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Worker's Compensation Claims Examiner
2 months ago
Location: Spring Valley, NY
Required Qualifications:
- Bachelor's degree.
- Professional designation such as CPCU, ARM, CRM, or similar.
- Proficient in Microsoft Office and adaptable to learn other software applications.
- Excellent oral and written communication skills.
- Detail-oriented with a high accuracy rate.
- Strong critical thinking and organizational skills.
- Ability to problem-solve and use good judgment.
- Self-motivated with excellent time management skills.
- 5+ years adjusting workers' compensation claims in multiple jurisdictions.
- Experience in NY, NJ, and PA preferred, with NY experience required.
- Healthcare industry experience.
- Construction industry experience.
- 5-7 years experience as a Workers Comp loss time claim adjuster.
- Investigate and manage workers' compensation claims in multiple jurisdictions.
- Coordinate with nurse case managers, counsel, external vendors, and insureds for efficient claims handling.
- Complete and document initial loss investigations to determine compensability.
- Establish initial and subsequent reserves for anticipated exposure.
- Review medical bills for a causal relationship to reported claims.
- Liaison with insureds, nurse case managers, and counsel to oversee claim management and facilitate return to work.
- Develop and maintain action plans to ensure reserve adequacy and timely resolution of claims.
- Negotiate settlement of claims within designated authority.
- Prepare and present claim review summaries for insureds, brokers, and internal contacts as requested.
- Participate in discussions with insureds and counsel on strategies for successful claim closure.
- Provide guidance and assistance to insureds and brokers on timely reporting of claims.
- Manage insured onboarding, including training on claims reporting and use of the insured portal.
- Great work-life balance
- Market leader in commercial insurance and risk management
- Offer a wide range of career paths and opportunities for growth
- Competitive Compensation and Benefits: health insurance, retirement plans, and other benefits
