Claims Examiner

2 days ago


New Haven, Connecticut, United States ICONMA Full time
Job Title: Claims Examiner - Lost Time Specialist

At ICONMA, we are seeking a skilled Claims Examiner - Lost Time Specialist to join our team. As a Claims Examiner - Lost Time Specialist, you will be responsible for handling all aspects of workers' compensation lost time claims from set-up to case closure, ensuring strong customer relations are maintained throughout the process.

Key Responsibilities:
  • Investigation and Analysis: Conduct thorough investigations of lost time claims, gathering facts and taking statements as necessary, to determine compensability.
  • Claim Management: Evaluate the facts gathered to determine the validity of claims, and inform insureds, claimants, and attorneys of claim denials when applicable.
  • Reporting and Communication: Prepare reports on investigation, settlements, denials of claims, and evaluations of involved parties, and communicate with stakeholders to ensure timely administration of statutory medical and indemnity benefits.
  • Collaboration and Teamwork: Work with attorneys to manage hearings and litigation, and collaborate with vendors, nurse case managers, telephonic case managers, and rehabilitation managers on medical management and return to work initiatives.
  • Compliance and Regulatory: Comply with customer service requests, including Special Claims Handling procedures, file status notes, and claim reviews, and ensure compliance with statutory regulations by filing workers' compensation forms and electronic data with states.

We are looking for a highly skilled and detail-oriented Claims Examiner - Lost Time Specialist to join our team. If you have a strong background in workers' compensation and excellent communication skills, we encourage you to apply.


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