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Claims Associate, Workers Compensation Examiner

4 months ago

Fresh Meadows, United States Tandym Group Full time

A leading professional services organization located in Flushing/Queens is seeking a new Claims Associate, Workers Compensation Examiner.

Responsibilities:

The Workers Compensation Examiner will:

  • Review of electrical industry workers compensation claims and determine compensability.
  • File all required workers compensation forms timely.
  • Oversee medical management and investigations of claims.
  • Calculate payroll and compensation payment based on set guidelines.
  • Serve as liaison and interface with Magna Comp nurse and claimant as part of the review process.
  • Assign cases for investigations and review progress.
  • Prepare workers compensation claim for long-term disability.
  • Ability to evaluate the degree of disability and scheduled loss value.
  • Maintains professional relationship with all appropriate parties involved with the claim.
  • Refers cases as appropriate to management.
  • Actively executes appropriate claims activities to ensure consistent delivery of quality claims service.
  • Develops and manages claims through well-developed action plans; continues to work on the action plan to bring the claim to an appropriate and timely resolution.
  • Analyzes and processes workers' compensation claims by investigating and gathering information to determine the exposure on the claim.
  • Communicate with Local 3 Business representative regarding claims management.
  • Perform other duties and special assignments as necessary.
Qualifications:
  • A four-year college degree required.
  • A minimum of 3 years of experience as workers' compensation examiner required.
  • Extensive knowledge of NYS Disability and Worker's Compensation laws.
  • Excellent interpersonal, organizational, and communication skills.
  • Working knowledge of Microsoft Word & Excel.
  • Must be able to work independently and collectively.
  • Familiarity with claim reserve.
  • Must possess the ability to make sound judgment.
  • Strict confidentiality.
Work Environment:
  • This job operates in a professional officecustomer service environment. This role routinely uses standard office equipment such as desktop computers, phone, scanner, printer, keyboard, photocopiers, shredder, and fax.
  • Physical Demands
  • Sedentary work environment with physical demands described are representative of those that must be met by an employee to successfully perform the functions of this job. This would require the ability to lift files, pull files/forms/books, stand, bending, shred documents, open/close filing cabinets as necessary.
  • Position Type/Expected Hours of Work
  • This is a full-time onsite 35 hours per week. Days and hours of work are Monday through Friday 8:30AM-4:30PM.
  • Flexibility: Must be able to work overtime when necessary.
  • TravelNo travel is expected for this position.