Lost Time Claims Examiner

About the Role:Job Title: Claims Examiner-Lost TimeLocation: 555 Long Wharf Drive, New Haven, CT. 06511Duration: 3 monthsJob Schedule: 5 days on-siteJob Hours: 8:30am-5:00pm ESTInterview Process: 1 round of interview - VirtualDuties and Responsibilities:- Handles all aspects of workers’ compensation lost time claims from set-up to case closure ensuring strong customer relations are maintained throughout the process.- Reviews claim and policy information to provide background for investigation.- Conducts 3-part ongoing investigations, obtaining facts and taking statements as necessary, with insured, claimant and medical providers.- Evaluates the facts gathered through the investigation to determine compensability of the claim.- Informs insureds, claimants and attorneys of claim denials when applicable.- Prepares reports on investigation, settlements, denials of claims and evaluations of involved parties, etc.- Timely administration of statutory medical and indemnity benefits throughout the life of the claim.- Sets reserves within authority limits for medical, indemnity and expenses and recommends reserve changes to TeamLeader throughout the life of the claim.- Reviews the claim status at regular intervals and makes recommendations to Team Leader to discuss problems and remedial actions to resolve them.- Prepares and submits to Team Leader unusual or possible undesirable exposures when encountered.- Works with attorneys to manage hearings and litigation- Controls and directs vendors, nurse case managers, telephonic cases managers and rehabilitation managers on medical management and return to work initiatives.- Complies with customer service requests including Special Claims Handling procedures, file status notes and claim reviews.- Files workers’ compensation forms and electronic data with states to ensure compliance with statutory regulations.- Refers appropriate claims to subrogation and secures necessary information to ensure that recovery opportunities are maximized.- Works with in-house Technical Assistants, Special Investigators, NurseConsultants, Telephonic Case Managers as well as Team Supervisors to exceed customer's expectations for exceptional claims handling service.Technical Skills & Competencies:- Lost Time Claim Examiner position with prior experience in workers’ compensation as a medical only examiner, or commensurate examiner experience in paralegal, short-term / long-term disability, auto personal injury protection / medical injury, general liability or as a claim technical assistant for lost time claims.- Requires knowledge of workers’ compensation statutes, regulations and compliance.- Ability to incorporate data analytics and modeling into daily activities to expedite fair and equitable resolution of claims and claim issues.- Exceptional customer service and focus.- Ability to openly collaborate with leadership and peers to accomplish goals.- Demonstrates a commitment to a career in claims.- Exceptional time management and multi-tasking capabilities with consistent follow through to meet deadlines.- Use analytical skills to find mutually beneficial solutions to claim and customer issues.- Ability to prepare and make exceptional presentations to internal and external customers.- Conscientious about the quality and professionalism of work product and relationships with co-workers and clients.- Willing to take ownership and tackle obstacles to meet Client's quality standards for service, investigation, reserving, inventory management, teamwork, and diversity appreciation.- Superior verbal and written communication skills.