Claims Specialist

Foundation Risk Partners is seeking a highly skilled Claims Specialist to join our team at the Durnan Group in Rockville Centre, NY.

The Claims Specialist will work under the direct supervision of the Vice President of Risk Management, receiving and processing incoming workers compensation claims, assisting in the claims management process, and managing communication with regard to claims.

• Manage data extraction regarding potential claims from fax, email, or other communication sources.
• Examine and evaluate claims for denial, subrogation, and possible fraud and report to the Vice President of Risk Management.
• Enter claims in the system, review claims, update/correct information in the system.
• Assist in maintaining all medical documentation and records regarding workers' compensation cases.
• Make and maintain contacts with clients, adjusters, employees, and providers.
• Report claims to the carrier and Vice President of Risk Management.
• Manage correspondence, answer emails and phone calls, and note files.
• Participate in claims reviews with client representatives when needed.
• Ensure all claimants complete all necessary paperwork regarding claim cases.

• Strong computer literacy.
• Knowledge of insurance-related laws and medical and legal terminology.
• Excellent written and oral communication skills and ability to interact with personnel at various levels.
• Excellent organizational skills.
• Strong sense of accuracy and attention to detail.
• Ability to exercise tact and discretion in handling confidential material.
• Ability to manage multiple projects, tasks, and priorities to achieve desired goals.
• Ability to work effectively with employees at all levels within the organization.

• 2 years of insurance industry experience.
• Associates degree or equivalent years of experience.

The salary range for this position is $65,000-$70,000 USD.

Foundation Risk Partners offers a comprehensive range of health-related benefit options, including medical, vision, and dental. We also offer a 401(k) with company match, company-paid life insurance, STD, LTD, and a generous PTO policy starting at 18 days per year plus 10 paid holidays and 2 floating holidays.

Foundation Risk Partners is an equal employment opportunity employer and welcomes applications from diverse candidates.