ROBIN RUSHEY
East Syracuse,NY
Summary
Adept at driving significant outcomes, my tenure at NCA COMP showcases my ability to handle 400 complex claims efficiently, ensuring zero EDI filing penalties over seven years. Skilled in multitasking and trend analysis, I excel in implementing change and fostering team growth, Detailed Senior Adjuster/Teams Administrator who strives for perfection and client satisfactory.
Overview
13
13
years of professional experience
Work History
Senior Workers' Compensation Claims Adjuster
NCA COMP
09.2017 - Current
- Researched claims and incident information to deliver solutions and resolve problems.
- Conducted day-to-day administrative tasks to maintain information files and process paperwork.
- Conducted comprehensive interviews of witnesses and claimants to gather facts and information.
- Reviewed police reports, medical treatment records, and physical property damage to determine extent of liability.
- Reviewed new files to determine current status of injury claim and to develop plan of action.
- Triaging all new accounts to include filing proper EDI, training our new client on our system, forms to be completed, and resolving any issues with the claim transfers
- Training all new hires on claim expectations and EDI
- Training all examiners within the company how to identify 114-A claims and how to pursue them
- Currently handling 400 claims some include 207-C, Schools, Counties, Firefighters, and Ambulance claims
- Section 32 settlements to include the 15-8 buyout claims
- Maintaining no penalties for any EDI filings in the seven years of being employed
- Maintaining diary system at a 1 day turn around time
- Handling large dollar CAT claims and negotiating settlements
- Maintaining an up to date payment list for check issuing
Workers' Compensation Claims Adjuster
POMCO
01.2012 - 08.2017
- Reviewed new files to determine current status of injury claim and to develop plan of action.
- Maintained contact with claimants and attorneys to determine treatment status.
- Conducted comprehensive interviews of witnesses and claimants to gather facts and information.
- Conducted day-to-day administrative tasks to maintain information files and process paperwork.
- Reviewed questionable claims by conducting agent and claimant interviews to correct omissions and errors.
Education
High School Diploma -
East Syracuse Minoa
East Syracuse, NY06.1993
Skills
- Meeting all time deadlines for hearing notices, WCB decisions, filing the appropriate EDI timely
- Multi tasking on any given day and still ensure a quality work product
- Easily identifying any issues with billing trends, WCB trends, and report to the proper management any ongoing issues with trending
- Communicate accordingly to any new hires questions that may be asked
- Work well as a team or individually
- Training new hires how to run a efficient desk and keep up with a work load
Accomplishments
Settling all of the 15-8 buy out claims within 6 months giving my clients a huge surplus with their budgets
Never obtaining a penalty in seven years as we file all of our own EDI
Highest fraud adjuster within the company with the most findings
Promoted to Team Administrator within a short period of time
Making every client I have ever been assigned to impressed with my quality and timing of responses and having them report this to my owner on numerous occasions
Timeline
Senior Workers' Compensation Claims Adjuster
NCA COMP
09.2017 - Current
Workers' Compensation Claims Adjuster
POMCO
01.2012 - 08.2017
High School Diploma -
East Syracuse Minoa
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