Claims Examiner

1 week ago


New York, New York, United States Tandym Group Full time

A professional services organization, Tandym Group, is seeking a skilled Claims Examiner to join their team.

Responsibilities:

  • Review and determine the compensability of workers' compensation claims in the electrical industry.
  • File necessary forms in a timely manner.
  • Manage the medical aspects and investigations of claims.
  • Calculate payroll and compensation based on established guidelines.
  • Act as a liaison with relevant parties in the review process.
  • Assign cases for investigation and monitor progress.
  • Prepare claims for long-term disability.
  • Evaluate the degree of disability and loss value.
  • Maintain professional relationships with involved parties.
  • Make appropriate case referrals as needed.
  • Execute claims activities to ensure quality service.
  • Develop action plans for claims resolution.
  • Analyze and process workers' compensation claims.
  • Communicate with union representatives regarding claims management.
  • Perform additional duties as required.

Qualifications:

  • Bachelor's degree required.
  • Minimum 3 years experience as a workers' compensation examiner.
  • Knowledge of NYS Disability and Worker's Compensation laws.
  • Strong interpersonal, organizational, and communication skills.
  • Proficiency in Microsoft Word & Excel.
  • Ability to work independently and collaboratively.
  • Familiarity with claim reserve and sound judgment.
  • Strict confidentiality.

Work Environment:

  • Operates in a professional office setting.
  • Requires use of standard office equipment.
  • Physical demands involve lifting, bending, and standing.
  • Full-time position with flexibility for overtime.
  • No travel required.


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