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Claims Examiner | WC | NY License

  • Location: Remote, NY
  • Remote: Remote
  • Type: Questpro - Contingent
  • Job #19994

Title:  Claims’ Adjuster – Workers’ Compensation
Work Status: 100% Remote – 
Geographical Preference – Eastern or Central Time Zone

Workers’ Compensation Claims’ Professionals who will be the handle NY  Loss Time Claims   Ideal candidate will have min. 3+ years of lost time claims’ handling experience. MUST possess and active NY License.  Senior Loss Time opportunities also available with Min 5+ years experience.

General Description:

Manage within company standards and best practices complex and problematic high visibility workers’ compensation claims within delegated limited authority to determine benefits due, work closely with case managers and attorneys; manage subrogation and negotiate settlements to ensure specific customer requirements to achieve the best possible outcome in the claim.

Essential Job Duties:

  1. Receives claim, confirms policy coverage & acknowledgement of claim
  2. Determine validity & compensability of claim by investigating & gathering infor, file necessary documentation with state agencies
  3. Establish reserves & authorize payments within reserving authority limits
  4. Develop and manage well documented action plan with case manager, attorney, supervisor & client to reduce overall cost of claim
  5. Coordinating early return to work efforts with case manager & employer
  6. Negotiates settlements when necessary
  7. Actively manage the litigation process
  8. Identifies potential subrogation claims
  9. Communicate claim status with customer and claimant
  10. Adhere to client guidelines & participate in claim reviews as needed
  11. Develops & maintains professional customer relationships

Education/Training Requirements:

  1. Degree at an accredited college or university preferred
  2. Three years handling claims WC Lost Time 
  3. Excellent oral, written communication skills & customer service
  4. PC literate, including Microsoft Office (Word, Excel)
  5. Effective analytical & interpretive skills
  6. Strong organizational skills
  7. Great interpersonal skills

Related Opportunities – Claims Supervisor (required NY License and strong Jurisdictional  exposure

Skills: claims, workers compensation, lost time, loss time, indemnity 
Recruiter Contact: [email protected]

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