specialist
11.2019 - 07.2022

Job overview

  • Company Overview: This is a federal job
  • Serves as the Medical Protection System (MEDPROS) Readiness Coordinator and senior analyst providing technical guidance and problem solving to the 85th Army Reserve Support Command and tactical units on the medical readiness standing of their respective units/organizations as required.
  • Receives and thoroughly evaluates all medical evidence, reports, and medical documents.
  • Develops facts and evidence for evaluating conflicting statements or allegations.
  • Initiates contact and corresponds with claimants, physicians and medical providers.
  • Reviews and adjudicates a variety of medical issues within a claim characterized by situations where causative factors of the disease or injury are uncertain or the symptoms are subjective.
  • Provides effective customer service, including answering routine, incoming phone calls from claimants and other claim stakeholders, to provide technical assistance.
  • Assists and instructs subordinate units with the implementation and sustainment of the MEDPROS Army Immunization Campaign Plan, Individual Medical Readiness (IMR), and Deployment Health Assessments (DHA) requirements.
  • Serves as an expert in all areas of implementation, to include, but not limited to, inputting of immunizations and IMR data, distribution of training aids, monitoring of scheduled compliance, and all education and training endeavors.
  • Reviews and makes recommendation on implementation of regulations, directives and instructions for the installation or region.
  • Establishes, develops, and issues policy and guidance for accomplishment of Unit Medical Readiness (UMR) and Individual Medical Readiness (IMR) oversight.
  • Collects, evaluates, publishes and disseminates information, including but not limited to policies and regulations.
  • Organizes meetings, functions, or conferences to ensure program effectiveness and compliance for the 85th and downtraces.
  • Presents detailed MEDPROS and medical readiness briefings, presentations, and demonstrations for all leadership levels.
  • Conveys policies and procedures for medical readiness to post Commanders.
  • Tailors and presents standard MEDPROS briefings and presentations.
  • Provides monthly MEDPROS Data Entry Courses and MEDPROS Web Data Entry Course and MEDPROS Web Reporting as requested.
  • Provides support to the Military Vaccine Agency (MILVAX) Immunization Course.
  • Develops and maintains training curriculum.
  • Monitors and conducts MEDPROS, UMR and IMR training.
  • Develops plans, executes and monitors medical readiness training requirements, which include computer hardware and software, to support training.
  • Plans, develops, and implements medical readiness reporting procedures.
  • Executes a variety of tasks involving collecting, interpretation, analysis and presentation of medical readiness data relating to the preparedness for deployment and mobilization.
  • Establishes Performance Improvement indicators.
  • Ensures quality assurance of data management.
  • Generates reports for commanders to review readiness status, such as: MEDPROS and CSMM.
  • Evaluate methods for determining readiness status of units and/or individuals.
  • Performs extensive analysis and studies of wide number of variables which influence the medical readiness posture.
  • Analyzes claims to determine if diseases and/or injuries were incurred or aggravated by military service in the line of duty for purposes of compensation, treatment, or hospitalization.
  • Edit reports, briefings, and other informational material designed to report functions of the 85th ARSC.
  • Retrieves and compiles information, prepares summaries, tracks input from outside sources, and may prepare narrative segments of reports.
  • Attend executive level meetings and discussions to provide administrative and medical assistance.
  • Process and maintain administrative records, such as performance management plans, working files, travel vouchers.
  • Track and ensure staff actions are timely and accurately completed to meet mission and operations requirements.
  • Provide moderately complex management advisory and technical services on recurring human resources issues within the 85th ARSC and downtraces.
  • Apply standardized analytical and evaluation techniques; and interpreting regulatory material related to employee onboarding, processing personnel actions, and employee benefits.
  • Research, analyze, and apply policies, regulations, and standard procedures to perform work in a human resources program area while using automated Human Resource Systems.
  • Provide assistance to other staff members in order to resolve difficult personnel action problems and issues such as those requiring research of legal authorities, multiple corrective actions and those that are less frequently encountered; and communicating with external and internal customers.
  • This is a federal job

United States Army Reserve Civilian
Fort Sheridan, United States

Staff Administrative Specialist
03.2010 - 11.2019

Job overview

  • Company Overview: This is a federal job
  • Currently serves as the principal administrator responsible for performance of a variety of technical, analytical, advisory, liaison and coordinating duties for the USAR Battalion Commander in accomplishing the overall functions of the 6/100th Battalion at Ft. Sheridan IL.
  • Provide administrative and management support for the 6/100th.
  • Provide assistance and support to all down trace units.
  • Help with planning and establishing priorities; assigns, distributes and reviews work of subordinate unit sections and personnel with in the Battalion.
  • Prepare and maintain personnel records in accordance with the regulation.
  • Solve Problems regarding administrative and military personnel matters; Manages unit and individual training for those assigned to the 6/100th in DTMS.
  • Interpret regulations and policies to ensure that all units under the 6/100th are in compliance.
  • Uses CSMM to review unit readiness.
  • Primary for updating and validating ESRB for Soldiers assigned to the unit.
  • Advise subordinate employees on mission objectives as they relate to recruitment goals or customer services at multiple locations.
  • Manages personnel, finance and automated systems activities in RLAS.
  • Manages and provides technical review of completed personnel actions in EPAT.
  • Processes a variety of pay actions utilizing Defense Joint Military Pay System-Reserve Component and Automated Drill Attendance Reporting Software systems in RLAS.
  • Manages a unit supply program within the GCSS-Army system.
  • Serves as the key point of contact regarding recruitment and retention for the unit.
  • Compile data to identify trends, deficiencies, or accomplishments for Yearly Training Brief and also on a quarterly basis for the Commander to review.
  • Review and Maintain correspondence and reports for 6/100th Battalion.
  • Review regulations and directives for Administrative Operations and Military Personnel Programs to include RLAS, Iperms, SMS and E-MILPO.
  • Manage Administrative and Military Personnel Operations at the Battalion.
  • Works as the primary ATRRS operator for the unit.
  • Submits applications for a variety of ATTRS courses to ensure DMOSQ and NCOES stays in the top percent of the Battalion.
  • Reviews records to ensure Soldiers are eligible to attend schools and meet the prerequisites.
  • Works as the primary reviewer and approver for DTS Authorization and Vouchers with in the 6/100th Battalion.
  • Updates and maintain data in RLAS for personnel and pay.
  • Updates and maintains training records in DTMS to ensure that all Soldiers Records are updated.
  • Works as the Primary Card holder for the Government Purchase Card.
  • Monitors MEDPROS for deficiencies with Soldiers Assigned.
  • Creates a tracking list to allow enough lead time so Soldiers do not become deficient in PHA or Dental.
  • Tracks and Monitors Soldiers that are deficient in Medical Class 3 categories to ensure that they are getting the treatment that they need.
  • Creates vouchers in AVS for Soldiers to receive medical services.
  • Creates, tracks and reviews LOD's in the EMMPS system for accuracy and timely processing.
  • Compiles, Reviews, and track profiles submitted to the ARRMC for timely submission.
  • Uses Commanders Portal to look at profiles that the Commander needs to review.
  • Prepare reports and briefings on the wellness of the Battalion on a monthly basis.
  • Additionally assess learning needs, develop learning plans, implement learning opportunities, and evaluate optimal modes of delivery for each unique Soldier.
  • Provides ongoing consultation and development assistance in the implementation; and collaborates with facility regulatory and specialty programs to support unique learning/training needs and/or requirements.
  • Develop, modify, or adapt new or revised training or testing materials.
  • Coordinates educational program/project activities such as meetings, conferences, information gathering, and conducting negotiations for various aspects of the program/project.
  • Monitor and track obligations and expenditures throughout the current and prior fiscal years.
  • Perform budget analysis for execution of funds.
  • Compile and summarize budget estimates for the organization.
  • Consolidate and balance budget and accounting data for organization.
  • Prepare and maintain financial data to support execution reflected on Status of Funds reports.
  • Monitors spend plan commitments, obligations, adjustments and changes in budget requirements.
  • Assist in resolving accounting and funding discrepancies.
  • Monitor, research, and resolve unliquidated obligations.
  • Identify and report funding deviations on spending plans.
  • Assist in on-the-job training for new employees in the organization.
  • Examine and adjudicate claims involving injuries or illnesses arising for Soldiers.
  • Determines the proper disposition of claims, and medical bills.
  • Examine injury and disease cases for factual sufficiency and legal correctness.
  • Determines any wage earning capacity loss.
  • Provides effective customer service to all Soldiers.
  • This is a federal job

Education

Carthage College
Kenosha, WI, United States

Bachelor's degree from DUAL MAJOR in Business Administration and Accounting
05.2009

University Overview

Credits Earned: Semester Hours

Skills

  • Claims adjudication
  • Medical evidence evaluation
  • Fact-finding techniques
  • Disability management
  • Regulatory compliance
  • Compensation calculations
  • Customer service
  • Analytical thinking
  • Attention to detail
  • Case management
  • Problem solving
  • Data analysis
  • Denied claims identification
  • Problem-solving
  • Research techniques
  • Complex Problem-solving
  • Time management abilities
  • Self motivation
  • Relationship building
  • MS office
  • Written communication
  • Customer service and support
  • Claims processing
  • Claims investigation

Timeline

Claims Examiner

Department of Labor
07.2022 - 04.2025

Human Resource Specialist

85th ARSC
11.2019 - 07.2022

Staff Administrative Specialist

United States Army Reserve Civilian
03.2010 - 11.2019

Carthage College

Bachelor's degree from DUAL MAJOR in Business Administration and Accounting

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Michael Bucaro